THE KISSING BUG DISEASE

But to start, the first phase of President Donald Trump's peace deal between Israel and Hamas has been agreed to, and ALL hostages will be released by the Hamas early next week.  In this photo, nothing related to the story of the day, but just Secretary of State Marco Rubio whispering to Trump about the breakthrough news.  

On Day One two years ago, 250 Israelis were kidnapped by Hamas fighters.  So far 148 hostages and 57 deceased remains have been returned.  There are around 20 hostages left, plus 28 dead bodies left.  In return, 250 Palestinian prisoners serving life sentences and 1700 Gazans will be released.  67,000 Palestinians have been killed in this war.  Donald Trump will go to Israel on Sunday.  Will he now get the Nobel Peace Prize?  Well, not tomorrow, but in the future?

Have you heard of the kissing bug disease, known medically as the Chagas disease?

• It is endemic in the Americas.  Read this report.  The abstract.

Chagas disease, caused by Trypanosoma cruzi parasites, is considered endemic to 21 countries in the Americas, excluding the United States. However, increasing evidence of T. cruzi parasites in the United States in triatomine insects, domestic animals, wildlife, and humans challenges that nonendemic label. Several triatomine species are common in the southern United States, where they transmit T. cruzi and invade human dwellings. Wildlife, captive animals, and companion animals, especially dogs, are commonly infected with T. cruzi parasites in this region and serve as reservoirs. Autochthonous human cases have been reported in 8 states, most notably in Texas. Labeling the United States as non–Chagas disease–endemic perpetuates low awareness and underreporting. Classification of Chagas disease as endemic, in particular as hypoendemic, to the United States could improve surveillance, research, and public health responses. Acknowledging the endemicity of Chagas disease in the United States is crucial for achieving global health goals.

• 
  The conclusion of this report.

T. cruzi and the ecologic conditions that sustain its transmission cycles are naturally occurring throughout the southern half of the United States. Infection has been consistently demonstrated in wildlife reservoirs, companion animals, zoo and exotic mammals, and humans. At least 4 triatomine species are frequently encountered in homes and found to be harboring T. cruzi parasites. Canine Chagas disease is a concern in many working and companion dog populations in the southern United States but is likely underrecognized in many areas. The exposure of nonhuman primates to T. cruzi–infected triatomines poses a challenge to medical research. Moreover, the lack of reporting requirements for human Chagas disease adds complexity to the documentation of autochthonous cases. The number of documented autochthonous cases is higher in Texas than in other states, and cases are consistently documented each year.

So are only animals like pets infected?  Nope, we are all susceptible.  Details from UCLA Health.  Involved were Judith Currier (right), Joanna Schaenman and Shangxin Yang.

• Can cause heart failure and cardiac arrest.
• Why is it called the Kissing Bug Disease?  Not sure if you want these details, but....

• 
  The triatomine bug is nocturnal and feeds on people and animals while they sleep.
• The bug then defecates near the site of the bite.
• These feces contain the flagellated protozoan parasite Trypanosoma cruzi (also called the conenose bug, barber bug or vinchuca in Spanish), which cause the Chagas disease, also known as American trypanosomiasis.
• Infection occurs when the person inadvertently scratches the resultant itch and rubs the parasite-filled feces into the wound, or eye or mouth.
• The disease may also spread through blood transfusion, organ transplantation, consuming food or drink contaminated with the parasite and from mother to baby.
• Early symptoms are mild, and may include fever, swollen lymph nodes, headaches or swelling at the site of the bite.
• However, 4-8 weeks later, untreated individuals enter the chronic phase.
• Up to 45% of those infected develop heart disease in 10-30 years.
• That's not all.  There can also be digestive complications.  21% suffer from enlarges esophagus or colon and 10% may experience nerve damage.
• 
  Discovered by Brazilian physician Carlos Chagas in 1909.
• Early diagnosis is by finding the parasite in the blood using a microscope or detecting its DNA by polymerase chain reaction.
• Best defense is to eliminate these bugs with insecticides or bed nets.
• The big question is why would you go to a doctor to be checked if you have Chagas Disease.

• 
  Early infections are treatable with benznidazole or nitfurtimox, which gets rid of the disease,
• The longer you wait, the less effective the treatment.
• A human vaccine has not yet been developed.
• Mostly in Mexico, Central America and South America, it is estimated that 6.5 million have this disease, resulting in 9,490 deaths/year.
• According to Google AI, over 150 species of wild and domestic mammals are infected.  

• 
  But this disease has spread to the U.S. and Europe.
• However, from 2000 to 2018, there have only been 29 confirmed cases in eight U.S. states.  Yet, Google AI says there has been a more recent upsurge, and that as many as 10,000 new cases/year might well be the true severity.  It's just that this ailment is rarely reported.  An indicator might be animals.

Cats and dogs are among infected animals, and in parts of Texas, up to 50% of dogs have this disease.

• 
  Been to Mexico, Central America and South America in the past?  Not to scare you, but here is a quote from Wikipedia.

Signs and symptoms differ for people infected with T. cruzi through less common routes. People infected through ingestion of parasites tend to develop severe disease within three weeks of consumption, with symptoms including fever, vomiting, shortness of breath, cough, and pain in the chest, abdomen, and muscles.^[2] Those infected congenitally typically have few to no symptoms, but can have mild non-specific symptoms, or severe symptoms such as jaundice, respiratory distress, and heart problems.^[2] People infected through organ transplant or blood transfusion tend to have symptoms similar to those of vector-borne disease, but the symptoms may not manifest for anywhere from a week to five months.^[2] Chronically infected individuals who become immunosuppressed due to HIV infection can have particularly severe and distinct disease, most commonly characterized by inflammation in the brain and surrounding tissue or brain abscesses.^[4] Symptoms vary widely based on the size and location of brain abscesses, but typically include fever, headaches, seizures, loss of sensation, or other neurological issues that indicate particular sites of nervous system damage.^[20]Occasionally, these individuals also experience acute heart inflammation, skin lesions, and disease of the stomach, intestine, or peritoneum.^[4]

Something tells me that I should have bypassed this bit of medical news.  But Time magazine has reported that 280,000 people in the U.S. have been infected with American trypanosomiasis.  Further, patients are now in 32 states.  Time argues that this disease has not yet been identified as endemic to the USA, and there is thus under-reporting with resultant low awareness.  So maybe I'm providing a necessary service.  But I don't think you should take this precaution where the disease is a real problem.

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