The New AIDS: Blood-Sucking ‘Kissing Bug’ Sees 300,000 Americans Infected With Deadly Disease

Reuters / Tomas Bravo TB / JJ

The United States is being infected by Chagas, a deadly disease spread by the faeces of a parasite nicknamed the 'kissing bug'. It bites sleeping victims, ingests the blood and defecates on them; patients then unknowingly rub the feces into open membranes.

RT.com reports Chagas disease is seen as a “silent killer” by those who study and treat it, as it can often lurk in people’s bloodstreams for up to two decades before causing their organs to fail. The initial stage of the tropical illness ‒ the acute phase ‒ is mostly symptom-free and lasts for the first few weeks or months, according to the US Centers for Disease Control and Prevention. If a patient does exhibit symptoms, they can easily be mistaken for another disease.

The symptoms noted by the patient can include fever, fatigue, body aches, headache, rash, loss of appetite, diarrhoea, and vomiting. The signs on physical examination can include mild enlargement of the liver or spleen, swollen glands, and local swelling (a chagoma) where the parasite entered the body, the CDC explained.

"People don't normally feel sick," Melissa Nolan Garcia, a research associate at Baylor College of Medicine in Houston and the lead author of two of three recently published studies, explained in a statement, "so they don't seek medical care, but it ultimately ends up causing heart disease in about 30 percent of those who are infected."

It is the second ‒ or chronic‒ phase that is deadly. Patients can develop cardiac complications, including an enlarged heart (cardiomyopathy), heart failure, altered heart rate or rhythm, and cardiac arrest (sudden death), as well as intestinal complications, such as an enlarged esophagus (megaesophagus) or colon (megacolon) and can lead to difficulties with eating or with passing stool.

In July, the Centers for Disease Control estimated that 300,000 people in the US had been infected, and but now it could be closer to 400,000. Medical research suggests that 40,000 pregnant North American women may be infected with the disease at any given time, resulting in 2,000 congenital cases through mother-to-child transmission, according to Fox News Latino. Garcia believes that the numbers may actually be higher than that, the Examiner reported.

The Baylor team presented the results of its work on Tuesday at the 63rd Annual Meeting of the American Society of Tropical Medicine and Hygiene (ASTMH) in New Orleans. In one of their pilot studies, her team looked at 17 blood donors in Texas who tested positive for the parasite that causes Chagas disease.

“The concerning thing is that majority of the patients [I spoke to] are going to physicians, and the physicians are telling them, ‘No you don’t have the disease’,” Garcia said, according to Al Jazeera America.

Chagas disease (American trypanosomiasis) is caused by Trypanosoma cruzi, a protozoan parasite related to an African version that causes sleeping sickness. It is endemic to Mexico, Central America, and South America, where an estimated 8 million people have the illness, most of whom do not know they are infected. If untreated, infection is lifelong and can be life threatening, the CDC noted.

Garcia spoke to several groups of physicians and cardiologists as part of an educational campaign to increase physician awareness.

“A lot of the cardiologists were aware of Chagas disease, but they don’t make the connection when the patient is sitting in front of them,” she said.

Dr. Julie-Ann Crewalk, a pediatrician in Northern Virginia who has dealt with Chagas, also thinks that the disease is being underdiagnosed.

“It’s not something that we think of asking right away,” she told the Atlantic. “I wouldn’t be surprised if the numbers were higher and we’re just not seeing it.”

The CDC says that most of the Chagas cases in the US are from people who have traveled to Latin America, and were infected there. But Garcia told HealthDay News her research showed that the parasite has arrived in the US, and the government agency has admitted that triatomine bugs can be found across the lower half of the country.

"We are finding new evidence that locally acquired human transmission is occurring in Texas," she said. "We were surprised to find that 36 percent had evidence of being a locally acquired case.”

“Additionally, 41 percent of this presumably healthy blood donor population had heart abnormalities consistent with Chagas cardiac disease," Garcia noted. The illness can also be spread through blood and organ donation, as well as from mother to infant during childbirth.

The disease is also growing just outside Washington, DC. While the number of people with Chagas disease in Northern Virginia is small ‒ about two dozen cases, according to interviews by the Atlantic with local physicians ‒ doctors and experts there say they wouldn’t be surprised if the numbers were higher because, along with the lack of routine screening for it, many patients tend to be undocumented immigrants without health insurance.

Dr. Rachel Marcus, a cardiologist, believes Northern Virginia could be “ground zero” for Chagas disease, because of the volume of immigrants from Bolivia, where the disease is endemic. She told the Atlantic that it’s easy to diagnose the disease with an electrocardiogram (EKG), but that American doctors don’t know what they are looking for. “If you were to find that EKG from an area where Chagas is common, it’s diagnostic,” she said.

Garcia also agreed with the need to focus on EKGs as a diagnostic tool for the disease. "Physicians should consider Chagas when patients have swelling and enlargement of the heart not caused by high blood pressure, diabetes or other causes, even if they do not have a history of travel," she said.

The life cycle of Chagas disease, a zoonotic disease that can be transmitted to humans by blood-sucking triatomine bugs that contain the protozoan parasite, Trypanosoma cruzi, in their feces (US Centers for Disease Control and Prevention)

But even if the deadly disease is diagnosed, there are no viable government-authorized treatments. The Food and Drug Administration has not yet approved two medicines ‒ nifurtimox and benznidazole ‒ that are currently used to treat the disease but carry a risk of nerve damage, nausea and weight loss, according to the ASTMH statement.
The CDC makes the drugs available "when no satisfactory alternative treatment exists," according to the FDA, adding that "subjects are generally willing to accept greater risks from test articles that may treat life-threatening and debilitating illnesses."

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WHAT NIGERIA CAN LEARN FROM NORWAY — How Norway Has Avoided The 'Curse Of Oil'

Bergen is not a place to go looking for supercars racing around

Hugged by mountains and perched on a stunning coastline of fjords, Bergen, Norway's second-largest city, has picture-postcard views.

As the centre of Norway's booming oil and gas industries, it is also a very wealthy place.

Yet there are few displays of ostentatious spending - there are no supercars with tinted windows, no designer handbag shops, and no queues of people outside exclusive nightclubs.

For while other countries have struck oil and then binged on the revenues, by contrast Norway is continuing to invest its oil and gas money in a giant sovereign wealth fund.

The fund, worth about $800bn (£483bn), owns 1% of the entire world's stocks, and is big enough to make every citizen a millionaire in the country's currency, the kroner. In effect, it is a giant savings account.

And most Norwegians are seemingly very content with this - according to a 2012 study by New York's Columbia University Norway is one of the world's happiest countries.

"We had to invest a lot of money before we could spend anything," says Prof Alexander Cappelen, from the Norway School of Economics, explaining why the country has apparently avoided the pitfalls of vast wealth.

"In other countries the oil is much easier to extract, so they got the money straight away.

"We were put in the right mindset by knowing it was a long-term plan."

Trusting the government

So, no spending bonanza for Norway. In fact there is a closely followed guideline that only 4% of the surplus from the fund is spent or invested in public projects.

"Actually we are spending less than 4% currently - we are saving," says Prof Cappelen.

Norway's economy has been transformed by its oil boom

There are several reasons, he says, why Norway is happy to save its wealth and shrug off the temptations of a luxury life.

"For this kind of system to work, you need to have an enormous level of trust," says Prof Cappelen. "Trust that the money isn't going to be mismanaged - that it's not going to be spent in a way you don't like.

"As a result of social democracy and egalitarian policies it is a homogenous society and has built up an enormous level of trust. 

Norway is in a fortunate position, says Finance Minister Siv Jensen

"We trust the government. We believe our tax money will be spent wisely. once you start trusting that others are contributing their share then you are happy to contribute yours."

So is Norway rich because of Norwegians high level of trust, or are its citizens trusting because they are rich?

"I think it is both," says Prof Cappelen. "High levels of trust make economic growth easier."

Norway is already planning for when its oil and gas reserves run out

But this oil boom is tailing off. So what's next?

"Norway's economy is in a very fortunate situation. We are talking about a gradual shift over the next few years," says Norway's Finance Minister, Siv Jensen.

"We have had a slower growth in productivity over the past few years, and for this government we have to look at a competitive tax level and reducing red tape to attract investment.

"But it is true we have a higher cost level than any comparable country."

'We respect hard work'

Those costs can be quite shocking for a visitor. In cafe overlooking Bergen's fish market, while sipping a cappuccino costing almost US$10, Tone Hartvedt from Business Region Bergen explains that costs are simply comparable to wages.

It isn't cheap for Norway to get at all its offshore oil and gas deposits

"It may sound surprising, but for us it is not too expensive," says Ms Hartvedt. "We tend to have summer and winter holiday houses or cabins, and we can afford life here. It is comfortable."

This is surprising to the uninitiated visitor - after a trip to the local supermarket revealed that the cheapest pasta, bread, cheese and chopped tomatoes would come to around $50.

But, says Ms Hartvedt: "We pay our workers a wage that means they have a good quality of life. That is not so much the case in places like London.

"Here we respect hard work, but we don't believe that the highest paid worker in a company should earn vastly more than the lowest paid.

"This does mean that some very talented people leave for other countries where they will be paid more."

So, do people in Norway regard themselves as rich? "No, we don't think of things like that, it's for the future," she says.

Economic challenges

On an island half an hour from Bergen, is Coast Center Base (CCB), a huge support centre for the oil and gas industry. There's a rig, fire engine red and vast, sitting in the harbour being checked over.

"I remember the days when there were plenty of farmers and fish farmers in Norway. Life has changed for the average Norwegian," says CCB's chief executive, Kurt Andreassen.

"This base was started up in 1974, and there has been a tremendous change in those decades. The welfare is now very high. It is quite different to 40 years ago, many people are educated - things have changed."

Norway's shoppers are not often able to take advantage of a good bargain

As for when the oil does eventually run out, "Norway will survive, but it will be a challenge for all of us," he says.

"Our challenge will be to utilise our expertise and use it in other areas."

It's a point of view echoed by Dag Rune Olsen, rector of Bergen University: "I worry we do not invest to a sufficient extent in other ways to generate income in the next decades.

"We are very well aware that the oil and gas resources are limited, and at least for Norwegian oil it will cost us more year by year to extract the oil," he says.

"It is evident we need to find other sources of income, and now we have the ability to invest - it is crucial that we do."

'We will get jobs'

Perhaps this awareness that it won't last forever goes some way to explain the second-hand Volvos circling Bergen's winding streets, rather than the Porsches or Bentleys of wealthy parts of London.

Prudence and pragmatism rather than posing seems to be the attitude.

While there is an inkling of concern for what will become of Bergen, and Norway, when the oil runs out - most Norwegians remain confident about their prospects.

"We are in Norway, we are not worried about these things," reply students at the Norway School of Economics, slightly uncomfortably, when asked if they are concerned about jobs.

"We will work hard and we will get jobs."

By Sarah Treanor

Business reporter, BBC News, Bergen

 Culled From BBC.com