American Trypanosomiasis

American Trypanosomiasis is an illness caused by the protozoa Trypanosoma Cruzi and spread to humans by the kissing bug.

 Symptoms in humans can start with an area of redness and swelling at the area of bug bite with some swelling of lymph glands and associated fever. After apparent recovery, years or decades later one develops manifestations of chronic infection with involvement of the heart and gastrointestinal system.

Where does it occur?

American Trypanosomiasis is found in Mexico, Central and South America. There have been a handful of cases in Southern and Western United States in stated bordering Mexico.

How is it transmitted?

It is transmitted by the kissing bug or cone nosed bug which preferentially bite on the face, thus the term kissing bug. The kissing bugs defecate as they feed (not nice!). The trypanosoma are excreted in the kissing bug’s feces; which then penetrate through skin breaks, mucous membranes and conjunctiva of the eye.

It can also be transmitted through blood transfusions, organ transplantation, lab accidents and across the placenta from mother to fetus.

Is it contagious from person to person?

It is not directly contagious from person to person.

What is the risk for travelers?

Risk for travelers is usually low, long term visitors (game wardens/peace corps volunteers/missionaries etc.) with prolonged exposure to rural and forested areas are at higher risk. Staying in primitive dwellings (mud wall, mud floor, thatch) and accommodations also increases the risk of contracting the illness.

How soon after exposure will one develop symptoms?

Symptoms usually develop anywhere 1 to 2 weeks after the bite of the kissing bug.

What are the signs and symptoms?

Symptoms usually start with an area of swelling and redness at the area of the bug bite along with enlarged lymph nodes. A painless swelling of the eyelids and surrounding tissue; called Romana’s sign is seen when the trypanosoma gain entry through the eye. There maybe associated fever, lack of energy, loss of appetite and swelling of affected areas. All these symptoms resolve of a period of weeks to months.

However, the trypanosoma multiply in tissues and spread through the blood to other organs at this time.

Years or decades later one begins to see symptoms of chronic infection, with heart being the organ most commonly involved. Symptoms are of irregular heart beat with episodes of passing out, dizziness or seizures; heart failure with symptoms of shortness of breath, swelling of the legs and fatigue. Involvement of the gastrointestinal system results in massively swollen esophagus with difficulty swallowing, painful swallowing, choking with eating; massively dilated colon with constipation, abdominal pain, obstruction, perforation etc.

Is there any treatment?

Medications called Benznidazole and Nifurtimox are effective in acute treatment.

What preventive measures can be taken?

Take insect safety precautions and avoid staying in primitive dwellings and accommodations.

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