‘Kissing bug’ a risk for Manitobans from Central, South America

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This article was published 13/12/2017 (2843 days ago), so information in it may no longer be current.

The last thing Manitobans want to find under the mistletoe this holiday season is the “kissing bug.”

Medical experts are encouraging Manitobans who are from specific south and central American countries to get tested for Chagas disease following a case study on a Winnipeg family diagnosed with the disease. An account of the family was published in the Canadian Medical Association Journal earlier this month.

A bite from the bug that carries the parasite and is found in Argentina, Bolivia, El Salvador, Guatemala, Honduras, Panama and Paraguay, can cause swelling, nausea, fevers and coughing, or no symptoms at all, said Dr. Pierre Plourde, a medical officer at the Winnipeg Regional Health Authority.

“It likes to feed around moist areas, around your face, close to the eye where there’s tears and the mouth area, so it likes to feed around the head and the face in the middle of the night,” he said.

“It’s sort of like you’ve been kissed by the bug.”

Anyone who’s bitten by the bug, or whose mother was bitten prior or during pregnancy, is at risk of heart failure years after the triatominae’s “kiss”— even if they now live in Canada.

Plourde estimates up to 10,000 Canadians have the disease, thousands having contracted it from a bite while around 150 have likely contracted the disease genetically.

“Most of them probably have no idea because the infection, initially, doesn’t cause much of a disease,” Plourde said. “You don’t realize you have it until 10, 20, 30 years down the road, the parasite gets a hold of your heart.”

In a press release published Wednesday, Plourde said the disease affects around one in four people who have contracted it at some point in their lifetime.

The kissing bug transfers a parasite to humans by excreting when they bite. The tropical medical expert said that when the bite’s scratched, the parasite enters the bloodstream and makes its way to the heart muscle.

Plourde was one of the case study authors—alongside Kamran Kadkhoda, a clinical microbiologist from Winnipeg’s Cadham Provincial Laboratory, and Dr. Momar Ndao, head of the National Reference Centre for Parasitology in Montreal—who describes an immigrant mother who grew up in Paraguay and Bolivia passed along Chagas disease to three of her children born in Canada. None of the children experienced symptoms.

One son found out he tested positive when he was rejected upon trying to donate blood in 2010—the year Canadian Blood Services started testing for Chagas antibodies.

“We’re seeing more and more and more people being rejected from blood donation because they’re Chagas positive,” said Plourde. “And in my practice, every single one of those people either comes from South or Central America, they either immigrated to Canada from there or they’re born—that was the case of this family with three adults.”

He said the mother must’ve been very highly infected with the parasite during pregnancy because it’s not typical for all children to be infected.

The chance of a mother transmitting the disease to a baby is only about five per cent on average but can be as high as 30 per cent, he added.

Plourde said the WRHA is specifically encouraging physicians to test patients in southern Manitoba because there’s a number of immigrants from South American countries who grew up there or worked as missionaries.

The first test is a simple Chagas antibody test. If a patient is positive, Plourde said, they are referred to a specialist for further care, which can include various treatments.

“The treatment is a little complicated and it’s hard to access in Canada due to the rarity of it,” he said.

He said physicians have to make a special request to Health Canada to get the drug.

“Depending on which drug, it’s 60 to 90 days, so yeah, it’s pretty arduous—two or three months of a drug that causes lots of side effects,” he said.

Plourde said the longer the infection is left untreated; the more damage it can cause. He added cure rates are higher in children because the treatments work better at a younger age.

“The management of Chagas disease requires lifelong evaluation,” according to the case study.

Patients who test positive are required to get a heart check-up once a year.

There’s no vaccine or prevention pills at present, so Plourde said sleeping under a bed net in listed countries is the best way to prevent the disease.

maggie.macintosh@freepress.mb.ca