Cases of ‘neglected’ tropical disease spread by blood-sucking ‘kissing bugs’ rise across parts of Europe

CASES of a tropical disease spread by blood-sucking “kissing bugs” are rising in some parts of Europe.

An estimated 6,469,283 Chagas disease (CD) infections were reported across 51 countries in 2019.

AlamyChagas disease is spread by blood-sucking ‘kissing bugs’[/caption]

While this is an overall decrease worldwide in the last 30 years, numbers are “increasing substantially” in new countries.

The illness is endemic to Latin America, primarily occurring in Bolivia, Venezuela, Argentina and Brazil.

But experts warn it is becoming more and more common in some European countries and North America.

Between 1990 and 2019, cases in Spain rose by 25,081, while in Italy they increased by 5,542, according to a study published in Global Heart Journal.

There were also rises in Iceland, Ireland, Portugal, and the UK.

The USA remained the non-endemic country with the highest estimated cases (63,553), with California the state with the highest prevalence (13,600).

CD, also known as American trypanosomiasis, now poses a “global health threat”, the authors said.

“Although the majority of cases remain concentrated in Latin America, the increase observed in countries in North America and Europe highlights the importance of screening at-risk populations and raising awareness of this neglected tropical disease,” they wrote.

The World Health Organization (WHO) estimates six to seven million people are infected with CD every year, with another 70million at risk.

Around 12,000 die annually, according to the World Heart Federation.

CD commonly spreads through bites from infected blood-sucking triatomine bugs, sometimes called kissing or vampire bugs.

But it is also transmitted via consumption of contaminated food and drink, blood transfusions, organ donations, and from mother to baby during pregnancy.

In the short-term phase (acute), which lasts about two months, symptoms include skin lesions, purplish swelling of the eyelid, a fever, headaches, muscle pain, difficulty breathing, fatigue, loss of appetite, and chest pain.

This can progress to an irregular heartbeat, heart problems, difficulty swallowing, constipation, and stomach pain if it becomes chronic (long-term).

But up to 80 per cent of people don’t show any symptoms at all, meaning it’s often dubbed a “silent disease”.

Many experience complications decades after being infected as CD can cause irreversible damage to the heart and other vital organs.

Evidence suggests the condition increases someone’s chances of developing heart failure, cardiac arrest, an irregular or very rapid heartbeat, and blood clots or blockages.

There were 7,292,889 cases in 1990. In 2019, there were an estimated 6,469,283.

Global deaths per 100,000 population now sit at around 0.12 – an 11 decrease from 0.31 some 33 years ago, data shows.

Cases “increased significantly” in Europe and North America between 1990 and 2010, then dropped off slightly after this point.

The authors said: “There has been a sustained decrease in CD burden worldwide from 1990 to 2019.

“Nevertheless, this trend has not been the same for every affected region, with a more abrupt reduction in Latin America, while data from North America and Europe reveal a more stable trend, with increasing prevalences until 2010.”

Now, the rises are concentrated in a group of countries including Iceland, Ireland, Italy, Portugal, Spain, the UK and the USA.

Outside of Europe and America, cases still appear to be rising in Andorra, Antigua and Barbuda, the Bahamas, Bermuda, Dominica, Japan, Puerto Rico, Saint Lucia, and Saint Vincent and the Grenadines.

CD is rarely reported in the UK; the government blames “a lack of testing and awareness”.

Almost all cases identified so far in Britain have been migrants from Latin America.

But less than five per cent of those infected have been detected, a study published in Travel Medicine and Infectious Disease estimates.

Author Marta González Sanz said: “Due to the changing patterns of migration from Latin America, either directly or indirectly via Spain, CD is an increasing and under-recognised public health problem in the UK, largely due to the fact that it is commonly asymptomatic.

“All countries in Europe should have in place policies to ensure screening for CD in blood and transplant donation; and for antenatal and congenital cases.

“Implementation of these policies should be monitored and regularly evaluated.”

Dr Ibrahima Socé Fall, director of WHO’S Global Neglected Tropical Disease Programme, said last year: “Chagas disease remains a blight on the lives of too many people, across Latin America and throughout the world.

“I join with my colleagues on the ground in calling for reinforced primary health care to better detect and diagnose cases and to ensure that more and more people are able to benefit from the treatments available to combat this debilitating disease.”

Despite CD spreading through food and drink, the WHO does not include it in its list of foodborne diseases.

It was omitted in 2015 due to a lack of resources, but scientists say it needs to be re-added.

Death rates from vector-borne CD is estimated to be between five and 10 per cent, while foodborne infection is said to be between eight to 40 per cent, Food Safety News reports.

The global health burden (calculated using reduction in life expectancy and diminished years of healthy life) is also higher for CD than other pathogens like Clostridium botulinum, Shiga toxin-producing E.coli, and Listeria monocytogenes.