'Kissing bug' poses risk to people from Central, South America, doctor says

A Winnipeg doctor is warning about the risk of a disease commonly found in Central and South American countries after several members of a family in Winnipeg were diagnosed with it.

Chagas disease is caused by a parasite and spread through the feces of an insect called triatominae — sometimes called "the kissing bug."

"It's known as 'the kissing bug' because it bites you usually in the middle of the night. You don't feel it and it bites around the face area and people don't often realize that they've been bitten by this bug," said Dr. Pierre Plourde.

He's the medical officer of health and medical director of travel health and tropical medicine services for the Winnipeg Regional Health Authority.

"When the bug bites you, it has a massive bowel movement at the same time that it's feeding," he said.

"And so if you then get an itchy bite and there's a small wound where the insect fed, and you scratch yourself and wipe all that feces unknowingly into the wound."

While most people with the disease will not experience any symptoms, the long-term effects in some people can lead to serious heart complications and even death later in life.

Without treatment, the parasite can travel to the heart muscle and cause damage.

"When it infects the heart, after 10, 20, 30 years, it's too late for treatment to have any effect at that point. You can develop heart conduction abnormalities, rhythm problems in the heart, irreversible, and it can lead to the person dying from heart failure," Plourde said.

Plourde estimates the disease affects about one in four people who contract the parasite at some point in their life.

Plourde co-authored a report published in the Canadian Medical Association Journal on a case of a Winnipeg family in which the disease spread from a mother to her three children.

The children, who are all adults now, were all born in Canada, but the mother had grown up in two countries, Bolivia and Paraguay, where the disease is most prevalent.

"It was a bit of a surprise, because at the end of the day, I realized that they were likely infected by their mother, having never really travelled," Plourde said.

Other countries where the disease commonly occurs include Argentina, El Salvador, Guatemala, Honduras and Panama.

Blood donations screened

Outside of Latin America, the disease is most commonly spread through blood transfusions. Since 2010, however, Canadian Blood Services has screened all blood donations for Chagas.

But now, the risk of transmission from mother to unborn child raises a new risk for Canadians, particularly in southern Manitoba, where there are many people who have lived in South America, Plourde said.

The disease doesn't pose a great risk to people travelling for short periods of time.

"It's unheard of, basically, to see this infection in the short-term, casual traveller."

Early detection is key, Plourde said, and young people who are treated early have a nearly 100 per cent cure rate.

The first test is a simple blood antibody test, which any physician can order.

The treatment can be hard to take, however, because the drugs have some serious side-effects, he said.

"It's not easily available in Canada. You need to be treated by an infectious disease or tropical medicine specialist, but they are available through special access program at Health Canada," Plourde said.

To protect yourself while travelling, Plourde recommends you sleep under a mosquito net.