Episode Overview
Podcast: Chasing Life
Host: Dr. Sanjay Gupta
Episode: Kissing Bug Disease Is Spreading; How To Stay Safe
Date: September 23, 2025
This episode dives into the growing concerns over Chagas disease—better known as "kissing bug disease"—as it spreads into new regions, including much of the United States. Dr. Sanjay Gupta addresses listener questions, explains what Chagas disease is, how it's transmitted, the signs and symptoms to watch for, available treatments, and how it affects both humans and pets. The conversation is conversational, engaging, and highly informative, with a particular focus on practical advice for prevention and protection.
Key Discussion Points and Insights
1. What is Kissing Bug (Chagas) Disease?
- Definition & Cause:
- Chagas disease is caused by the parasite called Trypanosoma cruzi ("T. cruzi") and spread through triatomine bugs, commonly called kissing bugs.
- These bugs typically bite people on the face at night, hence the nickname (“kissing bug disease”).
- Transmission:
- Parasite enters the body through bite wounds or if rubbed into the eyes/mouth.
- Not spread person-to-person except via infected blood (e.g., transfusions).
- Blood donors are screened for exposure.
- Prevalence:
- Globally: ~8 million infected, 10,000 deaths yearly.
- US: ~280,000 infections, but only 1% officially diagnosed ("because a lot of people may have mild symptoms or really no symptoms at all." - Dr. Sanjay Gupta, 05:18).
Memorable Quote
"It's called the kissing bug disease because it typically bites people on their face. Not entirely clear why, but it seems to be because at night is when these bugs typically come out." [00:53]
Timestamps
- [00:42] – Chagas disease overview
- [01:32] – Kissing bug behaviors and US spread
2. Symptoms, Diagnosis, and Course of Disease
- Two Stages:
- Acute Phase (First 2 Months):
- Often mild or unnoticed; fever, headache, rash, swollen eyelid ("Romaña sign"), skin lesions (chagomas).
- Chronic Phase (Years/Lifetime):
- Most have few/no symptoms; 20–30% develop severe heart or digestive problems as parasites move from blood to body tissues.
- Acute Phase (First 2 Months):
- Diagnosis:
- Blood tests for acute phase (looking for parasites).
- Antibody tests for chronic phase.
- Routine screening of blood donors.
Notable Quote
"That initial acute phase can last maybe up to two months after infection… you may have fever, headache, rash. Sometimes you can have something known as a Romaña sign, which is eyelid swelling." [05:28]
Timestamps
- [05:08] – Symptoms and progression
- [06:06] – Diagnosing Chagas disease in individuals
3. Treatment Options
- Two Main Antiparasitic Drugs:
- Benznidazole:
- First-line treatment, pill taken twice a day, fewer side effects.
- Nifurtimox:
- Pill taken three times a day; also approved for children, used when benznidazole is unsuitable.
- Benznidazole:
- Treatment Challenges:
- Duration: Typically a 60-day course; commitment required.
- Side Effects: Serious ones can force 20% to stop treatment; not safe for pregnant women or those with kidney/liver failure.
- Effectiveness: Medications are most effective if started before parasites move out of bloodstream.
- No preventative drugs or vaccines available.
- Special Cases:
- Cardiac or gastrointestinal complications require specialist care.
Memorable Quote
"About 80% of people who are treated complete the treatment, but 20% or so have to abandon the treatment because those secondary effects can be so severe." [07:24]
Timestamps
- [06:14] – Drug treatments explained
- [07:40] – Treatment limitations and need for new therapies
4. Pets and Chagas Disease
- Risk to Animals:
- Dogs and cats can be infected; cats are mostly carriers, dogs can get seriously ill.
- Symptoms in dogs: lethargy, weight loss, appetite loss, sometimes heart failure.
- Dogs at risk in over 23 US states; can also transmit via blood transfusions.
- Prevention for Pets:
- Minimize exposure in high-risk areas.
Notable Quote
"Chagas often infects animals before they infect humans. And they can be sort of a sign that humans are potentially at risk." [09:58]
Timestamps
- [09:43] – Dogs and cats, pet symptoms, and guidance
5. Practical Prevention Tips
- For People:
- Avoid travel/staying in poorly built, unscreened, or rural dwellings in affected regions.
- Stay in places with air conditioning/screens.
- Seal cracks and install screens on doors and windows.
- Use professional pest control/insecticides when needed.
- Be especially careful at night, when bugs are most active.
- For Pets:
- Similar preventative steps as for humans.
- Seasonal Risk:
- Transmission drops when temperatures are below 62°F (c. 16.7°C).
Notable Quote
"Remember what I said about nighttime? That's when these kissing bugs are most active, so that's the time you want to be the most careful." [11:28]
Timestamps
- [10:38] – Home and travel safety strategies
- [12:28] – When risk drops seasonally
Notable Quotes & Memorable Moments
| Timestamp | Speaker | Quote | |-----------|-----------------------|-----------------------------------------------------------------------------------------| | 00:53 | Dr. Sanjay Gupta | "It's called the kissing bug disease because it typically bites people on their face..." | | 05:28 | Dr. Sanjay Gupta | "That initial acute phase can last maybe up to two months after infection..." | | 07:24 | Dr. Sanjay Gupta | "About 80% of people who are treated complete the treatment, but 20% or so have to abandon the treatment because those secondary effects can be so severe." | | 09:58 | Dr. Sanjay Gupta | "Chagas often infects animals before they infect humans. And they can be sort of a sign that humans are potentially at risk." | | 11:28 | Dr. Sanjay Gupta | "Remember what I said about nighttime? That's when these kissing bugs are most active, so that's the time you want to be the most careful." |
Segment Timestamps
- [00:42–04:05]: Chagas disease background, spread, and prevalence
- [05:08–08:46]: Symptoms, diagnosis, and medical treatment discussion
- [09:35–12:38]: Pets, prevention strategies, and real-world advice
Conclusion & Takeaways
Dr. Gupta underscores that with climate change and warming temperatures, Chagas disease is spreading further north in the US and beyond its historical range. Despite its low awareness, the disease is a growing public health concern for both people and pets. Prompt diagnosis and completion of antiparasitic treatment are critical. Preventive measures—particularly when traveling or living in risk areas—center on physical barriers and environmental controls given the lack of a vaccine. Stay vigilant, especially during warmer seasons, to protect your family and pets from this emerging threat.
"But hopefully as a result of this podcast, you are better prepared." [12:36] – Dr. Sanjay Gupta