Kissing Bug Disease Is Spreading; How To Stay Safe

Summary

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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.

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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

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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.
• 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

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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.
• 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

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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

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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

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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." |

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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

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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

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Transcript

[Dr. Sanjay Gupta]

Welcome to Paging Dr. Gupta. You know, this is one of my favorite shows. I love it. I get to hear your voices. I get to answer your questions. I don't have scripts. So a lot of riffing, a lot of talking to experts, but hopefully we're addressing the things that are concerning you right now. Kira, let's cut to the chase. Who do we have first?

[Kira]

Hey, Sanjay. Okay, so our first question today is coming from a listener named Deidre, and she wants to know about kissing bug disease. Now, I don't know too much about this topic, and so I felt like this was a very interesting thing to learn about today. And so she's asking, what exactly is the treatment for kissing bug disease?

[Dr. Sanjay Gupta]

Okay, Deidre. Kira, thank you so much. Kissing bug disease, also called Chagas disease, that's spelled C H A G A S. It is a condition caused by a parasite. There's bacteria, there is viruses, and there are parasites. Those are the typical pathogens. This one is caused by a parasite, and it's been in the news a lot lately. So let me give you a little bit of background. First of all, it's caused by a parasite known as Trypanosoma cruzi. T. Cruzi. It's spread through contact with the triatomine bugs. T R I A T O M I N E. 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. You're in bed, most of your body is covered, but your face is exposed, and that's where it typically bites you. It drops off some parasites. And if these parasites get into your body through a cut in the skin or near the eye or mouth, that can lead to an infection. Sometimes people will rub or scratch around the bite wound, scratch around their eyes or their mouth. They may not realize it, and that's what allows the parasite to enter the body. Now, good news. It does not typically spread person to person or even through casual contact with people or animals who are infected. It can spread through infected blood, however, and that is why blood donors are actually screened for antibodies to the parasite. It's a little bit hard to know the exact numbers, but probably around 8 million people globally are infected, and 280,000 of them are in the United States. About 10,000 people die a year around the world. What is interesting about Chagas is that it was long considered a neglected tropical disease, mostly common in areas of rural Mexico, Central, and South America. But as weather has become warmer, you've seen some of these tropical diseases start to migrate further and further north. And now kissing bugs have been identified in 32 states and infections have been identified in eight states which are California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi and Arkansas. The CDC definition of endemic is the constant presence of a disease or infectious agent within a given geographic area or population group. And that seems to be what is happening now in the southern United States. Defining Chagas as endemic would probably lead to a lot more awareness of this and provide a better platform for surveillance. We are starting to grapple with a new infectious disease in the United States now. Again, kissing bugs, they feed on blood and and they are active mostly at night. If you look at them, adult kissing bugs are about a half inch to an inch long and can live up to two years. There are 11 different kinds of kissing bugs in the United States and about half of them are actually infected with the Chagas parasite. So that's the whole cycle. They bite you, they leave the parasite, the parasite enters your body. That can make you sick. But there's a treatment and I'm going to talk about that right after the break.

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[Dr. Sanjay Gupta]

Okay, back to the listener question. Now that we got the background out of the way, what is the treatment for kissing bug disease, also known as Chagas? First of all, before you get treated, you need to know what the symptoms are. So the early stage, or what we call an acute stage of Chagas disease is often mild, may go unnoticed and this usually happens within the first weeks or months after getting infected. By the way, out of the 280,000 people that are believed to be infected in the United states, only about 1% have been officially diagnosed because a lot of people may have mild symptoms or really no symptoms at all. So that initial acute phase can last maybe up to two months after infection. And that's when a high number of parasites start circulating in the blood. You may have fever, headache, rash. Sometimes you can have something known as a Romania sign, which is eyelid swelling. And that's because the parasite can get into your eyelid, usually after you accidentally rub the parasite into your eye or. Or into a bug bite near your eye. There are also skin lesions known as chagomas. Now, the chronic phase, that is after the first few months, that can last years or even a lifetime. And for a lot of people, they don't really, again, have much in the way of symptoms. But for 20 to 30% of those people, they can develop serious problems. Problems with their heart, problems with their digestive system. That's because the parasites have left the bloodstream and are now traveling around the body, and they get mainly into the heart muscle and the digestive muscles. You can test for this, and that's done with a blood test. For acute infections, you're trying to identify the parasite themselves. For chronic infections, tests are used to detect antibodies that fight the parasite. And as I mentioned earlier, blood donors are screened for antibodies to the parasite. So treatment. This is a parasite. So we are talking about antiparasitic drugs that can kill the parasite that causes Chagas disease. There are two different types that we typically talk about, and they can be very effective. Benznidazole is one of them, and Nifertamox is another one. Benznidazole is a pill taken twice a day, and that's usually the first line. Treatment has fewer side effects. Nifertamox is a pill that's taken three times a day. Both of them are FDA approved for children, but also prescribed for adults. Now, if you do develop other problems associated with the disease, such as cardiac problems, heart problems, or GI problems, you may need to see another specialist as well. Now, one thing about these treatments is that it's a commitment. Typically, it's about 60 days that you have to take these antiparasitic drugs. And you have to start early. You want to start before the parasite actually starts to leave the bloodstream and moves to other areas of the body. Sometimes the medications can have some serious side effects, and that's why they're typically not administered to pregnant women or people with kidney or liver failure. 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. We haven't really had new drugs for chagas since the 1950s. So there is a push to try and develop some new therapies. Up next, we have a question about pets and whether they too can be affected by kissing bug disease.

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[Dr. Sanjay Gupta]

Today's all about Chagas disease, something that a lot of people are talking about lately. It's also known as kissing bug disease. Kira, who do we have next?

[Kira]

Okay, this is starting to sound like a kiss. I definitely do not want to, but I do have a follow up question for you Sanjay, and it has to do with our furry friends and how it affects them. So can our pets get kissing bug disease too?

[Dr. Sanjay Gupta]

So the answer is yes. Yes, it can affect animals. In fact, Chagas often infects animals before they infect humans. And they can be sort of a sign that humans are potentially at risk. We know that dogs and cats can potentially be infected. Cats are mostly carriers, which means they don't necessarily get sick even as they are carrying the parasite. But dogs, they can get pretty sick. And we have seen dogs exposed to this parasite in 23 states. Sometimes they become infected just like humans do. They get bit and then the parasite gets into the body. Sometimes it's because they eat animals that have been infected with the parasite. Chagas can even be transmitted through canine blood transfusions if an infected dog serves as a blood donor. Now the symptoms for dogs may be subtle. Lethargy, tiredness, decreased appetite, weight loss. In more severe cases, you may notice fainting, exercise intolerance, vomiting, diarrhea. In the most severe cases, the vet may notice signs of heart failure, fluid in the abdomen, lymph node enlargement, just like with humans. If you're concerned, you want to try and get a diagnosis as quickly as possible. Doesn't really help to wait. In this case. There are plenty of steps you can take to try and protect yourself, your family and your pets. Easiest thing is not travel to rural areas that have kissing bugs, but I realize that's not always possible if you are traveling to or living in an area that might have Chagas disease. As best you can, try and stay in well built places that have air conditioning screenshots. This lowers the risk of contact with infected kissing bugs which often live in poorly built dwellings and are particularly active at night. Make sure to seal entry points, close cracks and gaps in walls, roofs, doors and windows, install and repair screens on doors and windows and spray places where you're staying if you're going to be there for a while. With long lasting insecticides, professional pest control can apply a long lasting insecticide to walls and and also other hiding spots in your house. 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. Now there are treatments as I mentioned the antiparasitic drugs, but at this time there are no vaccines or drugs that can prevent Chagas disease. So hope that helps. We've been getting so many questions about this. Do keep in mind as the weather gets cooler, typically below 62 degrees or so, transmission goes almost down to zero and we're getting into the cooler weather now. When it starts to get warmer next year, that's when we need to start thinking about Chagas again. But hopefully as a result of this podcast, you are better prepared. Thanks so much to everyone for your questions. You make this show come to life, so keep the questions coming. If there's something health related you've been wondering about, record a voice memo, email it to asksanjayn.com or give us a call 470-396-0832 and leave a message. Thanks so much for listening. I'll talk to you on Friday.

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[Dr. Sanjay Gupta]

Ooh, Mad Max. You might be right on the Mad Max.

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[Dr. Sanjay Gupta]

Oh, that's me.

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