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Racing to diagnose Chagas disease, a silent killer in Florida

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When Norman Beatty first witnessed people sleeping under mosquito nets in rural Arizona, he was stunned. And yet, some residents of remote areas in the U.S., including parts of Florida, use the nets in their homes each night – not to protect against mosquitoes, but kissing bugs, blood-sucking insects that can spread a potentially lethal disease known as Chagas.

A bed with a mosquito net.
In Bisbee, Arizona, this homeowner sleeps under a mosquito net nightly to protect herself from being bitten by invading kissing bugs. Photo courtesy of Norman Beatty.

Those nets were a catalyst for Beatty, M.D., an assistant professor of medicine in the University of Florida’s Division of Infectious Diseases and Global Medicine and a member of the Emerging Pathogens Institute. Since 2015, Beatty has dedicated his research program to the study of Chagas, a little-known illness caused by a microscopic parasite called Trypanosoma cruzi, passed primarily via the feces of infected kissing bugs.

Chagas disease can be a silent killer: Symptoms may take decades to appear and are often irreversible once they are recognized. Most people infected with T. cruzi do not know they carry the parasite, Beatty said. Without treatment, they can remain infected for life. About one-third will develop chronic Chagas, which can attack the heart, brain and gastrointestinal and peripheral systems with fatal results.

An estimated 300,000 people are living with Chagas disease in the U.S., but fewer than 1% have been diagnosed. Florida, home to both the kissing bug and T. cruzi, is thought to have the third-highest number of people living with chronic Chagas, behind California and Texas. But the disease remains poorly studied in the state and globally.

“Chagas truly is a neglected tropical disease,” said Beatty. “A tremendous amount of work needs to be done to understand this parasite and how it’s affecting human beings.”

Chagas is also a disease of inequity, he said. In the U.S., it disproportionately affects people who have immigrated from Latin America, where the parasite is more common, and those exposed to kissing bugs in rural areas. These groups also tend to have limited access to healthcare.

As part of a three-year investigation, Beatty and UF/IFAS collaborators Samantha Wisely, Nathan Burkett-Cadena and John Diaz, as well as Colin Forsyth from the Drugs for Neglected Diseases initiative and Eva Novakova from the University of South Bohemia, have been working with urgency to track and diagnose the disease in Florida and investigate the ways in which T. cruzi spreads.

“It’s important that we try to reach all the populations at risk for Chagas,” Beatty said. “Without access to resources, patients will continue to manifest the chronic disease state and may die from this infection without ever knowing they had this disease.”

This piece was originally written by Natalie Van Hoose and published here on the Emerging Pathogens Institute website.

Chigas, Kissing Bugs, University of Florida, Natalie Van Hoose, UF Emerging Pathogens Institute