Health Officials Confirm Presence of "Kissing Bug" in Delaware

A recent article published in the US Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report details the first detection of a Triatoma sanguisuga, an insect also nicknamed a “kissing bug,” in Delaware.

Triatomines are a type of blood-sucking insect that feeds on humans and animals and is known for biting the face of humans. These vectors can transmit the parasite Trypanosoma cruzi, which causes Chagas disease, a serious infection that can lead to serious cardiac and gastrointestinal complications.

Triatomine insects are more commonly encountered in Latin America, although they have been previously detected in the United States. The CDC estimates that approximately 300,000 individuals in the United States are living with Chagas disease, yet very few of these cases are connected with contact with the bug within the United States.

According to the CDC, the case in Delaware was reported by a family living in Kent County who requested assistance from the Delaware Division of Public Health (DPH) and Delaware Department of Agriculture (DDA) in identifying an insect that had bitten their child’s face as she watched television in her bedroom in July 2018.

The family, who were concerned about vector-borne disease transmission, reported no recent travel, and resided in a home near a heavily wooded area. The report identifies that a window air conditioning unit was located within the bedroom where the child was reportedly bitten.

Health officials with the DDA preliminarily identified the insect as a Triatoma sanguisuga. An image of the insect was sent by the health officials to Texas A&M University, which is home to the Kissing Bug Citizen Science Program, a research organization that documents and collects kissing bugs from across the United States. The program used the picture to confirm the identity of the insect as a Triatoma sanguisuga.

Following the program’s confirmation, the insect was sent to the CDC for morphological species-level identification. Through the use of polymerase chain reaction testing, the CDC found that the insect did not possess T cruzi. An additional bloodmeal analysis detected human bloodmeal, likely from the girl who was bitten in Delaware. According to the report, the girl did not experience any adverse effects.

Although this is the first confirmed identification of the T sanguisuga in Delaware, there was a previous report of a suspected kissing bug in July 2017 in the same county. The insect was found dead and there was no reported human exposure. The Texas A&M program identified the insect as a kissing bug, via photographic evidence, yet health officials in Delaware identified the insect as a milkweed bug and the insect was destroyed before definitive identification could be confirmed.

The report indicates that although the T sanguisuga has been confirmed to be present in Delaware, there is no evidence of T cruzi in the state.

“Even where T cruzi is circulating, not all triatomine bugs are infected with the parasite,” write the authors of the report. “The likelihood of human T cruzi infection from contact with a triatomine bug in the United States is low, even when the bug is infected.”

In order to prevent infestations with triatomine bus, the report recommends the removal of trash, wood, or rock piles from around the home, positioning outdoor light away from the home, and sealing off cracks and gaps around windows, roofs and doors. Licensed pest control professionals can also be consulted for insect control.