Justin O. Schmidt

Feeding behavior of triatomines from the southwestern United States: An update on potential risk for transmission of Chagas disease

Chagas disease is an emerging infectious disease in North America due to the immigration of individuals from endemic areas. The parasite has been transmitted to patients in non-endemic areas by blood transfusion and organ donation. Only six autochthonous cases have been described in humans in the United States yet the parasite is widespread among native mammals and resident triatomines are competent vectors. We attempted to determine if common southwestern triatomines, Triatoma protracta and Triatoma rubida have the potential to amplify the disease among human residents of the Southwest. The defecation patterns of the bugs were studied while feeding upon immobilized mice. Wild-caught adult male and female triatomines were observed feeding one to three times for a total of 71 observed feedings. T. rubida (15 bugs) appeared to be more aggressive, beginning feeding shortly after being placed in proximity to the host (within 2.3 min) whereas Triatoma protracta (12 bugs) was more deliberate, beginning feeding, on average, at 4 min. There were 40 observations of T. rubida, which fed for 27.9+/-13.6 min, whereas T. protracta fed for 22.8+/-7.5 min (n=31). Bugs were weighed pre- and post-feeding and T. rubida females ingested>T. protracta females>T. rubida males>T. protracta males. Weight gain did not correspond to the feeding duration. Defecation occurred on 42% of the feedings (30 of 71), and no bugs defecated on the host. The majority of the defecations occurred within 1 min of feeding, usually at the time of repletion. A large proportion of defecations occurred after the bugs left the vicinity of the host. All bugs and at least one fecal smear from each feeding bug were tested for Trypanosoma cruzi and 21% of T. protracta were positive by PCR (4 bugs and 1 feces). No T. rubida tested positive for T. cruzi. The bugs defecation pattern is similar to that reported >50 years ago. Furthermore, there is no indication that they are becoming more domesticated in the desert Southwest. Thus, based on our observations, we do not believe that T. protracta and T. rubida pose an imminent risk for transmission of Chagas disease to residents of the southwestern United States.

Vector blood meals and Chagas disease transmission potential, United States.

A high proportion of triatomine insects, vectors for Trypanosoma cruzi trypanosomes, collected in Arizona and California and examined using a novel assay had fed on humans. Other triatomine insects were positive for T. cruzi parasite infection, which indicates that the potential exists for vector transmission of Chagas disease in the United States.

“Kissing Bugs”: Potential Disease Vectors and Cause of Anaphylaxis

Physicians in the United States should familiarize themselves with kissing bugs endemic to their area of practice and appreciate the medical implications of their bites. Bite victims often seek advice from physicians about allergic reactions as well as the risk of contracting Chagas disease. Physicians are generally knowledgeable about the role of kissing bugs in the transmission of Trypanosoma cruzi in Latin America. However, they may be unaware of (1) severe allergic reactions to kissing bug salivary antigens, (2) the widespread occurrence of T. cruzi amongst vertebrate hosts of kissing bugs, and (3) the incidence of T. cruzi among kissing bugs (T. cruzi may infect >50% of sampled bugs). Despite the potential for Chagas disease transmission, the major concern regarding kissing bugs in the United States is anaphylactic reactions to their bites resulting in frequent emergency department visits, especially in areas of endemicity in the Southwest.

Adverse reactions to ants other than imported fire ants

OBJECTIVEnTo identify ants other than Solenopsis invicta and Solenopsis richteri reported to cause adverse reactions in humans.nnnDATA SOURCESnWe conducted a literature review to identify reports of medical reactions to ants other than S. invicta and S. richteri. Our review of medical and entomological literature on stinging ants was generated from MEDLINE and FORMIS, respectively, using the key words stinging ants and ant stings. The search was limited to articles in English published from 1966 to 2004 on MEDLINE and all years on FORMIS. We also present 3 new case reports of severe reactions to stings by 2 different species of ants, Pseudomyrmex ejectus and Hypoponera punctatissima.nnnSTUDY SELECTIONnArticles that concerned anaphylactic (IgE-mediated) or anaphylactic-like (resembling anaphylaxis but mechanism unknown) immediate reactions to ant stings or bites were included in this review.nnnRESULTSnTaken together, our data demonstrate that S. invicta and S. richteri are not alone in their capability to cause serious allergic or adverse reactions. A diverse array of ant species belonging to 6 different subfamilies (Formicinae, Myrmeciinae, Ponerinae, Ectatomminae, Myrmicinae, and Pseudomyrmecinae) and 10 genera (Solenopsis, Formica, Myrmecia, Tetramorium, Pogonomyrmex, Pachycondyla, Odontomachus, Rhytidoponera, Pseudomyrmex, and Hypoponera) have now been shown to have this capability.nnnCONCLUSIONnAwareness that species other than imported fire ants may cause severe reactions should lead to more rapid evaluation and treatment and further investigation of the medical entomology of these ants.

Kissing Bugs. The Vectors of Chagas

A complete picture of Chagas disease requires an appreciation of the many species of kissing bugs and their role in transmitting this disease to humans and other mammals. This chapter provides an overview of the taxonomy of the major species of kissing bugs and their evolution. Knowledge of systematics and biological kinship of these insects may contribute to novel and useful measures to control the bugs. The biology of kissing bugs, their life cycle, method of feeding and other behaviours contributing to the transmission of Trypanosoma cruzi are explained. We close with a discussion of vector control measures and the allergic complications of kissing bug bites, a feature of particular importance in the United States.

Repellency of DEET, Picaridin, and Three Essential Oils to Triatoma rubida (Hemiptera: Reduviidae: Triatominae)

ABSTRACT n The kissing bug, Triatoma rubida (Uhler) is a common hematophagous bug in Tucson, AZ, and is responsible for causing severe allergic reactions in some bitten individuals. DEET, picaridin, tea tree oil, peppermint oil, and citronella oil were tested for repellency to T. rubida and its ability to probe and feed on a small restrained rat. No long range repellency was observed with any of the test materials. The lowest repellent concentrations observed were: 10% DEET, 7% picaridin; 30% tea tree oil, 3.3% peppermint oil, and 0.165% citronella oil. Only citronella oil was able to stop all probing and feeding by T. rubida. Citronella oil appears to be a promising potential repellent to prevent sleeping people from being bitten by kissing bugs.

Repellency of the Components of the Essential Oil, Citronella, to Triatoma rubida, Triatoma protracta, and Triatoma recurva (Hemiptera: Reduviidae: Triatominae)

ABSTRACT n The kissing bugs—Triatoma rubida (Uhler), Triatoma protracta (Uhler), and Triatoma recurva (Stal)—are common hematophagous bugs in southeastern Arizona and responsible for severe allergic reactions in some individuals who are bitten. They also possess the potential to transmit the blood parasite, Trypanosoma cruzi. We previously found the essential oil, citronella, to be an excellent deterrent of feeding of T. rubida on a restrained mouse. In this work, we tested major components—alcohols, aldehydes, and monoterpenes—of citronella oil for repellency against the three common triatome species endemic in southern Arizona. The following citronella oil components—geraniol, citronellol, limonene, and citronellal—in different concentrations and combinations were tested. All components of citronella oil demonstrated some inhibition of feeding, ranging from very weak inhibition (limonene) to significant inhibition (geraniol and citronellol). A mixture of geraniol and citronellol was found to be repellant at concentrations of .165 and .165 vol%, respectively, for all three triatome species. Citronellal and limonene had no significant repellent activity. The repellent activity of citronella oil appears to be acting through direct contact with the bugs rather than diffusion of vapors.

Towards a phylogenetic approach to the composition of species complexes in the North and Central American Triatoma, vectors of Chagas disease.

Phylogenetic relationships of insect vectors of parasitic diseases are important for understanding the evolution of epidemiologically relevant traits, and may be useful in vector control. The sub-family Triatominae (Hemiptera:Reduviidae) includes ∼140 extant species arranged in five tribes comprised of 15 genera. The genus Triatoma is the most species-rich and contains important vectors of Trypanosoma cruzi, the causative agent of Chagas disease. Triatoma species were grouped into complexes originally by morphology and more recently with the addition of information from molecular phylogenetics (the four-complex hypothesis); however, without a strict adherence to monophyly. To date, the validity of proposed species complexes has not been tested by statistical tests of topology. The goal of this study was to clarify the systematics of 19 Triatoma species from North and Central America. We inferred their evolutionary relatedness using two independent data sets: the complete nuclear internal transcribed spacer-2 ribosomal DNA (ITS-2 rDNA) and head morphometrics. In addition, we used the Shimodaira-Hasegawa statistical test of topology to assess the fit of the data to a set of competing systematic hypotheses (topologies). An unconstrained topology inferred from the ITS-2 data was compared to topologies constrained based on the four-complex hypothesis or one inferred from our morphometry results. The unconstrained topology represents a statistically significant better fit of the molecular data than either the four-complex or the morphometric topology. We propose an update to the composition of species complexes in the North and Central American Triatoma, based on a phylogeny inferred from ITS-2 as a first step towards updating the phylogeny of the complexes based on monophyly and statistical tests of topologies.

Kissing Bug (Triatoma spp.) Intrusion into Homes: Troublesome Bites and Domiciliation

Kissing bugs (Triatoma spp.) frequently enter homes and bite human and pet occupants. Bites may lead to severe allergic reactions and, in some cases, death. Kissing bugs are also vectors of Trypanosoma cruzi, the cause of Chagas disease. In general, modern houses in the United States are not conducive to domiciliation of kissing bugs (bugs living out their entire life within the home with the presence of eggs, nymphs, adults, and exuviae). Construction features such as concrete foundations, solid walls and ceilings, window screens, tight thresholds for doors and windows, and other measures impede bug entry into homes, and air conditioning reduces the need for open doors and windows. Where Chagas disease is endemic in Mexico and Central and South America, homes often have thatch roofs, adobe walls, and open doors and windows. We investigated numerous instances of kissing bug intrusions into homes in Southern Arizona, California, and Louisiana and documented the reactions to kissing bug bites. Our work confirms the importance of modern home construction in limiting kissing bug intrusions. Older homes, especially those lacking modern screening, caulking, and weather stripping to reduce air leakage, may be subject to kissing bug intrusions and domiciliation. We describe a community in Southern Arizona where domiciliation of homes by Triatoma recurva is common. We also provide recent data regarding kissing bug bites and allergic reactions to the bites.