A “Kissing Bug” Bites a Child in Delaware: The State’s First Confirmed Triatoma sanguisuga

In July 2018, a family in Kent County, Delaware, asked state health and agriculture officials to identify an insect that had bitten their daughter’s face while she watched television in her bedroom late in the evening. The parents were worried it might carry disease.

Identifying the bug

The family lived in an older single-family home near heavy woods, with a window air conditioner in the bedroom where the bite happened, and had not traveled outside the area.

Staff of the Delaware Department of Agriculture made a preliminary identification: Triatoma sanguisuga, a “kissing bug.” Triatomines are blood-sucking insects that feed on animals and people, and they tend to bite people on the face. The state contacted Texas A&M University’s Kissing Bug Citizen Science Program, which collects kissing bugs from across the United States and confirmed the identification from a photograph. T. sanguisuga can transmit Trypanosoma cruzi, the parasite that causes Chagas disease.

CDC then confirmed the species by examining the insect and tested it:

• PCR testing of its hindgut was negative for T. cruzi
• analysis of its blood meal found human blood
• the girl had no ill effects

A first for Delaware

This was the first confirmed identification of T. sanguisuga in Delaware. There had been an earlier report, in July 2017, also from Kent County: a dead insect, with no human exposure, that Texas A&M identified from a photo as T. sanguisuga. But a local institution had first identified it as a milkweed bug and destroyed it, so the identification could never be confirmed.

How big is the risk?

Chagas disease can cause serious heart and digestive complications. CDC estimates about 300,000 people with Chagas live in the United States, most infected in parts of Latin America where the disease occurs. Triatomine bugs live in the United States too, but only a few cases caught from them have been documented here.

• T. cruzi infects many kinds of mammals and is found across the southern half of the United States.
• There is no current evidence of T. cruzi in Delaware, although the bug is now confirmed there.
• Even where the parasite circulates, not every bug is infected — and the chance of a person catching T. cruzi from a bug in the United States is low, even when the bug is infected.

Keeping kissing bugs out

• Place outdoor lights away from homes, dog kennels and chicken coops, and turn off lights not in use.
• Clear away trash, wood and rock piles, and remove bird and animal nests around the house.
• Inspect and seal cracks and gaps around windows, air conditioners, walls, roofs, doors and crawl spaces.
• Keep chimney flues tightly closed when not in use, and put screens on all doors and windows.
• Ideally, have pets sleep indoors, especially at night, and keep outdoor pet areas clean.
• Consider a licensed pest control professional.

Sources

Based on Eggers P, Offutt-Powell TN, Lopez K, Montgomery SP, Lawrence GG, "Notes from the Field: Identification of a Triatoma sanguisuga ‘Kissing Bug’ — Delaware, 2018," MMWR Vol. 68, No. 15, CDC; a work of the United States government in the public domain.