The 1899 United States Kissing Bug Epidemic

Carlos Chagas is credited with the discovery of Chagas disease because of his 1909 published findings of the Trypanosoma cruzi parasite isolated in the blood of a Brazilian patient [1]. Following his discovery, reports of Chagas disease from across Latin America were published, classifying these countries as endemic with continual transmission occurring [2]. The United States has long been considered a non-endemic country due to the opinion that transmission between local vector populations and humans is non-existent or infrequent [3]. We recently published an extensive review with published reports of routine human exposure to nocturnal Triatominae vector bites and continual reports of autochthonous transmission to Texas locals over the past 60 years [4]. In the midst of performing this historical literature review, we came across a reference to the original source of the term “kissing bug.” Accessing the historical archives that were available online for five different urban newspapers, we searched for newspaper articles that included the key words “kissing bug” and were published between January 1, 1899, and December 31, 1899. What we unearthed was an unexpected “outbreak” of kissing bug assaults that were reported in newspapers across the nation. Ten years before Carlos Chagas described Chagas disease (in 1909), the US experienced a multi-city hysteria caused by the routine, nightly bites of the “kissing bug” that resulted in numerous hospitalizations and even a few deaths. On Tuesday, June 20, 1899, The Washington Post published the first article describing “the bite of a strange bug” [5]. Reporters noted “several victims. . .woke up to find both eyes nearly closed by the swelling. . .the matter is beginning to interest physicians” [5]. During the early days of the epidemic, no one had seen the insect, but only reported that it struck during the night without any initial pain. The afflicted victim would awake in the morning with swelling mostly of the eyelid and lips, and occasionally on the hand, shoulder, or arm [5–9]. Swelling typically subsided within 48 to 72 hours and was accompanied, on occasion, by fever and/or symptoms that resembled poisoning [10–12]. Sadly, several fatalities were reported throughout the continuing epidemic, with one death certificate specifically stating “chief and determining cause of death—sting of a kissing bug” [11,13–16]. Between June and July of 1899, reports of kissing bug victims were rampant across the continental US (Fig 1). More than sixty newspaper articles were published that referenced over 100 cases, with The Washington Post, The New York Times, The Atlanta Constitution, the Boston Daily Globe, and the Chicago Daily Tribune newspapers publishing the majority of the relevant articles. (Of notable interest, patients’ names, ages, and residential addresses were published in the newspaper alongside their accounts.) The bug responsible for these attacks was anecdotally referred to as the “kissing bug,” “Hobson bug,” and “Dorsey Foultz bug” [17]. Despite the ambiguous nature of the newly emerging epidemic, early reports from local entomologists