Bedbugs and transmission of Trypanosoma cruzi.

To the Editor—I read with interest the article by Delaunay et al [1] about bedbugs and disease transmission. Although the article was interesting and broad in scope (describing entomology, epidemiology, and medical impact), at least one of its conclusions may have been based on improper understanding of the references. The authors quoted an article stating that wild-caught bedbugs have been found to be naturally infected with Trypanosoma cruzi in Mexico [2]. They also quoted an article, stating that bedbug salivary glands have been studied to precisely describe their ultrastructure, as ‘‘T. cruzi stored therein might be transmitted during a blood meal’’ [3]. Their conclusion was that bedbug transmission of Chagas disease was "not unlikely." Stating that something is ‘‘not unlikely’’ is actually stating that it is likely. If one examines the literature quoted in the article, the report by Villagran et al [2] was not about bedbugs. The article pertained to kissing bugs found naturally infected with T. cruzi. Misuse of the common name ‘‘bedbugs’’ by the Mexican researchers is unfortunate; however, they listed the scientific names of specimens collected, and every one of them is a Triatoma species. No Cimex species were collected. Furthermore, Azevedo et al [3] studied the gut of bedbugs, not salivary glands. Azevedo and colleagues concluded that Cimicidae and Triatominae midgets are similar in structure, sharing many adaptations for blood-feeding, but there is no mention of Chagas disease transmission by bedbugs. Evidence for bedbug transmission of disease agents was carefully reviewed previously [4]. If the Delaunay et al [1] wanted to cite an article supporting possible Chagas transmission by bedbugs, they should have used the report by Jörg [5], who reported that 125 bedbugs acquired infection with T. cruzi after feeding on infected Azara’s grass mice and that 96.6% of white mice were (apparently) subsequently infected with T. cruzi 15 days after bug bites. Although it is possible that bedbugs may indeed be involved in transmission of T. cruzi, convincing proof is lacking thus far. The statements in the article by Delaunay et al [1] are confusing and misleading and should be clarified.