What better way to ring in the spooky season than by talking about bloodsucking bugs? (Or more accurately, arthropods, if you want to get technical. 🤓) From the spread of Lyme disease and West Nile virus to growing concerns about Chagas disease in the southern U.S., nurse practitioners are seeing renewed attention on vector-borne diseases (VBDs).
Disease-spreading invertebrates (vectors) such as ticks, mosquitos, and kissing bugs, aren’t new threats, but recent reports and research have pulled them into the spotlight. Climate shifts, global travel, and changing ecosystems have given common vector creatures new opportunities to expand their reach. Due to increased media attention and viral horror stories, patients are hearing about it too.
Parasites in the Spotlight
While these aren’t the only arthropods that can spread disease, much of the discussion on vector-borne diseases in the news lately can be boiled down to three main culprits.
Ticks: Tick-borne illnesses are a concern each year. However, they’re getting more and more attention as ticks and the illnesses associated with them are reportedly rising in many regions, in large part because warming temperatures are extending the periods when ticks are active and expanding their habitat northward.
Alongside Lyme disease, lesser-known tickborne illnesses (Babesiosis, Anaplasmosis, Powassan virus, and more) are also creeping into awareness as public health departments in some areas report more cases.
Mosquitoes: Like with ticks, climate change has fueled a longer mosquito season and a correlating rise in mosquito-borne diseases such as West Nile virus. Dengue, once rarely locally transmitted in the continental U.S., is becoming a recurring concern. The Aedes mosquitoes that transmit dengue (Aedes aegypti and Aedes albopictus) are now found across more parts of the U.S. than in the past, raising the possibility of wider local transmission.
More broadly, mosquito season is lengthening and vector populations are shifting due to climate change, increasing the window of risk not just for dengue but for arthropod-borne viruses (a.k.a. arboviruses) like West Nile virus and Eastern Equine Encephalitis.
Kissing bugs: While human cases of Chagas disease remain rare in the US, the insects called Triatomines (or kissing bugs) that can carry and transmit the Trypanosoma cruzi (T. cruzi) parasite are now documented in 32 states — a fact that underscores how widely the vector is established. Some health experts are now calling for Chagas to be considered endemic in the US, or at least raising the profile of the disease in policy and surveillance efforts.
Reports have been surfacing of new, locally acquired cases of Chagas disease in southern US regions, which adds urgency to efforts to raise awareness, detect early disease, and expand testing.
The Diagnostic Puzzle
One of the most challenging aspects of vector-borne illnesses for clinicians is that early signs often mimic common viral or bacterial infections. Fatigue, fever, headaches, or muscle aches don’t immediately scream “parasite,” which makes clinical suspicion all the more important.
For example:
- A patient with a lingering fever and a history of camping in the Northeast may warrant testing for tickborne diseases even without the classic bullseye rash.
- A recent traveler returning from the Caribbean with GI distress could raise suspicion for mosquito-related infections.
- A patient from the Southeastern US presenting with unexplained cardiac symptoms might deserve a closer look for Chagas disease.
Being alert to these red flag clusters of symptoms and circumstances can help determine when it’s worth ordering further labs or referring to infectious disease.
Collaboration With Public Health
NPs don’t have to do this work alone. In fact, when suspicion for a vector-borne disease is high, connecting with local public health departments or infectious disease specialists can be invaluable. These teams may have up-to-date data on local outbreaks, access to specialized labs, or guidance on reporting requirements. For example, the CDC outlines here how medical professionals can collect entomological specimens for testing at local health departments. Along with benefiting patients in the long run, collaborative sharing of information also contributes to surveillance efforts that can help entire communities.
Knowing is half the battle, and clinicians often aren’t extensively trained to spot or treat these types of illnesses. The CDC maintains a library of free Continuing Education courses on vector-borne diseases and arboviruses for medical professionals. Among many other CE resources, the library contains CE activities about Chagas disease, plus many courses on tickborne diseases in particular.
Educating Patients About Prevention
While diagnosis and treatment are critical, prevention is where NPs can have an immediate impact. Many patients are unaware of how simple changes can reduce their risk. Conversations might include:
Insect repellents and protective clothing: Invaluable tools in reducing the likelihood of being bitten by ticks or mosquitoes, especially for those who spend long hours outdoors or travel to endemic areas.
Risk reduction strategies: Eliminating standing water around homes to reduce mosquito breeding sites, or ensuring window screens are intact.
Housing considerations: Especially in regions that are known to have kissing bugs, some strategies that can reduce the likelihood of contact include sealing cracks in homes, keeping outdoor lights away from sleeping areas, and safely managing pet bedding, since dogs are frequent targets of kissing bug bites.
Parasites may not dominate every clinical encounter, but awareness is critical as their reach expands. For NPs, that means being alert to the subtleties of presentation, knowing when to collaborate with public health, and leaning into prevention conversations. These steps not only support individual patients but also strengthen community-level responses to parasitic threats.
This content is intended for educational purposes only and does not substitute for clinical judgment. Treatment decisions should be based on individual patient needs, professional guidelines, and a comprehensive clinical evaluation.
