The Kissing Bug

Starred review from April 5, 2021
Hernández (A Cup of Water Under My Bed), a creative writing professor at Miami University of Ohio, blends family memoir, scientific inquiry, and journalistic exposé in this poignant study of Chagas disease, an insect-borne tropical parasitic infection that can cause lifelong heart and intestinal problems if left untreated. After the death of her aunt Dora, who came to the U.S. from Colombia to seek treatment for her intestinal issues, Hernández poured her grief into exploring the history of Chagas disease. She lucidly describes the parasitological research that brought it to light in the early 20th century, and documents the chronic presence of insects, including the “kissing bugs” that spread the disease, in poor households in Latin America and the U.S. Profiles of other immigrant families who struggle to access adequate health care, and discussions of experiments on Black asylum patients in the 1940s and price-gouging by pharmaceutical executives add weight to Hernández’s searing indictment of the U.S. medical system, which fails to routinely screen for the infection, despite knowing that it is widespread and that presymptomatic treatment is the only cure. This vivid, multidimensional account brings an ongoing medical injustice to light.

May 1, 2021

In this latest work, Hern�ndez (A Cup of Water Under My Bed) chronicles the history of the parasitic disease trypanosomiasis--also known as Chagas (after its 1909 discoverer), or the kissing bug disease--which quietly impacts as many as 300,000 people in the U.S. each year. Hern�ndez centers the narrative on her family's history with Chagas; she also weaves the personal stories of several people living with Chagas into her exploration of the disease's history, pathology, treatment, and role in ideas of the health care system. The insect-borne disease can incubate for years, and can manifest as either cardiovascular or, less often, gastroenterological problems, leading to death. Chagas can be treated when it is recognized at an early stage, but the disease persists because U.S. practitioners are not widely aware of it, it is often difficult to diagnose, and it is prevalent among low-income and immigrant populations that are often neglected in the American health care system. VERDICT Hern�ndez presents a comprehensive picture of Chagas and its impact in the U.S.; she makes clear that this is far from the only instance of the medical system failing the patients in its care. Blending family and medical history, this account is especially relevant in an era of pandemics.--Richard Maxwell, Porter Adventist Hosp. Lib., Denver

Copyright 2021 Library Journal, LLC Used with permission.

May 1, 2021
A deeply personal, unsparing analysis of how neglected diseases disproportionately affect marginalized peoples in the world's richest country--and why they need not. While Covid-19 continues to circle the globe and wealthy countries clamor for vaccines, dozens of "neglected tropical diseases" are ravaging more than 1 billion people living in developing regions of Africa, Asia, and the Americas. The treatments for some of these are available, but accessing them can be difficult or impossible. When these diseases appear in developed, Northern Hemisphere countries, they are rarely diagnosed accurately by doctors, who did not learn about them in medical schools, and sociocultural barriers, political choices, and racism further limit options for care. In her latest, Hern�ndez, a professor of English and former New York Times reporter, explores her family's struggles with Chagas disease, better known as "kissing bug disease." The author highlights how poverty, policies that limit health care for immigrants and marginalized peoples, and the worldwide neglect of public health infrastructure all contribute to the 10,000 deaths among the 6 million cases of Chagas disease in the Americas, 300,000 of which are in the U.S. The heroes of this story are not only the doctors, nurses, public health professionals, and volunteers who work tirelessly testing for and treating the disease--as well as identifying and controlling infestations of kissing bugs (Triatoma species) and the Trypanosoma parasite that causes the illness--but also the patients and support groups who have increased awareness of it, especially in Texas and California, where it is most prevalent in the U.S. And, of course, the tireless family members-cum-caregivers like Hern�ndez. The author's T�a Dora, who lived with and died from Chagas disease, changed Hern�ndez's life. Her story, ably rendered by the author, should open readers' eyes to a persistent plague. A compelling indictment of our failing health care system and the people falling through its ever widening cracks.

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