Perhaps you’ve seen the “kissing bug” disease all over the internet in the past few weeks — and the images of the culprit, a dark, penny-sized insect with orange and red markings along its sides.
Formally called Chagas disease, kissing bug disease is endemic in 21 countries across Latin America. Though it’s nothing new (kissing bugs have been around for thousands of years), the disease is sparking interest and concern stateside: In a paper published this month in the Emerging Infectious Diseases journal, public health experts argued that Chagas disease should be considered endemic in the United States.
The researchers pointed to the widespread presence of kissing bugs and infected animals in the country, as well as the steady stream of local human cases in Texas between 2013 and 2023. Cases aren’t necessarily increasing, but the researchers argued that an ongoing local presence of Chagas warranted the disease being categorized as endemic, which can help increase its awareness.
Triatomine bugs — kissing bugs — are bloodsucking insects that tend to bite people’s faces, hence their macabre nickname. About half carry a parasite that causes Chagas disease, which is passed when the insects defecate. Scratching the bite or rubbing your eyes can push the infected fecal material inside your body.
When you’re infected with Chagas, you’re generally infected for life, though most people with the disease are free of symptoms and may never even know they have it. That’s why Chagas disease is rarely caught in its early stages, when it is curable, although treatment can still halt or slow down the progression of the disease later on. The Centers for Disease Control and Prevention estimates that 20 to 30 percent of those infected can develop serious issues, including heart failure.
But the risk of getting Chagas disease in the United States is extremely low.
“Most Americans should not be worried at all,” said Dr. Caryn Bern, an epidemiologist at the University of California San Francisco who researches parasitic diseases.
Who is at risk of getting Chagas disease?
According to the C.D.C., around 8 million people globally have Chagas disease. In 2022, researchers estimated that about 288,000 people in the United States had the disease, but only about 10,000 had been infected inside the country itself. Most others contracted the disease in Latin America and then traveled or immigrated to the United States.
Still, kissing bugs have been found in 32 states. And there have been cases of local transmission in people in 8 states: California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi and Arkansas.
Regular contact with kissing bugs is a big risk factor, said Dr. Sarah Hamer, a veterinary ecologist at Texas A&M University. One study from Latin America estimates that it typically takes about 900 to 4,000 kissing bug bites to become infected.
Almost every mammal, including dogs, can get Chagas disease, said Dr. Hamer. But your dog can’t infect you; it’s more of a sign that there are kissing bugs in the area, she added.
What are the signs and symptoms?
While many people might not even realize they’ve been bitten by a kissing bug, others may experience minor swelling, itching or an allergic reaction, Dr. Bern said.
In the days or weeks after being infected, Chagas disease can cause a fever, fatigue and other flulike symptoms, said Dr. Norman Beatty, an infectious diseases doctor at University of Florida Health. Some people also develop eyelid swelling. The symptoms, if present, usually resolve on their own.
Most people in the United States only get diagnosed if they go to donate blood, Dr. Bern said. Only about 1 percent of people infected with Chagas disease in the United States have been diagnosed.
About 70 percent of patients will have no long-term symptoms, but others can develop severe heart disease. Early symptoms can be subtle, such as an irregular heartbeat, but for some patients, the first sign of infection might be a stroke or even sudden cardiac death, Dr. Beatty said. There are two medicines that can kill the parasite and treat this disease, although they tend to work better if they are started soon after infection.
What precautions can you take?
Kissing bugs sometimes invade homes and can also be found in kennels and hunting lodges, since dogs, raccoons, possums and skunks are regularly infected, Dr. Hamer said.
To reduce the risk of the bugs getting into your home, consider installing window and door screens and sealing up any cracks in those screens or in your walls, Dr. Beatty said. It may also be worthwhile to talk to an exterminator if you have seen kissing bugs in or around your property. And clear out any nearby wood piles or other debris, since the bugs tend to congregate there, Dr. Hamer said.
If you manage to trap one, you can send it to Texas A&M University or, in some cases, your state health department to get it tested for the parasite, she added.
And if you have a family member who was diagnosed with Chagas disease, you should get tested, as the bugs are most likely in your home, Dr. Beatty said.
Women of childbearing age should be particularly aware, since Chagas disease can spread to a fetus but is not routinely tested for during prenatal care, Dr. Beatty said. If kissing bugs are in your area or if you’re worried, ask your doctor to get tested. The antiparasitic drugs are not safe to take during pregnancy, but a woman and her child can be successfully treated after delivery.
Simar Bajaj covers health and wellness.
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