Oct. 1, 2025 — If you recently learned about “kissing bug” disease, you’re not alone.
The parasitic infection — which is actually called Chagas disease but earned the nickname because it’s spread by so-called kissing bugs, or triatomine bugs — drew public attention recently after a new CDC report suggested it is now endemic in the U.S. (a significant upgrade from its previous status of “nobody knows what this is”).
Is it really a big deal? Experts say the risk is low. But it’s smart to keep your antennae up, especially if you live in a southern state and spend time outdoors. That’s because of another little-publicized fact: The infection can lurk silently for decades before leading to serious (even deadly) complications like heart failure or an enlarged colon.
Unlike more common insect-borne diseases, like Lyme disease and West Nile virus, Chagas isn’t required by law to be reported to health authorities, meaning it’s very likely undercounted in the United States. Research suggests that less than 1% of people infected in the U.S. get testing and treatment.
That matters because treatment can head off those serious problems. “Early intervention can either prevent or halt the progression of Chagas disease,” said Norman Beatty, MD, associate professor of medicine at the University of Florida College of Medicine and a co-author of the CDC report.
Here’s how to know if you might be at risk — or already infected.
Why You May Have Chagas Disease and Not Know It
Chagas disease is an infection from the parasite Trypanosoma cruzi — carried by kissing bugs, which are more prevalent in Latin America (South America, Mexico, and Central America) but also found in the southern United States.
Estimates suggest that about 300,000 people in the U.S. are infected with Chagas, and most caught it abroad. Just 29 confirmed and 47 suspected human Chagas infections were acquired in the U.S. from 2000 to 2018, in California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi, and Arkansas. But experts say the actual U.S.-originating cases may be higher — closer to 10,000, some estimates show.
Early symptoms, such as fatigue and achiness, are easy to miss — and often there are no symptoms. “Most people who have the infection never become symptomatic,” said Caryn Bern, MD, MPH, professor of epidemiology and biostatistics at the University of California, San Francisco. The infection is treatable with antiparasitic medication. But if left untreated, it lasts for life.
Unchecked inflammation from the disease can lead to serious outcomes. Studies show that 30% of people with untreated infections develop heart problems, such as heart failure or sudden cardiac death. About 15% to 20% develop digestive complications, such as an enlarged colon (which can lead to severe constipation and blockages requiring surgery) or a swollen esophagus, causing reflux and pain while swallowing. Another 5% develop neurologic complications, such as nerve damage marked by numbness and tingling in the hands and feet. Some may develop more than one complication.
How Does It Spread?
Kissing bugs spread the parasite by defecating while feeding on your blood, often near your mouth and while you sleep.
“They clear out their gut when they’re taking the blood so they can take a bigger blood meal,” said Bern. “When the person then wakes up, they may scratch where the bite wound is and inoculate the feces into the bite wound or the eye.” The parasite then invades cells, multiplies, and enters the bloodstream. In the U.S., a little more than half of kissing bugs carry the parasite that causes Chagas, according to Texas A&M University, which has a lab that tests bugs from all over the country.
Human-to-human transmission is possible — babies can acquire the infection from their mothers through the placenta during pregnancy, and transplant or transfusion recipients could be exposed through infected donor organs or blood. In the U.S., blood donations are screened for Chagas to prevent that.
The disease can also spread through contaminated food or water, though this is rare in the U.S.
Are You at Risk for Chagas Disease?
“If you are living in a rural area, in a state where they might have seen more cases, and you are in proximity with the vector, it’s something for you to keep in mind,” said infectious disease specialist Andrés Henao, MD, PhD, associate professor of medicine at the University of Colorado.
These are the states where Chagas has been reported or kissing bugs have been found:
If you live in one of these states, you could be at risk if you:
- Have seen kissing bugs in or around your home. They tend to hide in cracks, crevices, and outdoor shelters. Spotting them — especially indoors — is a warning sign.
- Live in housing with gaps, cracks, or other structural issues that allow bugs to enter. These can include homes with adobe, mud, or thatch construction (common in rural Latin America and can be found in the U.S.) or older homes with worn foundations or torn window screens.
- Live in a rural area, especially on a farm or ranch or near dog kennels. Kissing bugs may feed on domestic or wild animals, increasing your potential exposure.
- Regularly camp, hike, or spend time outdoors in regions where kissing bugs are known to live. Staying overnight in infested areas can increase the chances of being bitten.
Should You Get Tested?
Chagas disease can be detected with a simple blood draw. Experts recommend asking your doctor for tests if:
- You’ve seen kissing bugs in your home or have been bitten by one. Take a picture of the bug or, without touching it, place it in a sealable plastic bag. Contact your local university extension office — many offer bug identification or testing. Talk to a pest control expert to prevent further exposure.
- You donated blood and received a letter indicating you are infected with Chagas. Call your doctor for a blood test to confirm the results. Two blood tests are recommended to diagnose chronic Chagas because no single test is sensitive and specific enough to be reliable on its own.
- A close family member has been diagnosed with Chagas disease. You might have been exposed to the same infected bugs, especially if you share a residence in a region with infections.
- You were born in, lived in, or traveled for six months or more in areas of Mexico, Central America, or South America with Chagas disease. This is especially important if you’re a woman of childbearing age (or the adult child of a mother who lived there while pregnant).
If you test positive for Chagas disease (expect results in one to two weeks), your doctor will prescribe antiparasitic medications and may order an electrocardiogram to check your heart for early signs of damage.
Need more help? Visit uschagasnetwork.org to find a clinician knowledgeable about the disease. “Most physicians have no experience with Chagas disease, so the first step is to make sure the physician feels comfortable managing this,” said Bern.