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Chagas Disease (Kissing Bug Disease): Causes, Symptoms, + Prevention

By  InHouse Physicians  ·  2 minute read

Chagas disease, also known as American trypanosomiasis or kissing bug disease, is a parasitic illness that affects more than 7 million people worldwide,  mostly in Latin America. It is caused by the protozoan parasite Trypanosoma cruzi and is transmitted primarily through the bite of the triatomine insect, also known as the “kissing bug”. 

Once thought to be confined to rural areas of Latin America, Chagas is now recognized as a global issue. Increased travel, migration, and urbanization have led to cases being identified in 44 countries, including the United States, Canada, and several European nations. 

How Chagas Disease Spreads (Transmission of Kissing Bug Disease)

The primary method of transmission is vector-borne: kissing bugs feed on human or animal blood and defecate near the bite site, allowing the parasite to enter the body when a person scratches or rubs the area. Other transmission routes include:

  • Oral: contaminated food or beverages

  • Congenital: during pregnancy or birth

  • Blood and organ donation

  • Laboratory exposure 

In the U.S., infected bugs have been found in 32 states, with human cases reported in eight states—Texas, California, Arizona, Louisiana, Tennessee, Missouri, Mississippi, and Arkansas. Wildlife and domestic dogs have also tested positive in multiple states, raising concerns about the broader ecological circulation of the parasite.

Chagas Disease Symptoms and Long-Term Health Risks

Chagas disease symptoms occur in two phases:

  • Acute phase: Lasts up to two months. Symptoms are often mild or absent but may include fever, fatigue, rash, and swelling near the eye (Romaña’s sign). Other symptoms can include headaches, body aches, or digestive discomfort.

  • Chronic phase: Parasites lodge in the heart and digestive tissue. Years or decades later, up to one-third of patients develop cardiac complications (arrhythmias, heart failure, sudden death), while about 1 in 10 develop digestive or neurological complications.

Because the infection can remain silent for years, many patients are unaware until severe cardiac issues emerge.

Treatment for Chagas Disease

Antiparasitic medications, such as benznidazole and nifurtimox, are highly effective in curing Chagas if given early, including in congenital cases. Their effectiveness declines the longer someone has been infected, and side effects are more common in adults. For chronic cases, treatment can help slow disease progression and prevent transmission.

For patients with advanced complications, long-term monitoring and care for heart, digestive, or neurological conditions is often required. 

Chagas Disease Prevention and Control

There is currently no vaccine against Chagas. Preventive strategies focus on reducing contact with kissing bugs and improving screening. WHO recommends:

  • Spraying insecticides in homes and surrounding areas

  • Improving housing to prevent bug infestations

  • Screening blood donors, organ donors, and pregnant women

  • Promoting safe food practices and hygiene

  • Raising awareness among clinicians and communities

In the U.S., simple precautions like sealing windows, reducing outdoor woodpiles or debris, and using insect repellent can reduce the risk of exposure. 

Chagas Disease in the U.S.: Emerging Concern

Although the CDC and WHO currently classify the U.S. as “non-endemic,” research points to increasing evidence of local transmission.

A 2016 study estimated that as many as 300,000 people in the U.S. may already be infected, many unknowingly. Experts warn that low awareness and inconsistent reporting are limiting public health responses.

As one researcher put it, documented U.S. cases may be “just the tip of the iceberg”.

Why Awareness Matters for Global Health

World Chagas Disease Day, observed on April 14, is a reminder of how overlooked conditions can become serious public health challenges without early recognition. Strengthening surveillance, improving access to diagnosis and treatment, and training healthcare providers are all essential steps toward reducing the burden of this neglected tropical disease.

At InHouse Physicians, we understand the importance of global health awareness, including emerging conditions like Chagas disease. While rare in the U.S., kissing bug disease can affect international populations and mobile workforces. By staying informed about Chagas disease prevention and treatment, healthcare providers, employers, and event organizers can better protect individuals wherever they live, work, or travel.