Triatomines are bugs with a cute nickname and some nasty, potentially deadly habits.
Known as the “kissing bug,”
There have also been recent reports of the insects showing up in states where they aren’t all that common.
The “kisses” they give are actually bites. The bugs are blood suckers that tend to bite people on the face and around the mouth.
And when they do, they poop. And sometimes that poop gets ingested by their victims.
It’s gross and also potentially dangerous.
Some triatomines carry in their feces a parasite called Trypanosoma cruzi, which causes Chagas disease. That ailment can have serious long-term health consequences if untreated.
Experts stress, however, that the risk of Chagas infection remains low.
Not every kissing bug carries the parasite. And even if you are bitten by an infected bug, odds are you still won’t be infected.
That’s because the bite itself doesn’t transmit the disease.
The parasite usually only enters the body when triatomine feces is rubbed into fresh bite locations, other breaks in the skin, or through mucous membranes like those in the eyes or mouth.
Chagas disease can also be transmitted in several other ways, including via blood transfusions, organ transplants, from infected pregnant women to their babies, and by consuming uncooked food that’s contaminated with triatomine feces. But these cases are rare.
A recent report from the Centers for Disease Control and Prevention (CDC) casts new attention on the kissing bugs.
Epidemiologists reported the first-ever documented case of a kissing bug bite in the state of Delaware, although the young victim tested negative for Chagas disease.
That doesn’t mean kissing bugs — or the disease — are becoming more common.
“According to the CDC, the bugs were first reported in the state of Georgia in 1855 and have been reported in many states across the southern United States ever since,” Paula Eggers, RN, an infectious disease epidemiologist for the Delaware Division of Public Health, told Healthline.
“There is no evidence to suggest that the bugs are increasing in number or spreading. Rather, increased awareness about the bugs and about Chagas disease likely has resulted in an increase of bugs recognized as or thought to be triatomines,” she said.
“It’s not an emerging disease, just a neglected disease,” Paula Stigler-Granados, PhD, an assistant professor at the Texas State University School of Health Administration and leader of the Texas Chagas Task Force, told Healthline. “The biggest struggle we have is getting healthcare providers to diagnose and treat the disease.”
In Texas, the Chagas Task Force was convened after officials at Lackland Air Force Base reported that dogs on the base were getting infected and dying from Chagas disease.
That sparked concern that the disease could be quietly spreading among the human population as well.
Researchers subsequently discovered that 60 to 70 percent of the triatomine bugs collected in Texas were infected with Trypanosoma cruzi, the parasite that causes Chagas disease.
Stigler-Granados said veterinarians are more aware of Chagas disease than medical doctors. In the United States, dogs are far more at risk of being bitten by kissing bugs than people.
“Dogs sleep outside. They eat the bugs,” she said. “They’re an easy blood meal.”
People, by contrast, don’t face as high a danger.
“The risk is low because in most places we have pretty good housing conditions and we don’t sleep outside,” Stigler-Granados said.
Both triatomines and Chagas disease are more common in Mexico, Central America, and South America than in the United States.
There are also an estimated 300,000 people living in the United States who carry the disease, but only a handful of cases of Chagas transmission have been reported in the States. Most people from the United States were infected in other countries.
“Honestly, we really don’t see this disease,” Dr. Gary Procop, a pathologist associated with the Cleveland Clinic in Ohio and past chair of the College of American Pathologists Microbiology Resource Committee, told Healthline. “We’ve always looked at it as a ‘south of the border’ disease.”
However, as more people infected with Chagas disease move into the United States, the disease could spread, said Procop.
Immediately after infection, Chagas can cause fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, vomiting, and — when triatomine feces is accidentally rubbed in the eye — a swelling of the eyelid called Romaña’s sign.
In the long term, Chagas disease can cause cardiac problems such as an enlarged heart, heart failure, altered heart rate or rhythm, and cardiac arrest.
There can also be gastrointestinal complications such as an enlarged esophagus or colon.
Chagas infections often occur during childhood. Because the disease often doesn’t cause acute symptoms, most people who have Chagas don’t know they’re infected.
If detected, the disease can be treated using an anti-parasitic drug called benznidazole.
Kissing bugs can live indoors or outdoors.
They often live in cracks and holes in substandard housing, in bedrooms, near pet sleeping areas, and in rodent nests or burrows.
But a few basic preventive steps can reduce your odds of being “kissed” by a triatomine.
Homeowners should seal cracks or gaps in walls, windows, doors, and chimneys to prevent bugs from entering the house.
Don’t let pets sleep outside and keep their bedding area clean.
Keep outdoor lights, which attract bugs, away from the house.
And clean up any debris near the house that could potentially serve as a nest for kissing bugs.
“Triatomines will take a blood meal wherever they can get one — people, dogs, rats, snakes, you name it,” said Stigler-Granados. “So it’s important to know what they look like to keep them away from your house.”
Procop advises people living in areas with greater triatomine populations not to ignore an unusual bug bite.
“I definitely would get tested if I was in Texas and I had a kissing bug bite,” he said.
“Chagas disease would not be on my worry-about list, especially compared to diseases like influenza and the measles,” said Procop. “It’s something to keep an eye on, but every time we draw blood from patients with suspected blood parasites we look for this pathogen, and we never find it.”
That said, Stigler-Granados cautioned that more research is needed to determine just how prevalent Chagas disease is.
“It may not be that common a disease, but we also don’t know how uncommon it is,” she said.