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They may have a harmless-sounding name, but don’t let that fool you. Kissing bugs, also known as triatomine bugs, can carry the parasite Trypanosoma cruzi, which causes Chagas disease (kissing bug disease).

Chagas disease is less common in the United States than in Mexico, Central America, and South America. However, the insect has infected more than 280,000 Americans with it, according to the Centers for Disease Control and Prevention (CDC). Eight states have locally acquired Chagas disease cases.

Kissing bugs have appeared in more than 30 states, including Pennsylvania, Maryland, Ohio, and West Virginia.

There’s no vaccine for Chagas disease, so the best way to prevent it is to protect yourself from kissing bugs. Learn about kissing bug safety for kids and adults, including how to protect yourself at home and while traveling.

What Is Chagas Disease?

Chagas disease, also known as kissing bug disease, is an illness caused by the parasite Trypanosoma cruzi. It can cause both short-term and long-term symptoms, some of which are life-threatening.

About 8 million people worldwide have Chagas disease. It’s most common in Central America, Mexico, and South America. In the United States, it’s most common in Southern states.

How Does Chagas Disease Spread?

Kissing bug disease typically spreads through the urine or feces of infected triatomine bugs. These bugs feed on the blood of humans and animals, including wild animals and pets.

When a kissing bug bites you, it urinates or defecates near the wound. People may inadvertently sweep the infected feces or urine into the open wound, their eyes, or their mouth, which can lead to infection.

In rare situations, Chagas disease can spread through:

• Blood transfusions with infected blood.
• Childbirth, from an infected mother to the child.
• Eating or drinking contaminated products.
• Lab accidents.
• Organ transplants involving infected donor organs.

What Do Kissing Bugs Look Like?

The CDC has identified 11 species of triatomine bugs in the United States.

Common characteristics include:

• A cone-shaped head.
• Black or dark brown color, sometimes with red, yellow, or orange markings.
• Typical length of about 0.75 inches to 1 inch.

Similar to stink bugs, adult kissing bugs may emit an odor when agitated. However, stink bugs have a shorter head, look shield-shaped, and are typically light-black, gray, or brown in color.

Where Can You Find Kissing Bugs?

Kissing bugs are most common in rural areas.

They can live in various cracks and crevices, including:

• Among brush, rock, or wood piles.
• Beneath porches.
• In attics or crawl spaces.
• In outdoor animal locations, such as doghouses or animal burrows.

Kissing bugs typically feed at night. Porch lights may attract them to your house, which they can enter through small openings. They’re typically most active in the summer.

How to Keep Kissing Bugs Out of Your House

Because there’s no Chagas disease vaccine, home pest control is the most effective protection.

Here are some kissing bug prevention tips you can try at home:

• Avoid outdoor clutter — Remove any piles of brush, rocks, or wood around your home. Kissing bugs can congregate in these areas.
• Fix cracks and gaps — Kissing bugs can enter your home through tiny cracks and crevices. Seal any gaps you find at home entry points, such as windows, walls, roofs, doors, attics, and crawl spaces. Use screens on your windows and doors. Ensure they have no holes or tears in them.
• Keep outdoor lights away from your house — Place lights away from your house and doghouses, if possible. If you have any porch lights, keep them off after dark. Consider using bulbs that emit yellow or orange light, rather than white, blue, or black.
• Let pets sleep indoors — Kissing bugs can bite dogs or cats, potentially infecting them. They can also live in outdoor dog houses and kennels. Keeping pets indoors at night, when triatomine bugs are most active, is an important kissing bug disease prevention practice for families with pets.
• Regularly clean your home — Vacuum areas indoors where kissing bugs may congregate. These can include carpeting, mattresses, baseboards, underneath bedroom furniture, and pet areas. Wash your sheets and blankets in hot water.
• Use natural repellents — Many essential oils can work as natural insect repellents. You can spray essential oils around and inside your home, or even use them as natural bug sprays. Just make sure you’ve properly diluted them. Examples of essential oils that may prove effective against kissing bugs include cinnamon, citronella, eucalyptus, lavender, mint, and neem. Because essential oils are sometimes volatile, you can also consider spraying a solution of vinegar and water around your home. Its odor can repel kissing bugs.

The CDC recommends consulting a pest control expert before using insecticides. There are no specific insecticides approved for treating kissing bugs in the United States. A pest control expert can evaluate your home and apply recommended insecticides to keep kissing bugs out.

What to do if you find a kissing bug in your home

According to the National Pesticide Information Center (NPIC), you should avoid touching any kissing bugs you find in your home. The NPIC recommends capturing the bug in a plastic bag or jar and freezing it until someone can identify it.

Preventing Kissing Bug Disease When Traveling

The kissing bugs that cause Chagas disease are most common in Central America, Mexico, and South America. In the United States, they’re most common in Southern states.

The CDC recommends the following tips to protect yourself from these parasite-carrying bugs if you’re traveling to areas where they’re common:

• Avoid staying in poorly built structures — Opt for hotels and homes that are well-built, such as those with screens on their windows and doors and without visible cracks.
• Cover your skin — Wear long sleeves and pants, and apply insect repellent with DEET to any exposed skin. This is especially important at night.
• Don’t eat potentially contaminated food — The CDC recommends avoiding raw vegetables and unpeeled fruits, salads, and unpasteurized fruit juice.
• Use bed nets — When sleeping, use insecticide-treated nets.

What Are the Symptoms of Chagas Disease?

Chagas disease has three stages: acute, indeterminate, and chronic. The acute stage can last about two months.

Symptoms are generally mild and include:

• Abdominal or chest pain.
• Body or muscle aches.
• Fatigue.
• Fever.
• Headache.
• Loss of appetite.
• Rash.
• Romaña’s sign (purplish swelling around the eyelids).

Chronic kissing bug disease can last for years, or even the rest of someone’s life.

In the indeterminate stage, patients have chronic infection with positive serology tests, but no symptoms or signs. This can last for decades. Most people don’t have symptoms during the chronic phase.

About one third of people with the indeterminate form progress to chronic Chagas disease with either cardiovascular or gastrointestinal problems, including:

• Abnormal heart rate.
• Constipation.
• Difficulty swallowing.
• Enlarged heart.
• Heart failure.
• Sudden cardiac death.

How to Identify a Kissing Bug Bite

Determining whether you’ve been bitten by a kissing bug and have Chagas disease isn’t always easy. Symptoms during the acute phase are similar to those of other illnesses.

If you’ve recently traveled to an area where Chagas disease is common and are experiencing symptoms, call your doctor.

Doctors can diagnose Chagas disease with blood tests that identify T. cruzi.

Can You Get Treatment for Kissing Bug Disease?

The U.S. Food and Drug Administration (FDA) has approved two antiparasitic treatments for Chagas disease:

• Benznidazole — Approved for use in children ages 2 to 12.
• Nifurtimox (Lampit^®) — Approved for use in children from birth to 18 years of age.

Use of benznidazole and nifurtimox in other age groups than specified is off label. Treatment can often occur after consultation with experts at the CDC.

Without proper evaluation and treatment, Chagas disease can progress as follows:

• If you take antiparasitic medications during the acute phase of Chagas disease, they can help cure the illness.
• If you take them during the chronic phase, they can’t cure the disease, but they may slow its progression.

Other Chagas disease treatments focus on symptom management.

Should I Worry About Kissing Bug Disease?

Your risk of Chagas disease depends mainly on your exposure to parasite-carrying triatomine bugs. The CDC considers kissing bug disease endemic in the United States, with the greatest risk in the Southern states. The disease is most common in Central America, South America, and Mexico.

To lower the risk of Chagas disease for you and your family, take steps to prevent exposure to kissing bugs at home and while traveling. If you’re experiencing symptoms and have recently traveled to an area where Chagas disease is common, call your doctor.