Triatomines, affectionately known as "kissing bugs," have made headlines lately. According to U.S. health officials, disease caused by these insects is on the rise, and in the long term can be quite serious. Known as Chagas disease,1,2 the infection is contracted through a bite from a triatomine, a nocturnal insect that crawls around on your face while you're sleeping.

It will typically bite around the lips or eyes - hence the nickname "kissing bug." Most people report they did not feel the bite. Like other bloodsucking insects, the triatomine sucks your blood. It then deposits parasite-infested feces near or into the open wound.

The parasite responsible for the disease, Trypanosoma cruzi, lives in the bug's digestive system, and researchers have found between 503 and 64 percent4 of triatomines tested are infected with this parasite.

Chagas Prevalence on the Rise

According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 300,000 Americans have Chagas disease,5 including 40,000 pregnant women,6 and prevalence is believed to be on the rise. The disease was initially reported in Texas in 2010, but has since been identified in 28 states.7

Chagas disease has also been identified in Spain, Italy, France, Switzerland, Australia, Japan and the U.K.8 Bolivia is thought to have the highest Chagas prevalence in the world.9 Globally, Chagas disease is thought to be responsible for 10,000 deaths each year.

In South and Central America - where Chagas disease is most prevalent - an estimated 12 million people are infected,10 and while it is not transmissible via person-to-person contact, you can contract it via blood transfusion, organ transplantation and/or eating food in which the insect has defecated.

Disturbingly, a 2014 study revealed 1 in 6,500 blood donors tested positive for Trypanosoma cruzi, the parasite responsible for Chagas. In April 2010, the U.S. Food and Drug Administration approved two screening tests to screen blood, tissue and organ donations for the presence of Trypanosoma cruzi antibodies11 to prevent the spread of the disease.

An infected mother can also transmit Chagas to her unborn child. As reported by The Charlotte Observer:12
Chagas often has no symptoms at first, according to the CDC, but it can lurk in the body for years and eventually cause serious problems such as an enlarged heart, enlarged colon, heart attacks and more ...

'Chagas disease causes early mortality and substantial disability, which often occurs in the most productive population, young adults, (and) results in a significant economic loss,' a medical representative from the American Heart Association said ...
What to Do if You Find a Kissing Bug or Believe You've Been Bitten by One

So far, 11 species of triatomines have been identified in the U.S.13 The most common are Triatoma sanguisuga and Triatoma gerstaeckeri, both of which measure about 1 inch in length. You can find photos to help with identification on the Texas A&M University website.14

Should you find a bug suspected of being a triatomine, you can send it to the Texas A&M University research team for inspection. The form and instructions can be found here. Details you need to provide include:
  • The location of where it was found
  • The date and time of day you found the bug
  • Whether the bug was alive or dead when you found it
  • What the bug was doing when you found it
The bug tends to hide out in crevices in the home during the day and only come out at night. If traveling, avoid sleeping in rooms with unplastered adobe walls, as this provides an excellent hiding place for the little critters.

If you believe you've been bitten by a kissing bug, whether you've found the bug or not, seek medical attention and let them know you suspect having been bitten by a triatomine.

If your health provider is unfamiliar with Chagas, they should contact their state health department and/or CDC.15 Treatment, which involves unapproved experimental drugs to kill the parasitic infection (which is why you can only receive treatment after approval by the CDC), is most effective when implemented during the early, acute phase.

The antiparasitic drugs used are not harmless, however. As so many others, they come with a list of side effects, ranging from insomnia and nausea to peripheral neuropathy and anorexia.16

At present, there is no known effective treatment for the later stages of the disease. In one study,17 treatment with the antiparasitic benznidazole had no impact on reducing cardiac complications from Chagas, even though the medication lowered levels of the parasite in the patients' blood.

Acute and Chronic Phases of Chagas

Triatomines can spread Chagas disease to humans and animals alike. In humans, the disease has two manifestation phases: an acute phase, which can last for a few weeks or months, and a chronic phase, which can manifest up to two decades later. While many have no symptoms at all during the acute phase, some may experience:
  • Fever
  • Fatigue
  • Body aches
  • Headache
  • Skin rash
  • Loss of appetite
  • Diarrhea
  • Vomiting
  • Mild liver or spleen enlargement
  • Swollen glands
  • Local swelling
  • Romana's sign (swelling on the eyelid near the bite, or where fecal matter was rubbed into your eye)
As for the chronic phase, Texas A&M explains:
Of those who are infected with the parasite, approximately 30 percent are at risk of developing chronic Chagas disease. Chronic Chagas disease includes cardiac complications and/or intestinal complications, and these signs may not be apparent until decades after the initial infection.

Cardiac signs include enlarged heart, heart failure, altered heart rate, and/or cardiac arrest. Intestinal signs include an enlarged esophagus or colon, which can cause difficulties with digestion.

Concerned individuals should discuss testing options with their physicians. Treatment of Chagas disease can be difficult, and drugs are available only through the CDC after consultation with a physician.
Lyme Disease Is a Much Greater Concern

While all of this may sound disconcerting, Chagas disease is not as common as Lyme disease, with which 300,000 Americans are diagnosed each year.18,19 This disease, originally identified in Lyme, Connecticut, in 1975, has now spread across every state in the U.S.20

The black-legged tick (Ixodes scapularis, also known as the deer tick) was linked to transmission of the disease in 1977, and while some still attribute transmission exclusively to ticks, the bacteria can also be spread by other insects, including mosquitoes, spiders, fleas and mites.

In 1982, Willy Burgdorfer, Ph.D., identified the bacterium responsible for the infection: Borrelia burgdorferi21 - a cousin to the spirochete bacterium that causes syphilis. Since then, five subspecies and 300 strains of B. burgdorferi have been identified, many of which have developed resistance to our various antibiotics.

Like Chagas, symptoms of Lyme disease often start with unrelenting fatigue, recurring fever, headaches and achy muscles or joints. Over time, these symptoms may progress to muscle spasms, loss of motor coordination and/or intermittent paralysis, meningitis or heart problems.22,23

Diseases such as Parkinson's, multiple sclerosis, cardiomyopathy, gastritis and chronic fatigue may also be expressions of chronic Lyme disease. Unfortunately, there's no simple way to diagnose Lyme.

It's also known as "the great imitator,"24 due to its ability to mimic many other disorders, including multiple sclerosis, arthritis, chronic fatigue syndrome, fibromyalgia, ALS, ADHD and Alzheimer's disease. As a result, misdiagnosis is very common. Negative test results are also more the norm than the exception when you have Lyme, as the spirochete has the ability to infect your white blood cells.

Diagnosing and Treating Lyme Disease

The reason blood tests are so unreliable for diagnosing Lyme is because the tests rely on the normal function of white cells, but when these cells are infected with Lyme, they lose the ability to produce antibodies. Hence, nothing shows up on the test. This is known as the "Lyme paradox," and necessitates putting treatment before diagnosis.

The idea is that by treating the infection, your white blood cells will regain their ability to mount a normal immune response, which can then be picked up by blood tests. For more in-depth information about Lyme disease and its treatment, I recommend listening to my previous interview with Lyme expert Dr. Dietrich Klinghardt.

According to Klinghardt, the IGeneX Lab in Palo Alto is the gold standard for Lyme testing, as they use two different antigens in their testing. There's also a useful indirect test called the CD57 test.

"CD-57" is a specific group of natural killer cells that are particularly damaged by the Lyme spirochetes. Therefore, if your numbers drop to a certain level, it is an indirect indicator that you may have Lyme disease, because the only known infection to suppress CD57 is that of B. burgdorferi.

Lyme and Chagas Prevention Tips

Whether we're talking about Chagas or Lyme, prevention is key, considering the difficulty of treatment. As mentioned, triatomine bites typically occur at night, while you're sleeping, and the bug gains access to your body at night by hiding in crevices in the walls.

Adobe-style walls are known to be more likely to harbor the insect. Sleeping outdoors in a tent or rustic accommodations may also raise your risk of being bitten. Lyme-bearing tick bites, on the other hand, typically occur outdoors, so commonsense prevention strategies for Lyme disease include:25
  • Avoid tick-infested areas such as leaf piles around trees. Walk in the middle of trails and avoid brushing against long grasses on path edgings. Don't sit on logs or wooden stumps, and avoid setting up camp or pitching a tent in areas covered with leaves
  • Wear light-colored long pants and long sleeves to make it easier to see the ticks. Tuck your pants into socks and wear closed shoes and a hat, especially if venturing out into wooded areas. Also tuck your shirt into your pants, and wear gardening gloves when gardening or working in the brush
  • Ticks, especially nymphal ticks, are very tiny. You want to find and remove them before they bite, so do a thorough tick check upon returning inside, and keep checking for several days following exposure. Also check your bedding for several days following exposure
  • If you find that a tick has latched onto you, it's very important to remove it properly. For detailed instructions, please see's Tick Removal page.26 Once removed, make sure you save the tick so that it can be tested for presence of pathogenic organisms
  • Your pets can become a host for ticks and may also become infected with Lyme disease, so be sure to check their fur and collars
Essential Oils May be a Safer Bet for Lyme and Chagas Vectors Alike Than Toxic Insect Repellents

As for using chemical repellents for either of these bugs, I do not recommend using them directly on your skin as this will introduce toxins directly into your body. If you use them, spray them on the outside of your clothes, taking care to avoid inhaling the spray fumes. I recommend avoiding insect repellent containing N,N-Diethyl-m-toluamide, also known as DEET, as it is a known neurotoxin.

According to a study27 published in February 2018, essential oils from the South American plants Azorella trifurcata,28 Senecio oreophyton J. Remy29 and Senecio pogonias Cabrera30 effectively repelled the Chagas vector Triatoma infestans.31 All three essential oils provided between 60 and 70 percent protection at 24 hours compared to DEET.

Similarly, oil of lemon eucalyptus has been found to keep ticks and mosquitoes at bay for at least seven hours. You can read more about this in "This Natural Bug Repellent Works Better Than DEET."

Sources and References