Last updated: November 7, 2026. A study in the US Centers for Disease Control and Prevention (CDC) journal Emerging Infectious Diseases (September 2025) concluded that Chagas disease should now be classed as endemic in the United States. This guide is for information only — it is not medical advice. Always follow your doctor's guidance for diagnosis and treatment. Medical disclaimer: this article does not replace professional medical advice; seek a doctor promptly for any worrying symptom, and never stop or change prescribed medicines without a doctor's advice.

Chagas Disease Symptoms 2026: US Kissing Bug Guide & Home Care

Written by Fatima Nursing Care

Doctors call it the "silent killer" — a parasitic disease that can hide in the body for years without symptoms, then damage the heart. For decades, Chagas disease was thought of as a Latin American illness. Now a CDC study says it is endemic in the United States itself: human cases caught inside the country have been confirmed in eight states, kissing bugs carrying the parasite have been found in 32 states, and an estimated 300,000 people in the US are living with the infection — most of them without knowing it. Here are the Chagas disease symptoms to watch for, how the disease spreads, and how to protect your family.

What the CDC study found

• Human cases in 8 states: Infections caught inside the US (autochthonous cases) have been confirmed in California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi and Arkansas — most notably Texas. The study was published in the CDC journal Emerging Infectious Diseases in September 2025 (Beatty et al.).
• Kissing bugs in 32 states: Triatomine insects, known as kissing bugs, have been found across the southern half of the country and have been identified in 32 states. Eleven triatomine species have been found in the US.
• About 300,000 Americans infected: The CDC estimates that roughly 300,000 people in the United States are living with Chagas disease, the large majority without knowing they have it.
• Texas is the hotspot: The first known US case caught inside the country was an infant in Corpus Christi, Texas, in 1955. Between 2013 and 2023, Texas health authorities recorded 273 cases of Chagas disease, including about 50 people infected inside the state.
• Infected bugs are becoming more common: A University of Texas at El Paso study found that 88.5% of kissing bugs collected near homes along the US–Mexico border carried the parasite — up from 63.3% in a 2021 study.
• Most cases are never counted: Chagas disease is not a nationally notifiable disease in the US, so doctors are not required to report it in most states. Only eight states require reporting. The study authors say labelling the US as non-endemic has kept awareness and reporting low.

What is Chagas disease?

Chagas disease, also called American trypanosomiasis, is caused by a tiny parasite called Trypanosoma cruzi. It is spread mainly by triatomine bugs — blood-sucking insects known as kissing bugs because they often bite people on the face at night. The bugs do not pass the parasite on through the bite itself: they leave droppings near the bite, and the parasite enters the body when a person scratches the bite or rubs the droppings into the eyes or mouth. The disease can also pass from a mother to her baby during pregnancy, through a blood transfusion or an organ transplant, and rarely through food or drink contaminated with the parasite.

Worldwide, the World Health Organization estimates that 6 to 7 million people are infected, mostly in Latin America, where the disease is endemic in 21 countries. In the US it was long treated as an imported infection, brought in by people who had lived in Latin America. The new CDC study says that picture is out of date: the parasite is firmly established in US insects, wildlife, domestic animals and people — and the US should now be counted as an endemic country too.

Chagas disease symptoms — what to watch for

Chagas disease has two phases, and the symptoms are very different in each. Most people have no symptoms at all in the early phase, which is exactly why the disease is called a silent killer.

Acute phase (first weeks to months)

• Mild flu-like illness — fever, tiredness, body aches and headache
• Rash, loss of appetite, diarrhoea or vomiting
• Swollen glands (lymph nodes)
• Swelling where the bug bit (called a chagoma)
• Romana's sign — swelling of one eyelid, when the parasite enters through the eye
• Most people feel nothing at all — the acute phase often passes unnoticed

Chronic phase (years or decades later)

After the acute phase, the infection usually goes quiet for years. But in about 20 to 30 percent of infected people, the parasite slowly damages the heart or the digestive system, often 10 to 20 years after infection:

• Heart problems — the most serious outcome: an enlarged heart, irregular heartbeat, heart failure, chest pain, or sudden cardiac arrest
• Breathlessness and tiredness that get worse over time
• Swelling of the legs or abdomen from heart failure
• Digestive problems — difficulty swallowing or severe constipation, from an enlarged oesophagus or colon
• Dizziness or fainting from a slow or irregular heartbeat

Only a blood test done by a laboratory can confirm Chagas disease. If you have lived in or travelled to an area where kissing bugs are found — especially Texas, Arizona, California, Louisiana or Florida — and you develop unexplained heart problems, tell your doctor about the possible exposure. Early testing matters, because treatment works best when it is started early.

Can Chagas disease be treated?

Yes — but timing matters. The medicines benznidazole and nifurtimox work best when treatment starts in the acute phase, the first weeks after infection, and can cure the disease at that stage. In the chronic phase, the medicines are less effective at clearing the parasite, but a doctor may still prescribe them, and the heart or digestive complications need specialist care of their own. Only a doctor can decide the right treatment after proper testing — never take medicines for Chagas disease without a doctor's prescription.

There is no vaccine against Chagas disease. Prevention is the best protection, and it starts with keeping kissing bugs out of the home.

Prevention: keeping kissing bugs away

• Seal cracks and gaps in walls, roofs and around windows and doors — kissing bugs hide in cracks during the day and come out at night.
• Fit screens on windows and doors, and repair any holes.
• Clear woodpiles, rock piles and debris away from the house, and keep pet sleeping areas clean — bugs shelter near animals.
• Keep pets indoors at night where possible, and check their bedding.
• Do not sleep outdoors in areas where kissing bugs are known, or use a bed net if you must.
• Never crush a kissing bug with bare hands — use a container, and wash your hands well afterwards.
• Use insecticide around the home if bugs are a known problem, following the product instructions.
• Check blood donations: in the US, donated blood is screened for Chagas disease, which protects transfusion recipients.

Home care for someone living with chronic Chagas disease

People with chronic Chagas heart disease need steady, long-term care — and most of that care happens at home, between doctor visits:

• Watch symptoms every day — breathlessness, swelling, tiredness and heartbeat changes — and keep a simple record to share with the doctor.
• Keep medicines on schedule exactly as the doctor prescribed, and never stop heart medicines without a doctor's advice.
• Help with daily living — bathing, dressing and meals — when heart failure makes these tiring.
• Limit salt and fluids only as the doctor advises, and weigh daily if the doctor has asked for it.
• Spot warning signs early — new swelling, sudden weight gain, worse breathlessness, or fainting — and contact the doctor promptly.

A trained home nurse can take over the watching — checking symptoms through the day and night, helping with medicines and daily care, and spotting the early warning signs that need a doctor — with the doctor directing the care plan. This matters most for elderly patients and for families living abroad who want a loved one with a heart condition looked after at home.

Frequently Asked Questions

What are Chagas disease symptoms?

In the first weeks after infection, Chagas disease symptoms are often mild or absent: fever, tiredness, body aches, headache, rash, loss of appetite, diarrhoea or vomiting, and swollen glands. Some people get a swollen eyelid (Romana's sign) or swelling where the bug bit. Years later, about 20 to 30 percent of infected people develop serious heart problems or digestive problems. Only a blood test done by a laboratory can confirm Chagas disease.

What is Chagas disease and how do you get it?

Chagas disease, also called American trypanosomiasis, is caused by the parasite Trypanosoma cruzi. It is spread mainly by triatomine bugs, known as kissing bugs, when their droppings get into a bite wound or the eyes or mouth. It can also pass from mother to baby during pregnancy, through blood transfusion or organ transplant, and rarely through contaminated food or drink.

Is Chagas disease now endemic in the United States?

A study in the CDC journal Emerging Infectious Diseases (September 2025) concluded there is enough evidence to call Chagas disease endemic in the United States. Human cases caught inside the country have been confirmed in eight states — California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi and Arkansas — most notably Texas. Kissing bugs carrying the parasite have been found in 32 states, and about 300,000 people in the US are estimated to be living with the infection.

Can Chagas disease be cured?

Treatment with the medicines benznidazole or nifurtimox works best when it is started early, in the first weeks after infection, and can cure the disease. In the chronic phase the medicines are less effective at clearing the parasite, but a doctor may still prescribe them, and heart or digestive complications need specialist care. Only a doctor can decide the right treatment after proper testing.

How can home care help someone living with chronic Chagas disease?

People with chronic Chagas heart disease need steady, long-term care at home: monitoring symptoms such as breathlessness, swelling and tiredness, keeping medicines on schedule as the doctor prescribed, and spotting warning signs early. A trained home nurse can watch for these changes day and night and help the family follow the doctor's care plan. WhatsApp +92 308 3688218 to arrange home nursing care.

Medical Disclaimer

This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Chagas disease can be serious, especially when it affects the heart — about 20 to 30 percent of infected people develop heart or digestive complications over time. Always seek the advice of a qualified doctor with any questions about a medical condition, and never disregard professional medical advice or delay seeking it because of something you have read here. If you develop breathlessness, chest pain, palpitations, swelling or fainting, seek medical attention promptly.