A Delaware girl was bitten on the face by a "kissing bug" in July, the Centers for Disease Control and Prevention confirmed last week, but what do you need to know about the insects that carry a potentially fatal disease?
Chagas disease is caused by the parasite Trypanosoma cruzi. Triatomine bugs carry it and can infect humans with their bite, the CDC says.
Chagas is found only in the Americas, and mainly rural parts of Latin America, the CDC says. While triatomine bugs are in the United States, only a few cases of Chagas disease from contact with the bugs in the US have been confirmed, health officials say.
Here's what you need to know:
What are 'kissing bugs' and how do you get Chagas disease?
Triatomine bugs get their nickname "kissing bugs" because they often bite people's face, the CDC says.
However, being bitten does not mean you'll get Chagas as the CDC says transmission is "not easy."
Triatomine bugs often ingest, or "suck," people's blood after they bite, and then defecate on the person. If their feces infected with the parasite T. cruzi enter the body, that's when infection can occur, according to the CDC.
In many cases, the bugs hide in cracks and corners in homes and often emerge overnight. When a bug bites then defecates on a sleeping person, they may unknowingly rub the feces into the bite or their eyes or mouth, per the CDC.
In the recent sighting in Delaware, the girl was bitten as she watched TV in her room.
The family lived in an older single-family home near a heavily wooded area, and there was an air conditioner in the window of the girl's bedroom, the CDC said.
The girl did not get sick, health officials said.
The disease can also be spread from congenital transmission, such as a pregnant woman to her baby, blood transfusion, organ donation or eating contaminated foods.
How widespread are 'kissing bugs' with Chagas and T. cruzi?
More than 300,000 people in the United States have T. cruzi infections, the CDC estimates. Most were infected in Latin America.
Triatomine bugs are found mostly in the southern United States and 11 species have confirmed sightings.
In September, the CDC warned that the deadly bloodsuckers were on the move up from Central and South America and had been reported in Maryland, Pennsylvania and Virginia.
How do I know if I have Chagas disease?
Acute Chagas is diagnosed through a blood test.
A few weeks or months after infection, a person may have no or mild symptoms, including fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea and vomiting, the CDC says.
However, those symptoms often are associated with other common diseases, and many people with Chagas do not suspect it, per the CDC.
Other symptoms can include mild enlargement of the liver or spleen, swollen glands, or swelling at the site of the bite.
Romaña's sign, swelling of the eyelid, is also an indicator and occurs when the infected feces is rubbed into a person's eye.
Young children with Chagas can also get severe inflammation and heart muscle or brain infections, which can be fatal, though it is rare, the CDC says. People with weakened immune systems, such as those with HIV or taking chemotherapy, are also at an increased risk.
Chronic Chagas can last a lifetime and many don't have symptoms. However, cardiac and gastrointestinal complications, which can be fatal, can occur in around 20% to 30% of people, the CDC says.
Can Chagas disease be treated?
Yes. Antiparasitic treatment can kill T. cruzi, especially with an early diagnosis. It can also help those with chronic Chagas, according to the CDC.
Symptomatic treatment may also be needed for those with complications from chronic Chagas.
There is no drug or vaccine to prevent Chagas, the CDC says.
How can I protect myself?
If you live in the United States and don't plan to travel to Latin America, you are likely safe from Chagas disease. The CDC says prevention in the U.S. is focused on stopping the spread from blood transfusion, organ transplantation and mother-to-baby.
When traveling, sleeping indoors in structures without cracks open to the outside can keep triatomine bugs from coming in. The CDC also says checking uncooked food and unpeeled fruits can help protect travelers.