A century of passive surveillance reveals widespread triatomines (Hemiptera: Reduviidae) across North Carolina, including detection of the Chagas disease parasite

Trypanosoma cruzi, the parasitic protozoan that causes Chagas disease, can be transmitted via bite wound contamination with feces from triatomines ("kissing bugs," Hemiptera: Reduviidae: Triatominae). Often thought of as restricted to Central and South America, kissing bugs live throughout North America, including North Carolina and other southern regions of the United States. In this assessment of kissing bugs in North Carolina, data were gathered from clinic samples and public submissions to online and university collections. Climate data were obtained through the National Oceanic and Atmospheric Administration. Polymerase chain reaction testing for T. cruzi was performed on a subset of bugs. Between 1904 and 2025, 116 kissing bugs were encountered in 42 North Carolina counties. Kissing bugs were either Triatoma sanguisuga or Paratriatoma lecticularia, and most of the records were from the last 15 years. Human-kissing bug encounters occurred year-round, with an average collection date temperature of 72.8°F and a significant correlation between monthly temperature and encounter (P = 0.0036). Four of 23 (17.4%) bugs tested were T. cruzi-positive; T. cruzi DTU TcIV was detected. Since many North Carolinians are likely unaware of the presence of kissing bugs in their state, and of clinics for submission and documentation, the true number of human-kissing bug encounters is presumed higher than reported here. Our study demonstrated that kissing bugs are found throughout North Carolina, can carry T. cruzi, and are encountered year-round, particularly in warmer months. Chagas disease surveillance and vector-related education are critical to ensuring healthcare provider and public awareness.