Kissing bugs, sometimes called triatomine bugs, don’t look particularly threatening. Many people would mistake them for just another nighttime insect. Yet these bugs can carry a parasite linked with a long-lasting illness known as Chagas disease—an infection that often begins quietly and may go unnoticed for years.

One of the biggest concerns with kissing bug exposure is that most people never realize they were bitten. The early signs can be mild, easy to overlook, or confused with far more common issues. For older adults especially, staying alert to subtle changes can make a meaningful difference in long-term wellbeing.

This guide explains what early symptoms may look like, why they can be missed, and when it’s wise to speak with a healthcare professional.

Why Many People Never Feel the Bite

Kissing bugs tend to be active at night and are drawn to the carbon dioxide we breathe out during sleep. They often bite areas that are uncovered—such as the face, eyes, lips, or neck—which is how they earned their nickname.

Unlike mosquitoes, these bugs inject a mild numbing substance when they feed. Most people don’t wake up, don’t feel pain, and don’t realize anything occurred.

The main concern isn’t the bite itself, but the possibility of contaminated insect material entering the body through the bite wound or the eyes or mouth—especially if someone rubs the area without realizing what happened.

Because the moment passes quietly, early signs are frequently explained away as simple irritation, allergies, or a passing stomach bug.

Early Skin Reactions at the Bite Area

One of the first clues that something unusual happened can be a small area of irritation on the skin. This may appear as:

• Mild redness or swelling
• A small, itchy rash
• A firm bump beneath the skin
• Tenderness around the spot

Because these symptoms resemble common insect bites, many people don’t connect them with anything more serious. Often, the irritation fades in a few days.

Swelling Around One Eye: A Distinctive Sign

A more recognizable sign is swelling around a single eye, known in medical settings as Romaña sign. This may occur when material from the insect reaches the eye after a bite near the face.

The eyelid may look puffy, reddish, and irritated—typically without severe discomfort. While this sign does not appear in every case, it is a meaningful early signal and should be evaluated promptly.

Mild Flu-Like Symptoms That Come and Go

In the weeks following exposure, some individuals feel as though they have a seasonal virus. These symptoms may include:

• Low-grade fever
• Fatigue
• Headaches
• Muscle or joint aches
• Reduced appetite

Because these signs are common and often short-lived, they are easily overlooked. Many people recover from this early phase assuming it was simply a temporary illness.

When Lymph Nodes Become Tender or Enlarged

Another early response the body can have is swelling of the lymph nodes near the area of exposure. These glands in the neck, armpits, or groin may feel slightly enlarged or sore as the immune system reacts.

While swollen lymph nodes happen for many reasons, this is another small piece of a larger picture that should not be dismissed.

Digestive Discomfort in the Early Stage

For some people, digestive changes appear early on. These may include:

• Nausea
• Abdominal discomfort
• Occasional diarrhea
• Vomiting

Not everyone experiences these symptoms, and when they do occur, they are often mistaken for food irritation or a mild stomach bug.