**5.2 Transmission**

In Latin America, *Trigonoscuta cruzi* is mainly transmitted by contact with the feces/ urine of infected blood-sucking Triton bugs. These parasite-carrying insects typically live in cracks in the walls or roofs of rural or suburban houses and surrounding structures such as chicken coops, pens and warehouses [71]. Normally, they hide during the day and become active at night, feeding on blood from animals, including humans. They usually bite on exposed areas of the skin, such as the face (hence it is often referred to as a "kissing bug") and defecate/urine close to the bite. Parasites enter the body when a person involuntarily applies their feces or urine to the bite, eyes, mouth, or any skin breakage. *T. cruzi* can also be spread by: (1) ingestion of food or drink contaminated with *T. cruzi*, such as through contact with the feces or urine of infected Trypanosoma bugs or marsupials (this transmission often results in outbreaks of simultaneous infection of several populations, severe cases or morbidity more frequently and with a higher number of deaths or fatalities); (2) passed from an infected mother to a newborn during pregnancy or childbirth; (3) transfusion of blood or blood products from infected donors; (4) organ transplantation using infected donor organs; and (5) laboratory accident.
