A shocking new report is leading to a dire warning about the innocuously named “kissing bugs,” painting the insects as far from a harmless creature. The bugs are so named because they bite humans near the lips and on the face as they sleep, and then they leave their feces in the wound, potentially releasing an infectious parasite called Trypanasoma cruzi.

This parasite enters the bloodstream and causes Chagas disease, or trypanosomiasis, which is usually mild or even asymptomatic, but sometimes causes deaths. This new study claims that the deaths are being greatly underreporting, meaing the kissing bug could be far more deadly than we realized.

The study, published in the journal PLOS Neglected Tropical Diseases, showed that infection with Chagas increased the risk of death by two or even three times. This applied to people in every age category as well.

“The fact that Chagas disease was not reported as an underlying or associated cause of death on the death certificate of 42% of seropositive donors that died due to cardiac causes demonstrates under ascertainment of Chagas disease pathogenesis, highlighting its status as a neglected tropical disease,” the researchers say in a statement. “Research is urgently needed in order to test new therapeutic options with fewer side effects and to find better correlates of disease progression.”