As if we didn’t have enough pests to worry about in the United States, between mosquitos, ticks and bees, there’s now another nefarious insect on the scene. Sand flies can transmit a parasite that causes a disfiguring skin disease, leishmaniasis. Sand flies are generally found in warm, wet, rural areas. Due to this, leishmaniasis is endemic in the Middle East, Asia, Africa and Latin America, says the CDC. However, the disease has become endemic in America, especially in the south. Additionally, with climbing temperatures, experts project that the sand flies that thrive in warm climates can become more pervasive.

CNN reports that the CDC has recently detected the disease in patients who have not traveled outside the country. Leishmaniasis has been observed in Texas for years, presumed to be contracted when people traveled to Mexico. However, experts have noticed an increasing number of cases in people with no history of travel outside the U.S., says CNN.

“This genetic information adds credence to this idea that leishmaniasis is occurring here,” Dr. Mary Kamb, of the CDC’s Division of Parasitic Diseases and Malaria, tells CBS News. “It’s endemic here in the United States, at least in Texas and maybe southern border states,” she adds. Right now, the disease is only reportable in Texas, but Dr. Kamb says there’s been an increase of American doctors seeking help with diagnosing leishmaniasis cases as it becomes more common.

Leishmaniasis can be asymptomatic or present as a bump that then becomes an ulcerous, potentially disfiguring, sore, says CNN. Parasitologist David Molyneux of the Liverpool School of Tropical Medicine in England tells Scientific American leishmaniasis can result in “facial scarring for life, which causes all sorts of issues relating to depression and stigma.”

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