Overview

• Triatomine insects carrying Trypanosoma cruzi are documented in 32 states, with locally acquired human infections reported in at least seven states including California, Texas, Arizona, Louisiana, Arkansas, Missouri, and Tennessee.
• Study authors propose classifying the illness as hypoendemic in parts of the country to bolster monitoring, research resources, and public-health responses.
• Public-health estimates suggest roughly 300,000 infections nationwide with very low awareness, including an estimated 45,000 cases in Los Angeles County.
• Texas recorded more than 50 locally acquired cases from 2013 to 2023, and some dog kennels showed infection rates up to 31%, underscoring entrenched animal reservoirs.
• Early antiparasitic treatment with benznidazole or nifurtimox is most effective, and experts urge targeted screening, blood and organ donor safeguards, and home vector-control measures to reduce risk.