Overview

• A Sept. 9 CDC report concluded the United States meets endemic criteria for Chagas disease based on widespread vectors, animal reservoirs, and confirmed local transmission.
• Triatomine “kissing bugs” have been found in 32 states, and nine of 11 U.S. species have tested positive for the Trypanosoma cruzi parasite; infections are documented in wildlife and domestic dogs.
• Locally acquired human cases have been confirmed in eight states: California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi, and Arkansas.
• A CDC review identified 29 confirmed and 47 suspected locally acquired cases from 2000–2018, yet about 280,000 Americans are estimated to be infected, underscoring substantial underdiagnosis.
• Transmission can also occur via blood transfusion, organ transplantation, or from mother to baby, and treatment with benznidazole or nifurtimox works best when started early as officials press for targeted surveillance and clinician training.