Overview

• Triatomine “kissing bugs” have been confirmed in roughly 32 states, with locally acquired human infections documented in California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi and Arkansas.
• A CDC review identified 29 confirmed and 47 suspected autochthonous cases from 2000–2018, a total the authors say likely undercounts true infections due to limited testing and reporting.
• Dogs and wildlife frequently test positive for Trypanosoma cruzi across many regions, signaling established local transmission cycles beyond human cases.
• Early infection is often mild or unnoticed, but 20–30% of infections later lead to serious cardiac or digestive disease; diagnosis typically requires two distinct antibody tests.
• Benznidazole and nifurtimox are most effective when started in the acute phase, while prevention guidance and routine screening of blood and organ donors help reduce transmission.