Chagas Disease: Neglected Parasitic Infections in the United States

Chagas disease is a preventable infection caused by the parasite Trypanosoma cruzi and spread by infected insects called triatomine bugs, also known as “kissing bugs.” The initial infection usually does not cause severe symptoms and is often not even diagnosed. After years of chronic infection, some people develop heart diseases such as abnormal heart rhythms, heart failure, and an increased risk of sudden death. Chagas disease can also cause gastrointestinal problems, such as severe constipation and difficulty swallowing.

Infection is typically spread by contact with the triatomine bug, most commonly found in rural parts of Mexico, Central America, or South America. However, the disease can also be transmitted from mother to baby (congenital transmission), through organ transplants, or through blood transfusion. Chagas disease is one of several parasitic diseases that results in significant illness among those who are infected and is often poorly understood by healthcare providers.

An estimated 300,000 infected people are living in the United States, nearly all of whom were originally infected in endemic areas. These persons often do not know they are infected and are at risk for severe cardiac or gastrointestinal problems from the disease. Diagnosis and treatment can reduce this risk.

Donor screening to detect T. cruzi infection in the blood supply began in early 2007. As of December 2019, more than 2,460 confirmed positive infections among blood donors were reported to AABB (formerly American Association of Blood Banks) by blood centers. While these efforts have likely reduced the risk of getting Chagas disease from blood products, the large number of positive donors identified indicates that many people with Chagas disease do not know they are infected and could benefit from diagnosis and treatment.

Infected triatomine bugs and wild animals that harbor T. cruzi infection have been found in the United States for decades. There are some reports of vector-borne (spread by contact with the bug) infection originating in the United States.

• Partnering with state and local health departments to educate and advise health professionals to help them better care for patients with Chagas disease
• Supporting physicians and patients in the United States with confirmatory diagnostic testing and answering questions regarding management of Chagas disease
• Increasing awareness of Chagas disease among healthcare providers, including publishing free, Web-based Continuing Medical Education (CME) and Continuing Nursing
  Education (CNE) programs
• Studying perception, awareness, and understanding of Chagas disease among patients and healthcare providers to help direct outreach efforts and address barriers to care for Chagas disease patients

• Improve outreach to healthcare providers so they can better care for patients with Chagas disease
• Determine the risk of transmission of T. cruzi in the United States from mothers with Chagas disease to their unborn babies
• Quantify the number of people with heart disease that was caused by Chagas disease
• Identify ways to prevent new infections from infected bugs in the United States

Alabama, Arizona, Arkansas, California, Colorado, Florida, Delaware, Georgia,  Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia