Trypanosoma cruzi and Chagas' Disease in the United States

Caryn Bern1, Sonia Kjos, Michael J Yabsley

  • 1Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. cxb9@cdc.gov

Insights

Chagas disease, caused by Trypanosoma cruzi, affects the heart and gastrointestinal tract. While endemic in Latin America, the United States sees cases from vectors and imported infections, necessitating updated public health strategies.

Area of Science:

  • Veterinary Medicine
  • Infectious Diseases
  • Parasitology

Background:

  • Chagas disease is a serious parasitic infection caused by Trypanosoma cruzi.
  • The parasite can lead to life-threatening cardiac and gastrointestinal conditions.
  • Enzootic cycles of T. cruzi exist in the southern United States, involving various triatomine vector species and animal reservoirs.

Purpose of the Study:

  • To describe the epidemiology of Chagas disease in the United States.
  • To identify the vectors and reservoirs of Trypanosoma cruzi in the US.
  • To highlight the changing patterns of Chagas disease transmission and the role of the US in addressing it.

Main Methods:

  • Review of existing literature on Trypanosoma cruzi vectors and reservoirs in the US.
  • Analysis of reported autochthonous, transfusion-associated, and organ donor-derived human infections.
  • Assessment of the prevalence of T. cruzi in different animal hosts and geographic regions.

Main Results:

  • Eleven triatomine vector species are recognized in the southern US, with higher diversity and density in the western regions.
  • Woodrats are common reservoirs in the west, while raccoons, opossums, armadillos, and skunks are key reservoirs in the east.
  • Seven autochthonous human infections were reported, alongside seven transfusion-associated and six organ donor-derived cases.

Conclusions:

  • The United States has established enzootic cycles of Trypanosoma cruzi with diverse vectors and reservoirs.
  • While autochthonous infections are rare, imported cases are increasing due to immigration and organ/blood donations.
  • The US must adapt public health strategies to manage the evolving epidemiology of Chagas disease.

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