Experts Warn Chagas Disease Is Now Endemic in the U.S.

WASHINGTON, D.C. — Chagas disease, a potentially deadly illness caused by a parasite carried by kissing bugs, should now be considered endemic in the United States, experts warn. With acknowledgment of its constant presence in certain regions, they believe more people can be saved from unnecessary suffering.

A recent report published in the U.S. Centers for Disease Control and Prevention’s journal, Emerging Infectious Diseases, discusses the growing threat of Chagas disease in America. Dr. Norman Beatty, a co-author of the report, emphasized that recognition is overdue. “We’ve been waiting forever; all of us Chagas people have been waiting for people to recognize this disease is in our communities,” said Beatty, who has studied the illness for a decade at the University of Florida College of Medicine.

The CDC recognizes Chagas as endemic in 21 other countries in the Americas but has yet to do so in the U.S. The disease is a leading cause of heart issues in Latin America and results in more disability than other insect-borne diseases, surpassing even malaria and Zika.

Chagas disease typically spreads when triatomine bugs, commonly referred to as kissing bugs, bite people while they sleep. The bugs defecate near the bite, and if feces enter the body through the eyes, nose, or mouth, infection occurs due to the parasite Trypanosoma cruzi. Transmission can also occur through contaminated food, blood transfusion, organ transplants, or from mother to baby during pregnancy.

Initial symptoms may include fever, headache, and tiredness, and can last for weeks or months post-infection. The CDC estimates that about 20-30% of infected individuals develop more serious complications, including heart failure or stroke.

The disease can be treated with antiparasitic medicines like benznidazole if caught early, but many are unaware they are infected. This lack of awareness is compounded by limited surveillance and reporting of the disease, with an estimated 280,000 people in the U.S. living with Chagas.

Kissing bugs have been identified in 32 states, primarily in southern regions, where warmer temperatures foster their survival. There have been confirmed human cases in states like Arkansas, Texas, and California, but the actual count is likely higher due to underreporting.

Dr. Mario J. Grijalva of Ohio University echoed the sentiment that acknowledging Chagas as endemic would vastly improve public health responses. “It’s a game-changer,” he stated. “When people recognize it as a problem here, it opens up possibilities for public policy and awareness needed to tackle the issue.”

Grijalva has traveled across Latin America to raise awareness about Chagas. He noted that resources and education in countries like Chile and Argentina have helped manage the disease effectively, unlike in areas where it remains unaddressed.

Beatty calls for increased awareness and surveillance in the U.S., arguing for the necessity of controlling kissing bugs similarly to mosquito control programs. Until significant action is taken, he urges the public to improve home sealing, use window screens, and take preventive measures against bugs.

In Florida, where many kissing bugs show high rates of the parasite, community members often reach out to Beatty, bringing the insects for testing. “They’re scared,” Beatty said. “And they have a right to be.”

He hopes that growing recognition of the issue will elicit more widespread health initiatives. “I’m just one person,” he said. “We need a larger team with more resources to address this.”