More than 7 million people worldwide are estimated to be infected with Trypanosoma cruzi (or T. cruzi), the parasite that causes Chagas disease. In the United States, the number of cases is relatively low but appears to be growing, especially in certain regions. According to experts at UCLA Health, approximately 45,000 people in Los Angeles County are infected, among more than 300,000 in the United States, and fewer than 2% of them are aware they carry the parasite. However, these reports are not as current as the clinical community would like, given the calculated risk of exposure. This has led the Centers for Disease Control and Prevention (CDC) to advocate for reclassifying certain states as endemic (en-DEM-ik) areas where infected parasites live and potentially transmit the disease.
What is Chagas disease?
Chagas (SHAH-gus) disease is caused by the T. cruzi parasite, which is harbored by approximately a dozen species of bloodsucking triatomine bugs, commonly referred to as “kissing bugs.” These bugs are named for their tendency to bite the face, drink human blood, and then defecate, depositing T. cruzi onto the skin. When a person scratches the kissing bug bite, the parasite enters the bloodstream. Notably, up to 50% of these triatomine insects can carry the parasite, and they are most active at night.
World Chagas Disease Day was celebrated for the first time in 2020 and it’s been an annual day of recognition and education each April 14 ever since. The date has some significance because Chagas disease is named after Carlos Chagas, a Brazilian physician and researcher who on April 14, 1909, diagnosed the disease in a person for the first time. For 2025, the World Health Organization’s theme for World Chagas Disease Day is “Prevent, Control, Care: Everyone’s Role in Chagas Disease.”
What does “endemic” do for Chagas care?
Chagas disease symptoms include fever, fatigue, body aches, headache, loss of appetite, diarrhea, and vomiting. But the real telltale sign of Chagas is severe swelling of the eyelids. Many people do not have any symptoms during the acute and chronic phases. However, the acute phase lasts about two months and during that time the eyelid swelling may occur, so it’s critical to find out, especially if you suspect Chagas disease.
The chronic phase of the disease can last a lifetime, especially since many of those infected are unaware they have it. Still, about 20% of those infected will develop serious, even deadly, heart or digestive problems such as an enlarged heart, heart failure, or cardiac arrest and in GI organs it can cause an enlarged colon or an enlarged esophagus. The World Health Organization estimates around 10,000 annual deaths worldwide happen due to this disease.
Is there a cure for Chagas disease?
Chagas disease is curable if antiparasitic treatment is initiated early, during the acute phase. In chronic infection, the treatment and follow up can potentially prevent disease progression and transmission, for instance, during pregnancy and birth.
There are treatment options for people of all ages, including young children. There are two main types of treatments; antiparasitic treatment kills the parasite that causes the disease, and symptom treatment helps with symptoms of Chagas disease. Antiparasitic treatment works best when started early but can be used at any stage. The two main drugs to treat Chagas disease used in the U.S. are:
- Benznidazole is FDA approved for use in children 2–12 years of age and is commercially available online.
- Lampit® (nifurtimox) is FDA approved for treatment of children from birth to age younger than 18 years and is commercially available to pharmacies.
How can I reduce risk?
Prevention is focused on reducing or eliminating the population of “kissing bugs” (the disease vectors that transmit the T. cruzi parasite to humans) by spraying insecticides or improving housing conditions by sealing entry points, eliminating breeding areas, etc. There’s also more that can be done in areas of blood and organ donation testing, food handling, and prenatal testing that can help reduce transmission. It should be noted that the U.S. blood supply has been screened for T. cruzi antibodies since as early as 2007.
When should I see a doctor?
Chagas disease can only be diagnosed by a healthcare professional. As noted, however, the sooner it’s treated, the more possibility there is to cure or prevent transmission. Talk to your child’s pediatrician as soon as possible if you see any suspicious bites or eyelid swelling. Depending on the disease phase, it may also be necessary to see a heart, stomach, or infectious disease specialist.
