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Authors of a new study have called for the parasitic infection, Chagas disease, to be classified as endemic—with human cases reported in eight states.
The study featured in the September edition of the peer-reviewed journal Emerging Infectious Diseases, which is published by the Centers for Disease Control and Prevention (CDC).
It reported that classifying the disease, which can be life-threatening in some cases, as endemic would "improve surveillance, research, and public health responses."
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"Acknowledging the endemicity of Chagas disease in the United States is crucial for achieving global health goals," the authors wrote.
Endemic, as defined by the CDC, refers to the constant presence and/or the usual prevalence of a disease in a population within a geographic area. The research team is calling for Chagas disease to be reclassified from nonendemic to endemic.
Newsweek has contacted the CDC outside of regular working hours via email for comment.
Why It Matters
"By calling this infection 'endemic' it brings greater attention to this devastating disease that currently affects 300,000 American residents living with this silent killer," Melissa Nolan, a professor of epidemiology and director of the University of South Carolina Institute for Infectious Disease Translational Research, who was not part of the study, told Newsweek.
Chagas disease is a condition caused by the parasite Trypanosoma cruzi, which is mainly found in the rural areas of Mexico and Central and South America.
While in its early stages, or as an acute infection, Chagas disease can cause mild symptoms or may not even result in symptoms for some individuals, but for some people, it can lead to serious issues if the infection becomes chronic.
Around 20 to 30 percent of those with a chronic infection of the disease may experience heart issues, including heart failure—even sudden death.
Some may also experience digestive problems, such as an enlarged esophagus or colon, leading to trouble eating or going to the bathroom.
What To Know
The map reflects "a collection of all published data on the distribution of kissing bugs, infection in animals and human Chagas cases" between 1855 and 2024, Dr. Norman Beatty, a professor of medicine at the University of Florida College of Medicine and one of the authors of the study, told Newsweek.
He said: "This highlights that kissing bugs and Chagas disease has been here in the United States for many years. It is time to recognize this infectious disease as an endemic disease in the U.S."
Chagas disease can be transmitted to humans by more than 130 different insects, all known as "kissing bugs," Melissa Nolan said, but "some of these insects are better at biting and transmitting this disease than others."
Central Texas—particularly the Austin-San Antonio areas—is a known "hotspot for local disease transmission to people," Melissa Nolan said.
She said this was "likely due to the presence of an insect species that is very good at biting humans."
"The one that lives in central Texas is very good at biting humans and transmitting this disease," she said, adding the species was called "Triatoma gerstaeckeri."
Human cases of Chagas disease have been reported in California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi and Arkansas**,** according to the authors of the study.
Some 18 states also had animal cases, while 12 more states had triatomines infected with Trypanosoma cruzi.
Other research from 2016 has indicated that there could be at least 300,0000 cases in the U.S of chronic Chagas disease in people originally from Latin America, where it is endemic in certain countries.
The authors noted that they thought Chagas disease should specifically be classified as "hypoendemic," and pointed to the World Health Organization (WHO)'s subcategories for malaria, where "hypoendemic" is one of a few subcategories of "endemic," with one each indicating a different prevalence.
The WHO's "hypoendemic" category referred to 0 to 10 percent of a population having a particular disease.
"Such an operative scale for Chagas disease has not yet been developed, but acknowledging the nuanced nature of endemicity and the unique characteristics of Chagas disease occurrence in different regions will be crucial when considering the endemicity status of Chagas disease in the United States," the authors wrote.
When approached for comment, the American regional office of the World Health Organization told Newsweek that usually "there is no 'declaration'" of an endemic disease. "Rather, it is referred to as endemic by national authorities," they said. They also directed Newsweek to the CDC for further comment.
Symptoms of Chagas disease include fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, vomiting, and eyelid swelling.
Chagas disease does not spread from person to person like a virus or flu, but it can be spread between people through blood transfusions, organ transplants, from a pregnant woman to her baby and through contaminated, uncooked food.
Those more at risk of getting Chagas disease are those with a history of living in Latin America, a history of extended travel to Latin America (usually greater than two weeks), those with outdoor occupations or who live in rural areas of states with triatomine insects, or those who frequently camp, hike or do other outdoor activities in states with triatomine insects, Nolan said.
Chagas disease is "a very important heart disease no matter if caught here or in Latin America," Dr. Robert Gilman, a professor of International Health at Johns Hopkins University, told Newsweek. He added that it results in "individuals having increased cardiomyopathy and dying earlier than most cardiac diseases."
What People Are Saying
The study's authors wrote: "The current classification of the United States as nonendemic for Chagas disease has led to critical issues such as low physician and veterinary awareness of possible human and animal exposure to T. cruzi, which prevents appropriate differential diagnosis and could subsequently contribute to potential underreporting. The nonendemic label is coupled with the portrayal of Chagas disease as an essentially foreign or an exclusively travel-related issue in the media. Such misrecognition impedes effective disease management and underscores the need to reevaluate Chagas disease's endemic status."
Nolan told Newsweek: "This disease has long been known to infect Americans, dating back to the early 1900s. It's not that the infection is spreading more today, but rather that public health officials are starting to pay attention to this disease."
She said: "This parasitic infection will stay in someone's body for their entire lifetime (without treatment), and we do not know what makes some people develop cardiac or gastrointestinal disease, whereas others will have an asymptomatic, dormant infection. The concern is that this slowly progressing disease, over the course of decades, is only treatable before you develop symptoms."
What Happens Next
As Chagas disease is thought by some to affect more people than current reports indicate, experts have also called for more screening of the disease to take place.
"It is imperative that people get screened for this disease while they are still healthy and asymptomatic, otherwise treatment is not recommended once you develop organ damage," Nolan said.
Update 9/5/25, 03:21 a.m. ET: This article was updated with comment from the American regional office of the World Health Organization.
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