Abstract

Chagas disease, a potentially life-threatening disease caused by the protozoan parasite Trypanosoma cruzi, has become a concern in the United States as a result of human emigration from Latin America where Chagas disease is endemic (1). It is estimated that as many as 8 million people living in Mexico, and Central and South America have Chagas disease.* Most cases of Chagas disease in the United States are chronic infections; however, rare cases of acute congenital infections and autochthonous vectorborne transmission have been reported (2). To understand how data are collected and used, a review of state-level public health surveillance for Chagas disease was conducted through semistructured interviews with health officials in six states (Arizona, Arkansas, Louisiana, Mississippi Tennessee, and Texas) where Chagas disease is reportable and one (Massachusetts) where it was previously reportable. States implemented surveillance in response to blood donor screening for Chagas disease and to identify the route of disease transmission. Many states reported primarily chronic cases and had limited ability to respond to local transmission because acute cases were infrequently reported. Surveillance remains important in states with large populations of immigrants or frequent travelers from countries with endemic disease and for states with a risk for local transmission. Surveillance efforts can also help increase awareness among providers and assist in linking patients with Chagas disease to treatment to help prevent cardiac and gastrointestinal complications.

Highlights

  • Chagas disease surveillance remains important in states with frequent travelers from countries where the disease is endemic and with a risk for local transmission

  • The risk for autochthonous transmission in the United States is considered low because of better housing conditions and a lack of transmission associated with domestic reservoirs, such as dogs, and human Chagas cases [1,6]

  • Awareness of Chagas disease as a public health problem in the United States increased after the introduction of blood donor screening for Chagas disease in 2007 [8]

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Summary

Introduction

Chagas disease surveillance remains important in states with frequent travelers from countries where the disease is endemic and with a risk for local transmission. Surveillance activities help increase awareness among public health professionals and physicians and can help link persons with chronic Chagas disease to treatment. The risk for autochthonous transmission in the United States is considered low because of better housing conditions and a lack of transmission associated with domestic reservoirs, such as dogs, and human Chagas cases [1,6].

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