Chagas disease is consolidating as an endemic disease in the United States.
The "kissing sickness" is spreading in the US: the CDC declares it endemic, with 300,000 possible cases and outbreaks in the south of the country.
Photo of József Szabó in Unsplash
Chagas disease, also known as the "kissing disease," has been declared endemic in the United States by the Centers for Disease Control and Prevention (CDC), indicating its continued presence in certain regions of the country.
What does this classification imply?
Traditionally associated with Latin America, Chagas is caused by the parasite Trypanosoma cruzi and transmitted primarily by triatomine bugs (known as "kissing bugs") through their feces. These insect species are now recognized as present in the southern half of the U.S., and autochthonous cases—that is, those contracted within the country—have been reported in at least eight states, including Texas, California, and Arizona.
Scope and number of infections
It is estimated that more than 300,000 people could be infected in the U.S., with some particularly notable hotspots like Los Angeles, which has 45,000 cases. However, due to the "silent" nature of the disease—many patients remain asymptomatic—the true number is suspected to be higher.
Clinical phases and complications
The disease has two phases: an initial phase, which may present mild symptoms such as fever or eyelid swelling, and a chronic phase, which, without treatment, can lead to heart failure, severe digestive problems, or even sudden death. Between the ages of 201 and 301, infected individuals develop complications.
Diagnosis and treatment
Only two antiparasitic drugs (benznidazole and nifurtimox) are approved in the US, and they are most effective if administered in the acute phase. No vaccine is currently available. A new, less toxic oral molecule, AN2-502998, is being investigated in clinical trials.
Public health challenges
The official recognition of Chagas disease as an endemic disease is an important step, but it is not sufficient. Surveillance remains insufficient, with only a few states reporting Chagas disease, such as California (in certain counties) and Texas. Furthermore, many cases remain undiagnosed because the disease is not included in standardized reporting systems.
Experts stress that without a robust public strategy—including education, active detection, and dedicated funding—the impact could be much greater.
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