The United States confirms that Chagas disease is now endemic and has spread to 32 states.

U.S. health authorities have detected cases of Chagas disease in 32 states, establishing it as a public health problem and providing sufficient evidence to consider it endemic in the country.

Traditionally associated with rural areas of Latin America, where it affects millions of people, the disease caused by the parasite Trypanosoma cruzi was detected in insects, domestic animals, wildlife, and humans in 32 states across the country, according to the Centers for Disease Control and Prevention (CDC).

Experts warn that maintaining the "non-endemic" label contributed to underdiagnosis , poor medical training, and an underestimation of its impact.

The World Health Organization (WHO) estimates that more than 7 million people worldwide are living with the parasite , while the CDC estimates that there are nearly 8 million, of whom about 280,000 are in the U.S., many of whom are unaware.

The CDC detailed that autochthonous cases , unrelated to travel to endemic areas, were confirmed in at least eight states, with a particular incidence in Texas.

The inclusion of the United States on the map of Chagas disease-endemic countries, along with 21 Latin American nations, represents a shift in focus in surveillance and research into this neglected tropical disease.

Chagas disease is transmitted by the insect known as the 'kissing bug' ( Triatominae ) and has two phases.

The acute stage is usually mild or goes unnoticed, although it may present fever, general malaise or the characteristic swelling of the eyelid , known as Romaña's sign.

A chronic phase can appear years later, during which up to 30% of those infected develop serious complications , especially cardiac and digestive, which can lead to heart failure or sudden death.

Nearly 10,000 deaths are recorded globally each year from this cause.

Specialists emphasize that early detection is essential , since antiparasitic treatments are more effective in the initial stages.

In the absence of a preventive vaccine, recommendations focus on improving epidemiological surveillance , training of professionals, and preventing transmission through transfusions, transplants, or from mother to child during pregnancy.

Norman L. Beatty, Gabriel L. Hamer, Bernardo Moreno-Peniche, Bonny Mayes, Sarah A. Hamer. Chagas Disease, an Endemic Disease in the United States. Emerging Infectious Diseases (2025). DOI: https://doi.org/10.3201/eid3109.241700.

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