New information points to a previously hidden burden of Chagas disease in North America, with as many as 300,000 to 1 million cases in the United States alone (1). This disease burden results in economic losses that approach $900 million annually. Texas already has the largest number of cases, possibly as many as 250,000 cases, with most of the infections occurring in South Texas (1-3) (The map on the right (3) shows the risk of acquiring Chagas disease in Texas). There now also is a high probability that the global climate change will lead to a shift in the distribution of the Chagas insect vector towards the North and East of the United States (4). Moreover, an estimated 40,000 pregnant women in North America are infected with Chagas disease, and in 2013, the U.S. reported its first case of congenital infection (1). There is strong evidence that many of the Chagas disease cases in South Texas are contracted within the state rather than imported through immigration. In our recent epidemiological studies, approximately one third of Chagas-positive blood donors in Texas are suspected to have acquired the infection locally (5, 6).
1. Hotez PJ, Dumonteil E, Betancourt Cravioto M, Bottazzi ME, Tapia-Conyer R, Meymandi S, Karunakara U, Ribeiro I, Cohen RM, Pecoul B. 2013. An unfolding tragedy of Chagas disease in North America. PLoS neglected tropical diseases 7:e2300.
2. Garcia MN, Woc-Colburn L, Rossmann SN, Townsend RL, Stramer SL, Bravo M, Kamel H, Beddard R, Townsend M, Oldham R, Bottazzi ME, Hotez PJ, Murray KO. 2014. Trypanosoma cruzi screening in Texas blood donors, 2008-2012. Epidemiol Infect:1-4.
3. Sarkar S, Strutz SE, Frank DM, Rivaldi CL, Sissel B, Sanchez-Cordero V. 2010. Chagas disease risk in Texas. PLoS neglected tropical diseases 4.
4. Garza M, Feria Arroyo TP, Casillas EA, Sanchez-Cordero V, Rivaldi CL, Sarkar S. 2014. Projected future distributions of vectors of Trypanosoma cruzi in North America under climate change scenarios. PLoS neglected tropical diseases 8:e2818.
5. Garcia MN, Murray KO, Hotez PJ, Rossmann SN, Gorchakov R, Ontiveros A, Woc-Colburn L, Bottazzi ME, Rhodes CE, Ballantyne CM, Aguilar D. 2015. Development of chagas cardiac manifestations among Texas blood donors. The American journal of cardiology 115:113-117.
6. Garcia MN, Aguilar D, Gorchakov R, Rossmann SN, Montgomery SP, Rivera H, Woc-Colburn L, Hotez PJ, Murray KO. 2014. Evidence of Autochthonous Chagas Disease in Southeastern Texas. The American journal of tropical medicine and hygiene.