Chagas kills more people in Latin America each year than malaria
Roughly 300,000 people in the U.S. are infected, many without knowing it
Cases have been confirmed in 30 states, including California
It’s one of the most insidious diseases you’ve probably never heard of. Chagas disease, caused by the parasite Trypanosoma cruzi, is spreading across California and at least 29 other states. Researchers estimate that as many as 300,000 people in the U.S. may already be infected — most of them unaware until it strikes years later with heart failure, stroke or sudden death.
The kissing bug connection
The parasite lives in a bloodsucking insect called the kissing bug. About a dozen species are found in the U.S. Research in Los Angeles’ Griffith Park shows that nearly a third of local kissing bugs carry the parasite. Wildlife including wood rats, skunks, mice, raccoons and even black bears have also tested positive, making the reservoir for infection wide and varied.
“Kissing bugs are pretty equal opportunity when it comes to who they take a blood meal from,” said Sarah Hamer, an epidemiologist at Texas A&M University in a Los Angeles Times report.
From rural stigma to urban reality
Historically regarded as a disease of rural Latin America, Chagas is increasingly appearing in U.S. patients with no foreign travel history. Doctors report infections in unexpected places, including an affluent Hollywood Hills neighborhood. California has the highest number of known cases — between 70,000 and 100,000 — both from immigrants arriving with the disease and from possible local transmission.
From 2019 to 2023, Los Angeles County alone confirmed about 180 cases. Health experts warn those numbers likely represent only a fraction of infections, since Chagas is not a reportable disease in most of California.
A neglected disease with deadly consequences
The lack of routine screening means many patients go undiagnosed until irreversible damage occurs. “If we screened for it and caught it early, most patients could be cured,” said Kaiser Permanente cardiologist Salvador Hernandez. “The problem is we don’t, and people end up dying or requiring terrifically expensive care.”
Antiparasitic drugs can stop the parasite if given in time. Dogs are also vulnerable, often becoming infected by eating the bugs.
Calls for recognition and action
Epidemiologists and medical experts are pressing the Centers for Disease Control and Prevention and the World Health Organization to declare Chagas endemic in the U.S. Such a move could bring wider awareness, research funding and public health investment.
“This is a disease that has been neglected and has been impacting Latin Americans for many decades,” said Norman Beatty, a University of Florida medical epidemiologist. “But it’s also here in the United States.”
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How to spot Chagas symptoms
Chagas disease can remain silent for years, but when symptoms do appear, they often mimic other illnesses. Doctors say early recognition is key.
Early or acute symptoms (days to weeks after infection):
Swollen eyelid or face (sometimes called Romaña’s sign)
Fever, fatigue, rash
Swollen lymph nodes
Nausea, diarrhea or loss of appetite
Chronic symptoms (years later, often mistaken for other conditions):
Irregular heartbeat or palpitations
Enlarged heart, heart failure or sudden cardiac arrest
Stroke or seizures
Difficulty swallowing or severe constipation from digestive tract damage
Why it’s missed:
Many patients have no symptoms until advanced disease develops
Signs often resemble more common cardiac or gastrointestinal problems
Most U.S. physicians do not routinely screen for it
What helps:
Blood donation centers sometimes detect infections during screening
Antiparasitic medications can stop disease progression if caught early
Regular check-ups and heart health evaluations are critical for those at risk