Volume 92, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Autochthonous transmission of in the United States is rarely reported. Here, we describe five newly identified patients with autochthonously acquired infections from a small pilot study of positive blood donors in southeast Texas. Case-patients 1–4 were possibly infected near their residences, which were all in the same region ∼100 miles west of Houston. Case-patient 5 was a young male with considerable exposure from routine outdoor and camping activities associated with a youth civic organization. Only one of the five autochthonous case-patients received anti-parasitic treatment. Our findings suggest an unrecognized risk of human vector-borne transmission in southeast Texas. Education of physicians and public health officials is crucial for identifying the true disease burden and source of infection in Texas.


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  1. Rassi A, Jr Rassi A, Marin-Neto JA, , 2010. Chagas disease. Lancet 375: 13881402.[Crossref] [Google Scholar]
  2. Sabino EC, Riberio AL, Salemi VM, Di Lorenzo Oliveria C, Antunes AP, Menezez MM, Ianni BM, Nastari L, Fernandes F, Patavino GM, Sachdev V, Capuani L, de Almeida-Neto C, Carrick DM, Wright D, Kavounis K, Goncalez TT, Carneiro-Proietti AB, Custer B, Busch MP, Murphy EL, National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study-II (REDS-II), International Component; , 2013. Ten-year incidence of Chagas cardiomyopathy among asymptomatic Trypanosoma cruzi-seropositive former blood donors. Circulation 127: 11051115.[Crossref] [Google Scholar]
  3. Jackson Y, Chatelain E, Mauris A, Holst M, Miao Q, Chappuis F, , 2013. Serological and parasitological response in chronic Chagas patients 3 years after nifurtimox treatment. BMC Infect Dis 13: 85.[Crossref] [Google Scholar]
  4. Pinazo MJ, Munoz J, Posada E, Lopez-Chejade P, Gallego M, Ayala E, del Cacho E, Soy D, Gascon J, , 2010. Tolerance of benznidazole in treatment of Chagas disease in adults. Antimicrob Agents Chemother 54: 48964899.[Crossref] [Google Scholar]
  5. Kirchhoff LV, , 1993. American trypanosomiasis (Chagas' disease)—a tropical disease now in the United States. N Engl J Med 329: 639644.[Crossref] [Google Scholar]
  6. Sarkar S, Strutz SE, Frank DM, Rivaldi CL, Sissel B, Sanchez-Cordero V, , 2010. Chagas disease risk in Texas. PLOS NTDs 4: e836. [Google Scholar]
  7. Kjos SA, Marcet PL, Yabsley MJ, Kitron U, Snowden KF, Logan KS, Barnes JC, Doston EM, , 2013. Identification of bloodmeal sources and Trypanosoma cruzi infection in triatomine bugs (Hemiptera: Reduviidae) from residential settings in Texas, the United States. J Med Entomol 50: 11261139.[Crossref] [Google Scholar]
  8. Woody NC, Woody HB, , 1955. American trypanosomiasis (Chagas' disease); first indigenous case in the United States. JAMA 159: 676677.[Crossref] [Google Scholar]
  9. Beard CB, Pye G, Steurer FJ, Rodriguez R, Campman R, Peterson AT, Ramsey J, Wirtz RA, Robinson LE, , 2003. Chagas disease in a domestic transmission cycle, southern Texas, USA. Emerg Infect Dis 9: 103105.[Crossref] [Google Scholar]
  10. 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. doi:http://dx.doi.org/10.1017/S0950268814002234. Published online: 28 August 2014. [Google Scholar]
  11. Texas Department of State Health Services, 2014. Texas Notifiable Conditions. Available at: http://www.dshs.state.tx.us/idcu/investigation/conditions/contacts/. Accessed March 25, 2014. [Google Scholar]
  12. Cantey PT, Stramer SL, Townsend RL, Kamel H, Ofafa K, Todd CW, Currier M, Hand S, Varnado W, Dotson E, Hall C, Jett PL, Montgomery SP, , 2012. The United States Trypanosoma cruzi infection study: evidence for vector-borne transmission of the parasite that causes Chagas disease among United States blood donors. Transfusion 52: 19221930.[Crossref] [Google Scholar]
  13. Bern C, Montogomery SP, , 2009. An estimate of the burden of Chagas disease. Clin Infect Dis 49: e52e54.[Crossref] [Google Scholar]
  14. Garcia MN, Murray KO, Hotez PJ, Rossmann SN, Gorchakov R, Ontiveros A, Woc-Colburn L, Bottazzi ME, Rhodes CE, Ballantyne CM, Aguilar D, , 2014. Development of Chagas cardiac manifestations among Texas blood donors. Am J Cardiol 115: 113117.[Crossref] [Google Scholar]
  15. Custer B, Agapova M, Bruhn R, Cusick R, Kamel H, Tomasulo P, Biswas H, Tobler L, Lee TH, Caglioti S, Busch M, , 2012. Epidemiologic and laboratory findings from 3 years of testing United States blood donors for Trypanosoma cruzi . Transfusion 52: 19011911.[Crossref] [Google Scholar]
  16. Wilson LS, Ramsey JM, Koplowicz YB, Valiente-Banuet L, Motter C, Bertozzi SM, Tobler LH, , 2008. Cost-effectiveness of implementation methods for ELISA serology testing of Trypanosoma cruzi in California blood banks. Am J Trop Med Hyg 79: 5368. [Google Scholar]
  17. Leiby DA, Read EJ, Lenes BA, Yund AJ, Stumpf RJ, Kirchhoff LV, Dodd RY, , 1997. Seroepidemiology of Trypanosoma cruzi, etiologic agent of Chagas disease, in US blood donors. J Infect Dis 176: 10471052.[Crossref] [Google Scholar]
  18. O'Brien SF, Chiavetta JA, Fan W, Xi G, Yi QL, Goldman M, Scalia V, Fearon MA, , 2008. Assessment of a travel question to identify donors with risk of Trypanosoma cruzi: operational validity and field testing. Transfusion 48: 755761.[Crossref] [Google Scholar]
  19. Garcia MN, Hotez PJ, Murray KO, , 2014. Potential novel risk factors for autochthonous and sylvatic transmission of human Chagas disease in the United States. Parasit Vectors 7: 311.[Crossref] [Google Scholar]
  20. Edwards MS, Rench MA, Todd CW, Czaicki N, Steurer FJ, Bern C, Montgomery SP, , 2013. Perinatal screening for Chagas disease in southern Texas. J Ped Infect Dis 14. Available at: http://jpids.oxfordjournals.org/content/early/2013/10/03/jpids.pit056.1.full.pdf+html?sid=f876a11f-40f5-44d5-91e0-219c6e0f257f. [Google Scholar]
  21. Di Pentima MC, Hwang LY, Skeeter CM, Edwards MS, , 1999. Prevalence of antibody to Trypanosoma cruzi in pregnant Hispanic women in Houston. Clin Infect Dis 28: 12811285.[Crossref] [Google Scholar]
  22. Stimpert KK, Montgomery SP, , 2010. Physician awareness of Chagas disease, USA. Emerg Infect Dis 16: 871872.[Crossref] [Google Scholar]

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  • Received : 16 Apr 2014
  • Accepted : 10 Oct 2014
  • Published online : 04 Feb 2015

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