Chagas disease, also known as American trypanosomiasis, is a tropical disease that predominantly affects people in rural and poor areas of Latin America, although it is also present in the US. It is caused by the protozoan parasite Trypanosoma cruzi, which is transmitted to humans and animals mainly through the faeces of triatomine insects, commonly called kissing bugs.
The disease has two phases: an acute phase that develops shortly after infection, and a chronic phase, which can persist silently for decades. Many individuals never develop symptoms, but a significant proportion may suffer life-threatening complications years after they were first infected.
During the acute phase, symptoms are often non-specific and can be mistaken for other illnesses. Common acute symptoms include:
The chronic phase may remain silent for years, but some people may develop:
The most serious dangers of Chagas disease arise during the chronic phase. The parasites embed in the heart and digestive muscles and 10 to 30 years after the initial infection some individuals – around 20-30 per cent – develop severe cardiac or gastrointestinal complications.
Cardiac complications include cardiomyopathy, heart failure, arrhythmias, and a risk of sudden cardiac arrest. Digestive problems include enlargement of the oesophagus or colon , leading to severe swallowing problems and chronic constipation.
The disease is spread through the bite of triatomine bugs, which feed on human blood at night. The parasite is present in the insect’s faeces, and infection occurs when contaminated faeces enter the body through mucous membranes, broken skin, or rubbing of the eyes. It can also be spread from mother to child during pregnancy, blood transfusion, organ transplantation and consumption of contaminated food or drink.
Two antiparasitic medicines are currently available: benznidazole and nifurtimox. These drugs are most effective when given soon after infection, but they can also help some individuals with chronic disease, particularly younger patients.
The best way to prevent the disease is to control the triatomine bugs, this includes using insecticides, and promoting bed nets and personal protection. The World Health Organization also recommends screening of blood donations, organ transplants, and pregnant women in affected regions.
Chagas disease has existed for millennia in both animals and humans – in 2011 the 1,200-year-old remains of a Native American man, with an enlarged colon characteristic of the chronic form of the disease, were found in Texas. However, it was first identified as a distinct disease in 1909 by Brazilian physician Carlos Chagas.
Since the 1990s Latin American control efforts have led to a substantial fall in the number of cases – however, increased movement of people around the world means that the disease has spread into new areas. In September 2025 a paper in the journal of the US Centers for Disease Control and Prevention, Emerging Infectious Diseases, reported that Chagas should be considered endemic in the US, with locally-acquired cases in eight states.
who.int/fact-sheets/chagas-disease
mayoclinic.org/diseases-conditions/chagas-disease
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