The potential for emergence of Chagas disease in the United States

Abstract

Abstract. To determine the risk for Chagas disease (American trypanosomiasis) in the United States, the characteristics that make the triatomine vector effective and the areas most at risk for transmission were delineated. In addition, the status of Chagas disease awareness among physicians in areas with a potential risk for the disease was determined. A geographical information system (GIS) was used to analyze three triatomine species within the United States known to harbor Trypanosoma cruzi and that exhibit qualities of domesticity. An analysis of the minimum temperature threshold for increased triatomine activity delineates the current population at increased risk, and by incorporating temperature predictions for 2030, the population at risk under a future climate scenario was also delineated. Considering both environmental and social factors, a vignette-based physician survey, based on the results of the GIS analysis, was used to gauge the level of awareness of Chagas disease within the delineated higher risk range.

Trypanosoma cruzi and Chagas' Disease in the United States

“…The detection of T. cruzi-infected wild mammals in many of these areas suggests the presence of the vectors. Additionally, recent efforts to model the geographic distribution of U.S. species based on the land cover, climate, and host composition of known collection sites indicate favorable habitat suitability in many of these unsurveyed or underreported regions (26,137,158,259). Characteristics of each species are summarized in Table 3 and described in detail in the sections that follow.…”

The impact of climate change on the geographical distribution of two vectors of Chagas disease: implications for the force of infection

“…Some of these studies have presented the results of climate change impacts in terms of 'vulnerability', usually in the form of maps highlighting changing vector distributions [47]. Other studies, such as [48], have combined geographic information system (GIS) and survey analyses to evaluate the role that temperature variability and disease awareness among physicians play in the potential emergence of Chagas disease in the USA. In this paper, we use the most direct indicator of the rate at which susceptible individuals acquire the Tr.…”

Opportunities and Challenges in Chronic Chagas Cardiomyopathy

“…Public health successes have led to a decline in at-risk populations and infected persons in endemic areas. However, there is an emerging rise in the number of T. cruzi –infected individuals in the United States and several nonendemic countries in Europe and the Western Pacific region [35–40,56–59]. This represents an important clinical and public health challenge.…”