Causal Agent:
The protozoan parasite, Trypanosoma cruzi, causes Chagas disease, a zoonotic disease that can be transmitted to humans by blood-sucking reduviid bugs.  Click here to see drawings of some common species of triatomine bugs found in the United States.

Life Cycle:

An infected triatomine insect vector (or “kissing” bug) takes a blood meal and releases trypomastigotes in its feces near the site of the bite wound.  Trypomastigotes enter the host through the wound or through intact mucosal membranes, such as the conjunctiva .  Common triatomine vector species for trypanosomiasis belong to the genera Triatoma, Rhodinius, and Panstrongylus.  Inside the host, the trypomastigotes invade cells, where they differentiate into intracellular amastigotes .  The amastigotes multiply by binary fission and differentiate into trypomastigotes, and then are released into the circulation as bloodstream trypomastigotes .  Trypomastigotes infect cells from a variety of tissues and transform into intracellular amastigotes in new infection sites.  Clinical manifestations can result from this infective cycle.  The bloodstream trypomastigotes do not replicate (different from the African trypanosomes).  Replication resumes only when the parasites enter another cell or are ingested by another vector.  The “kissing” bug becomes infected by feeding on human or animal blood that contains circulating parasites .  The ingested trypomastigotes transform into epimastigotes in the vector’s midgut .  The parasites multiply and differentiate in the midgut and differentiate into infective metacyclic trypomastigotes in the hindgut .
Trypanosoma cruzi can also be transmitted through blood transfusions, organ transplantation, transplacentally, and in laboratory accidents.

Geographic Distribution:
The Americas from the southern United States to southern Argentina.  Mostly in poor, rural areas of Central and South America.  Chronic Chagas disease is a major health problem in many Latin American countries.  With increased population movements, the possibility of transmission by blood transfusion has become more substantial in the United States.