Chagas Information for Healthcare Professionals

Return to Chagas Disease (American trypanosomiasis)

Page originally published 4/5/2024. Last updated 10/15/2025.

Following identification of T. cruzi parasites or antibodies, health care providers should consult with the Epidemiology Unit to determine if submission to Centers for Disease Control and Prevention (CDC) for confirmatory testing is indicated.

Positive microscopic results from specimen types other than blood or tissue may not be sufficient in diagnosing acute Chagas disease.
In California, Chagas disease has been reportable in Los Angeles County since 2019 and became reportable in San Diego County in 2024.

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Diagnosis

Acute Chagas Disease:

Diagnosed through various methods, including:
- Visualization of T. cruzi by microscopic examination (e.g. thick and thin Giemsa-stained blood smears, wet mount examination; histologic examination of biopsy specimens), or
- Detection of T. cruzi DNA by polymerase chain reaction (PCR).
Parasite numbers in the blood may vary; therefore, multiple specimens should be collected, and several techniques should be used.

Chronic Chagas Disease:

Diagnosed based on serologic testing (e.g., Enzyme Immunoassay (EIA) – detecting IgG antibodies to T. cruzi).
CDC may perform antibody detection by EIA to detect IgG antibodies to T. cruzi or use the Indirect Fluorescent Antibody Assay (IFA) to detect antigens of T. cruzi.

Note: Healthcare personnel working with specimens from patients suspected of having Chagas disease must use Standard Precautions. Trypomastigotes are highly infectious, and certain strains of the parasite are more virulent than others.

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Blood Donor Screening

The U.S. Food and Drug Administration (FDA) recommends that all blood donors should be tested at least once for detection of T. cruzi antibodies.

Blood banks screen all first-time blood donors for evidence of T. cruzi infection.
Donors who test positive are notified of their test results and recommended to follow up with their medical provider to further discuss the findings, potential implications, and more laboratory testing.
Potential blood donors infected with T. cruzi should not donate blood or tissues.
Donors who test negative are qualified to return to donate.

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Treatment

Children younger than 18 years: Indicated for all patients in the acute phase or reactivated Chagas disease and for patients in the chronic phase. Congenital infections are considered acute disease.
- The American Academy of Pediatrics (AAP) supports treatment of Chagas Disease in pediatric patients.
- There are two FDA-approved antiparasitic medications recommended to treat infection wth T.cruzi:
  - Benznidazole: For treatment in pediatric patients 2–12 years of age.
  - LAMPIT (Nifurtimox): For treatment in pediatric patients from birth to younger than 18 years (weighing at least 2.5 kg).
  - Use of benznidazole or Lampit® (nifurtimox) for patients outside the age range is based on clinical diagnosis and decision by the patient’s treating physician.
Adults 50 years and younger: Treatment is strongly recommended for patients with chronic infection, who do not already have advanced cardiomyopathy.
Adults over 50 years: The decision to treat patients with chronic infection using antiparasitic drugs should be individualized, weighing the potential benefits and risks.