Chagas

Reportable by Laboratories and Providers

About this Reportable Disease

Infectious agent:  Trypanosoma cruzi

Description of illness: Chagas disease, also called American trypanosomiasis, is caused by the protozoan parasite Trypanosoma cruzi. The parasite is transmitted to humans by an infected triatomine bug, or “kissing bug.” Chagas disease is comprised of acute and chronic phases. The acute phase usually occurs 1 to 2 weeks after infection and can last up to a few weeks or months. Parasites may be found in the blood during this time. The infection can be mild or asymptomatic. Symptoms, when they occur, include fever and swelling around the site where the parasite entered the host. After the acute phase, most people enter a chronic phase, during which no parasites are found in the blood. Many people remain asymptomatic for life; however, approximately 30% will develop medical problems that may be debilitating or life threatening, such as heart rhythm abnormalities that can cause sudden death or a dilated heart, esophagus or colon.

Interactive Disease Data


Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

  • It is caused by the parasite Trypanosoma cruzi, most commonly transmitted via the feces of infected triatomine (kissing) bugs. 
  • The disease has two phases: an acute phase (shortly after infection) and a chronic phase, possibly lasting years or decades.
  • Acute symptoms may be mild or absent; when present, they include fever, fatigue, body aches, and in some cases swelling of the eyelid (Romaña’s sign).
  • In the chronic phase, about 20-30% of infected individuals may develop serious complications such as heart enlargement, heart rhythm problems, or digestive tract enlargement. 
  • Treatment involves antiparasitic medications (e.g., Benznidazole, Nifurtimox) most effective when given early, plus management of any cardiac or gastrointestinal complications.

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting. 

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link. 

Information about this Reportable Disease for the Public

What it is

Chagas disease is an infection caused by the parasite Trypanosoma cruzi.

It is mainly found in rural parts of Latin America, but there is evidence of local transmission in parts of the United States as well.

The parasite is most often transmitted by insects called triatomine or “kissing bugs,” which bite and then leave parasite-laden feces near the wound or mucous membranes. 

Types

Chagas disease typically has two main phases:

The acute phase, which occurs shortly after infection and may last weeks or months. 

The chronic phase, which may persist for many years (even decades) after the initial infection; many people remain asymptomatic but a portion develop serious complications.

Signs and Symptoms

In the acute phase: Many people have no symptoms or very mild, non-specific symptoms such as fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, vomiting.

A characteristic sign can be swelling of the eyelid (“Romaña’s sign”) if the bug bite was near the eye.

In the chronic phase: About 20-30% of infected individuals may develop serious complications such as dilated cardiomyopathy (enlarged heart), arrhythmias (abnormal heart rhythms), heart failure, or gastrointestinal-tract problems (e.g., enlarged esophagus or colon).

Treatment

The most effective approach is antiparasitic therapy, which is most effective when started early after infection. CDC+1

Two drugs available in the U.S. are Benznidazole and Nifurtimox. CDC

Benznidazole is FDA-approved for children 2-12 years old; off-label use may apply for other ages under physician guidance. CDC

Nifurtimox (brand Lampit®) is FDA-approved for children under 18 weighing ≥2.5 kg; adults may be treated off-label under physician decision. CDC

In the chronic phase, antiparasitic treatment may not reverse established cardiac or gastrointestinal damage, so symptomatic care (e.g., for heart failure, arrhythmias, digestive issues) is often needed.

This Page Last Updated: March 25, 2026 at 8:53 PM