{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:39:24Z","timestamp":1781674764354,"version":"3.54.5"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013036","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000}}],"reference-count":92,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["1NU51CK000387-01-00"],"award-info":[{"award-number":["1NU51CK000387-01-00"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Chagas disease is caused by infection with the protozoan parasite <jats:italic>Trypanosoma cruzi<\/jats:italic>, which is carried in the guts of triatomine insects. Transmission typically occurs when infective trypomastigotes in triatomine feces encounter mucous membranes or bite wounds, though it is also possible by food-borne, transplant- and transfusion-mediated, and congenital routes. Most transmission occurs in rural and peri-urban parts of continental Latin America where triatomines often inhabit human dwellings. Triatomines infected with <jats:italic>T. cruzi<\/jats:italic> are also present across the southern United States, yet relatively few locally acquired infections have been documented. Rather, most reported cases have plausible exposure in Latin America. In California, the widespread distribution of <jats:italic>T. cruzi<\/jats:italic>-infected triatomines suggests a potential risk of local transmission. Here, we summarize triatomine submissions and human case reports made to the California Department of Public Health between 2013 and 2023. Of 226 triatomines tested, 63 (28%) were positive for <jats:italic>T. cruzi<\/jats:italic> via PCR; none were linked to any of the 40 human <jats:italic>T. cruzi<\/jats:italic> cases reported in the same period. Human cases were assessed for likelihood of local transmission. Country of birth, travel history, and location of primary residence suggested non-local transmission for 31 (78%) cases. Local transmission could not be ruled out for the remaining nine (22%) cases. Information on country of birth and travel history were missing from these case reports and prevented full assessment of local transmission criteria, though most of these patients resided within 400 meters of potential triatomine habitat. Despite the presence of triatomines, <jats:italic>T. cruzi<\/jats:italic>, and human cases in California, statewide data indicates the risk for locally acquired Chagas disease is low.<\/jats:p>","DOI":"10.1371\/journal.pntd.0013036","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T17:53:37Z","timestamp":1745258017000},"page":"e0013036","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Low risk for locally acquired Chagas disease in California: A review of human cases and triatomine submissions, 2013\u20132023"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0880-310X","authenticated-orcid":true,"given":"Andrea J.","family":"Lund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco E.","family":"Metzger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki L.","family":"Kramer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Kjemtrup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"issue":"8","key":"pntd.0013036.ref001","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1590\/S0074-02762003000800018","article-title":"Ecological characteristics of Triatoma patagonica at the southern limit of its distribution (Chubut, Argentina)","volume":"98","author":"C Wisnivesky-Colli","year":"2003","journal-title":"Mem Inst Oswaldo Cruz"},{"key":"pntd.0013036.ref002","doi-asserted-by":"crossref","first-page":"170050","DOI":"10.1038\/sdata.2017.50","article-title":"The contemporary distribution of Trypanosoma cruzi infection in humans, alternative hosts and vectors","volume":"4","author":"AJ Browne","year":"2017","journal-title":"Sci Data"},{"issue":"6","key":"pntd.0013036.ref003","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1021\/acsinfecdis.2c00123","article-title":"An Updated View of the Trypanosoma cruzi Life Cycle: Intervention Points for an Effective Treatment","volume":"8","author":"J Mart\u00edn-Escolano","year":"2022","journal-title":"ACS Infect Dis"},{"key":"pntd.0013036.ref004","doi-asserted-by":"crossref","DOI":"10.1093\/jmedent\/2.1.87","article-title":"Epizootiology of Trypanosoma cruzi in southwestern North America.","volume":"2","author":"RE Ryckman","year":"1965","journal-title":"J Med Entomol"},{"issue":"6","key":"pntd.0013036.ref005","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.3201\/eid2806.220079","article-title":"Lizards as Silent Hosts of Trypanosoma cruzi","volume":"28","author":"C Botto-Mahan","year":"2022","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pntd.0013036.ref006","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1186\/s13071-018-3067-2","article-title":"Trypanosoma cruzi transmission in the wild and its most important reservoir hosts in Brazil","volume":"11","author":"AM Jansen","year":"2018","journal-title":"Parasit Vectors"},{"key":"pntd.0013036.ref007","article-title":"Biology, ecology, and systematics of Triatominae (Heteroptera, Reduviidae), vectors of Chagas disease, and implications for human health","volume-title":"Hug the Bug, for love of true bugs","author":"J Jurberg","year":"2006"},{"key":"pntd.0013036.ref008","first-page":"33","article-title":"Chagas disease in Latin America: An epidemiological update based on 2010 estimates.","volume":"6","author":"World Health Organization.","year":"2015","journal-title":"Week Epidemiol Rec."},{"issue":"7","key":"pntd.0013036.ref009","doi-asserted-by":"crossref","first-page":"360","DOI":"10.3390\/tropicalmed8070360","article-title":"What Do You Need to Know before Studying Chagas Disease? 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Wood","year":"1951","journal-title":"Bull So Calif Acad Sci"},{"key":"pntd.0013036.ref063","article-title":"The distribution of triatomine (Hemiptera: Reduviidae) vectors of Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in Illinois and Missouri: Historical records and specimen submissions from community science programs","author":"EM Santos","year":"2023","journal-title":"J Med Entomol"},{"key":"pntd.0013036.ref064","first-page":"20","author":"Council of State and Territorial Epidemiologists","year":"2024"},{"key":"pntd.0013036.ref065","first-page":"167","article-title":"The kissing bug problem in western North America.","volume":"6","author":"RE Ryckman","year":"1981","journal-title":"Bull Soc Vector Ecol"},{"issue":"65","key":"pntd.0013036.ref066","doi-asserted-by":"crossref","first-page":"3544","DOI":"10.21105\/joss.03544","article-title":"tidygeocoder: An R package for geocoding","volume":"6","author":"J Cambon","year":"2021","journal-title":"JOSS"},{"key":"pntd.0013036.ref067","author":"Esri","year":"2025"},{"issue":"4","key":"pntd.0013036.ref068","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1111\/zph.12797","article-title":"History of indigenous Trypanosoma cruzi infection in humans, animals and triatomines in California, USA","volume":"68","author":"KC Dye-Braumuller","year":"2021","journal-title":"Zoonoses Public Health"},{"issue":"5","key":"pntd.0013036.ref069","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.4269\/ajtmh.2010.10-0167","article-title":"Infection rates of Triatoma protracta (Uhler) with Trypanosoma cruzi in Southern California and molecular identification of trypanosomes","volume":"83","author":"WS Hwang","year":"2010","journal-title":"Am J Trop Med Hyg"},{"issue":"6","key":"pntd.0013036.ref070","first-page":"737","article-title":"Probability of transmission of Chagas disease by Triatoma infestans (Hemiptera: Reduviidae) in an endemic area of Santiago del Estero, Argentina","volume":"68","author":"JE Rabinovich","year":"1990","journal-title":"Bull World Health Organ"},{"issue":"11","key":"pntd.0013036.ref071","doi-asserted-by":"crossref","first-page":"e2505","DOI":"10.1371\/journal.pntd.0002505","article-title":"The improbable transmission of Trypanosoma cruzi to human: the missing link in the dynamics and control of Chagas disease","volume":"7","author":"P Nouvellet","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013036.ref072","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/jmedent\/3.1.81","article-title":"Epizootiology of Trypanosoma cruzi in southwestern North America. 8. 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