Autochthonous Chagas Disease — Missouri, 2018

George Turabelidze, MD, PhD; Archana Vasudevan, MD; Christian Rojas-Moreno, MD; Susan P. Montgomery, DVM; Molly Baker, MPH; Drew Pratt, MS; Susanne Enyeart


Morbidity and Mortality Weekly Report. 2020;69(7):193-195. 

In This Article

Public Health Investigation

The patient had lived in Missouri her entire life and moved to her current county of residence in 1999. From 1999 to 2012, she had lived in three different houses of varying structural integrity and had moved into her current (fourth) house in 2012. The patient reported seeing boxelder bugs, which do not transmit disease, but had never seen a "kissing bug" at any of the four properties. The patient's husband recalled seeing some insects consistent with the digital images of triatomine bug in one of their residences but could not recall specific time and location.

An environmental evaluation was conducted by MDHSS and local public health agency staff members at all four residencies. Brush, woodpiles, and construction debris were found on most properties. Time-worn, nonresidential structures (e.g., sheds) that provided opportunities for animal nesting were also present at all properties. Two of the older residential structures had sufficient external damage to allow easy insect access to the interior. There were crawl spaces under the two houses. No triatomine insects were detected at any of the properties.