Genetic Diversity of in the United States of America: The Least Endemic Country for Chagas Disease.

Chagas disease (CD), caused by and endemic in Latin America, has become an emergent health problem in non-endemic countries due to human migration. The United States (US) is the non-Latin American country with the highest CD burden and cannot be considered as non-endemic, since triatomine vectors and reservoir animals have been found. Populations of are divided into genetic subdivisions, which are known as discrete typing units (DTUs): TcI to TcVI and TcBat. Autochthonous human infection in the US is sporadic, but it may change due to environmental factors affecting the geographic distribution of triatomines. We aimed to perform a literature review of the genetic diversity of in triatomine vectors and mammalian hosts, including human cases, in the US. The 34 analyzed studies revealed the presence of in 18 states, which was mainly concentrated in Texas, Louisiana and New Mexico. TcI and TcIV were the principal DTUs identified, being TcI the most genotyped (42.4%; 917/2164). This study represents a first attempt to compile the molecular epidemiology of in the US, which is fundamental for predicting the progression of the infection in the country and could be of great help in its future management.