Chagas Disease Screening in Maternal Donors of Publicly Banked Umbilical Cord Blood, United States.

Chagas disease, a parasitic disease caused by Trypanosoma cruzi, is increasingly seen in non–disease-endemic areas, secondary to population movements (1). Vertical transmission of this parasite to a developing fetus occurs at a rate of ≈4.7% and can cause substantial perinatal illness and death (2). Adverse pregnancy-related outcomes include increased rates of preterm delivery, restricted fetal growth, low birthweight, premature rupture of membranes, and polyhydramnios (3). Mortality rates among congenitally infected infants approach 5%, mostly secondary to myocarditis and meningoencephalitis. Long-term maternal and child conditions include dilated cardiomyopathy and gastrointestinal disorders, with mortality rates as high as 13% (4). Fortunately, infants within the first year of life tolerate treatment well, and the infection is usually cured (3). Because screening for and treating this infection has potential benefits, the World Health Assembly adopted a resolution recommending screening for Chagas disease among pregnant women in non–disease-endemic areas who were born in disease-endemic areas, who lived extensively in disease-endemic areas, or who were born to mothers who lived in disease-endemic areas (5). The US Food and Drug Administration instituted guidelines for screening in 2007 (6). This screening also applied to mothers donating their newborn infants’ cord blood to public cord blood banks. Therefore, we reviewed identified cases of Chagas disease in maternal donors to a public umbilical cord blood bank to estimate disease prevalence and population characteristics in a non–disease-endemic area of the United States.