Chagas disease, caused by the protozoan Trypanosoma cruzi, is responsible for a greater disease burden than any other parasitic disease in the New World. Infection occurs when the triatomine vector defecates during its blood meal and fecal material containing the parasite is inoculated through the bite wound or mucous membranes .Vector-borne transmission occurs only in the Americas, where an estimated 8 million people are currently infected with T. cruzi. Historically, transmission was concentrated in rural Latin America, but successful vector-control programs have greatly decreased transmission in areas where the disease was formerly endemic, whereas migration has brought infected individuals to cities in Latin America, as well as to the United States, Europe, and Japan .Chagas (CHAH-gus) disease is an inflammatory, infectious disease caused by a parasite found in the feces of the triatomine (reduviid) bug. Infected bugs defecate after feeding, leaving behind T. cruzi parasites on the skin. The parasites can then enter your body through your eyes, mouth, a cut or scratch, or the wound from the bug's bite the parasites usually enter the mammalian (human) host through the bug bite, or breaks in the skin or conjunctiva, replicate in mammalian cells, and may eventually reach other organs through the blood. Chronic-phase symptoms and signs of Chagas disease may be irregular heartbeats, EKG changes, palpitations, fainting (syncope), cardiomyopathy, congestive heart failure, shortness of breath (dyspnea), emphysema, stroke, sudden death, chronic abdominal pain, chronic constipation, dilated colon, and difficulty swallowing. Upper endoscopy, a procedure in which you swallow a thin, lighted tube (endoscope) that transmits images of your esophagus onto a screen. Treatment with antiparasitic drugs benznidazole (Rochagan, Ragonil) and nifurtimox (Lampit) kill or inhibit T. cruzi parasites; drugs are available from the CDC.