Skip to main content

Chagas Disease in the United States (USA)

  • Chapter
  • First Online:
Chagas Disease

Abstract

In recent years, Chagas disease has become an emerging public health interest, and new evidence suggests that a significant disease burden exists in the United States. Implementation of national blood donor screening and regionalized community screening projects have provided novel insight into the at-risk populations residing in the country. Despite the presence of triatomines in the United States being known to the scientific community for over a century, very little is known about the distribution of vectors and their influence on autochthonous human cases. This chapter reviews the 11 triatomine species naturally found in the United States and provides a summary of the clinical and epidemiologic characteristics of human disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Schofield CJ, Dolling WR. Bedbugs and kissing-bugs (bloodsucking Hemiptera). In: Lane RP, Crosskey RW, editors. Medical Insects and Arachnids. Dordrecht: Springer; 1993.

    Google Scholar 

  2. Krinsky WL. True Bugs (Hemiptera). In: Mullen GR, Durden LA, editors. Medical and veterinary entomology. Burlington, MA: Elsevier; 2009.

    Google Scholar 

  3. Schofield CJ. The biosystematics of Triatominae. In: Service MW, editor. Biosystematics of haematophagous insects. Systematics Association. Oxford: Clarendon Press; 1988. p. 284–312.

    Google Scholar 

  4. Briones MR, Souto RP, Stolf BS, Zingales B. The evolution of two Trypanosoma cruzi subgroups inferred from rRNA genes can be correlated with the interchange of American mammalian faunas in the Cenozoic and has implications to pathogenicity and host specificity. Mol Biochem Parasitol. 1999;104(2):219–32.

    Article  CAS  PubMed  Google Scholar 

  5. Gorla DE, Dujardin JP, Schofield CJ. Biosystematics of old world triatominae. Acta Trop. 1997;63(2-3):127–40.

    Article  CAS  PubMed  Google Scholar 

  6. LeConte J. Remarks on two species of American Cimex. Proc Acad Nat Sci. 1855;7:404.

    Google Scholar 

  7. Lent H, Wygodzinsky P. Revision of the Triatominae (Hemiptera, Reduviidae) and their significance as vectors of Chagas’ Disease. Bull Am Museum Nat Hist. 1979;163(3):123–520.

    Google Scholar 

  8. Bern C, Kjos S, Yabsley MJ, Montgomery SP. Trypanosoma cruzi and Chagas’ Disease in the United States. Clin Microbiol Rev. 2011;24(4):655–81.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Packchanian A. Natural infection of Triatoma gerstaeckeri with Trypanosoma cruzi in Texas. Public Health Rep. 1939;54:1547–54.

    Article  Google Scholar 

  10. Wood SF. New localities for Trypanosoma cruzi Chagas in southwestern United States. Am J Trop Med Hyg. 1941;17:85–94.

    Google Scholar 

  11. Wood SF. Notes on the distribution and habits of reduviid vectors of Chagas’ disease in the southwestern United States, part I. Pan-Pacific Entomol. 1941;17:85–94.

    Google Scholar 

  12. Burkholder JE, Allison TC, Kelly VP. Trypanosoma cruzi (Chagas) (Protozoa: Kinetoplastida) in invertebrate, reservoir, and human hosts of the lower Rio Grande valley of Texas. J Parasitol. 1980;66(2):305–11.

    Article  CAS  PubMed  Google Scholar 

  13. Klotz SA, Dorn PL, Mosbacher M, Schmidt JO. Kissing bugs in the United States: risk for vector-borne disease in humans. Environ Health Insights. 2014;8(Suppl 2):49–59.

    PubMed  PubMed Central  Google Scholar 

  14. Wozniak EJ, Lawrence G, Gorchakov R, Alamgir H, Dotson E, Sissel B, et al. The biology of the triatomine bugs native to South Central Texas and assessment of the risk they pose for autochthonous Chagas Disease exposure. J Parasitol. 2015;101(5):520–8.

    Article  PubMed  Google Scholar 

  15. Kjos SA, Snowden KF, Olson JK. Biogeography and Trypanosoma cruzi infection prevalence of Chagas disease vectors in Texas, USA. Vector Borne Zoonotic Dis. 2009;9(1):41–50.

    Article  PubMed  Google Scholar 

  16. Martinez-Ibarra JA, Alejandre-Aguilar R, Paredes-Gonzalez E, Martinez-Silva MA, Solorio-Cibrian M, Nogueda-Torres B, et al. Biology of three species of North American Triatominae (Hemiptera: Reduviidae: Triatominae) fed on rabbits. Mem Inst Oswaldo Cruz. 2007;102(8):925–30.

    Article  PubMed  Google Scholar 

  17. Ryckman RE. The vertebrate hosts of the Triatomine of North and Central America and the West Indies (Hemiptera: Reduviidae: Triatominae). Bull Soc Vector Ecol. 1986;11:221–41.

    Google Scholar 

  18. Pippin WF, Law PF, Gaylor MJ. Triatoma sanguisuga Texana Usinger and Triatoma sanguisuga indictive Neiva naturally infected with Trypanosoma cruzi Chagas in Texas (Hemiptera: Triatominae) (Kinetoplastida: Trypanosomidae). J Med Entomol. 1968;5(1):134.

    Article  CAS  PubMed  Google Scholar 

  19. Packchanian A. Natural infection of Triatoma heidemanni with Trypanosoma cruzi in Texas. Public Health Rep. 1940;55:1300–6.

    Article  Google Scholar 

  20. Ryckman RE, Ryckman JV. Epizootiology of Trypanosoma cruzi in southwestern North America. XII. Does Gause’s rule apply to the ectoparasitic Triatominae? (Hemiptera: Reduviidae) (Kinetoplastidae: Trypanosomidae) (Rodentia: Cricetidae). J Med Entomol. 1967;4(3):379–86.

    Article  CAS  PubMed  Google Scholar 

  21. Williams GD, Adams LG, Yaeger RG, McGrath RK, Read WK, Bilderback WR. Naturally occurring trypanosomiasis (Chagas’ disease) in dogs. J Am Vet Med Assoc. 1977;171(2):171–7.

    CAS  PubMed  Google Scholar 

  22. Yabsley MJ, Noblet GP. Seroprevalence of Trypanosoma cruzi in raccoons from South Carolina and Georgia. J Wildl Dis. 2002;38(1):75–83.

    Article  PubMed  Google Scholar 

  23. Moffett A, Strutz S, Guda N, Gonzalez C, Ferro MC, Sanchez-Cordero V, et al. A global public database of disease vector and reservoir distributions. PLoS Negl Trop Dis. 2009;3(3):e378.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kjos SA, Gillespie JJ, Olson JK, Snowden KF. Detection of Blastocrithidia spp. (Kinetoplastida: Trypanosomatidae) in Chagas disease vectors from Texas, USA. Vector Borne Zoonotic Dis. 2009;9(2):213–6.

    Article  PubMed  Google Scholar 

  25. Sullivan TD, Mc GT, et al. Incidence of Trypanosoma cruzi, Chagas, in Triatoma (Hemiptera, Reduviidae) in Texas. Am J Trop Med Hyg. 1949;29(4):453–8.

    Article  CAS  PubMed  Google Scholar 

  26. Mortenson EW, Walsh JD, editors. Review of the Triatoma protracta problem in the Sierra Nevada foothills of California. 31st Annual Conference of the California Mosquito Control Association; 1961. Sacramento, CA: California Mosquito Control Association; 1963.

    Google Scholar 

  27. Mehringer PJ, Wood SF. A resampling of wood rat houses and human habitations in Griffith Park, Los Angeles, for Triatoma protracta and Trypanosoma cruzi. Bull South Calif Acad Sci. 1958;57:39–46.

    Google Scholar 

  28. Walsh JD, Jones JP. Public Health Significance of the cone-nosed bug, Triatoma protracta (Uhler) in the Sierra Nevada foothills of California. Calif Vector Views. 1962;9:33–7.

    Google Scholar 

  29. Sjogren RD, Ryckman RE. Epizootiology of Trypanosoma cruzi in southwestern North America. 8. Nocturnal flights of Triatoma protracta (Uhler) as indicated by collections at black light traps (Hemiptera: Reduviidae: Triatominae). J Med Entomol. 1966;3(1):81–92.

    Article  CAS  PubMed  Google Scholar 

  30. Georgieva AY, Gordon ERL, Weirauch C. Sylvatic host associations of Triatominae and implications for Chagas disease reservoirs: a review and new host records based on archival specimens. PeerJ. 2017;5:e3826.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Wood SF. Importance of feeding and defecation times of insect vectors in transmission of Chagas’ disease. J Econ Entomol. 1951;44:52–4.

    Article  Google Scholar 

  32. Klotz SA, Dorn PL, Klotz JH, Pinnas JL, Weirauch C, Kurtz JR, et al. Feeding behavior of triatomines from the southwestern United States: an update on potential risk for transmission of Chagas disease. Acta Trop. 2009;111(2):114–8.

    Article  PubMed  Google Scholar 

  33. Ikenga JO, Richerson JV. Trypanosoma cruzi (Chagas) (protozoa: Kinetoplastida: Trypanosomatidae) in invertebrate and vertebrate hosts from Brewster County in Trans-Pecos Texas. J Econ Entomol. 1984;77(1):126–9.

    Article  CAS  PubMed  Google Scholar 

  34. Pfeiler E, Bitler BG, Ramsey JM, Palacios-Cardiel C, Markow TA. Genetic variation, population structure, and phylogenetic relationships of Triatoma rubida and T. recurva (Hemiptera: Reduviidae: Triatominae) from the Sonoran Desert, insect vectors of the Chagas’ disease parasite Trypanosoma cruzi. Mol Phylogenet Evol. 2006;41(1):209–21.

    Article  CAS  PubMed  Google Scholar 

  35. Wood SF. Additional observations on Trypanosoma cruzi Chagas, from Arizona in insects, rodents, and experimentally infected animals. Am J Trop Med Hyg. 1949;29(1):43–55.

    Article  CAS  PubMed  Google Scholar 

  36. Klotz JH, Dorn PL, Logan JL, Stevens L, Pinnas JL, Schmidt JO, et al. “Kissing bugs”: potential disease vectors and cause of anaphylaxis. Clin Infect Dis. 2010;50(12):1629–34.

    Article  PubMed  Google Scholar 

  37. Reisenman CE, Lawrence G, Guerenstein PG, Gregory T, Dotson E, Hildebrand JG. Infection of kissing bugs with Trypanosoma cruzi, Tucson, Arizona, USA. Emerg Infect Dis. 2010;16(3):400–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Wood SF. Notes on the feeding of the cone-nosed bugs (Hemiptera: Reduviidae). J Parasitol. 1944;30:197–8.

    Article  Google Scholar 

  39. Wood SF. Body weight and blood meal size in conenose bugs, Triatoma and Paratriatoma. Bull South Calif Acad Sci. 1959;58:116–8.

    Google Scholar 

  40. Elkens D. Nocturnal Flights of the Triatoma (Hemiptera: Reduviidae) in Sabino Cayon, Arizona, II. Neotoma lodge studies. J Med Entomol. 1984;21:140–4.

    Article  Google Scholar 

  41. Pinnas JL, Lindberg RE, Chen TM, Meinke GC. Studies of kissing bug-sensitive patients: evidence for the lack of cross-reactivity between Triatoma protracta and Triatoma rubida salivary gland extracts. J Allergy Clin Immunol. 1986;77(2):364–70.

    Article  CAS  PubMed  Google Scholar 

  42. Reisenman CE, Gregory T, Guerenstein PG, Hildebrand JG. Feeding and defecation behavior of Triatoma rubida (Uhler, 1894) (Hemiptera: Reduviidae) under laboratory conditions, and its potential role as a vector of Chagas disease in Arizona, USA. Am J Trop Med Hyg. 2011;85(4):648–56.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Usinger RL, United States. Public Health Service. States Relations Division. The Triatominae of North and Central America and the West Indies and their public health significance. Washington, DC: Govt. Print. Off.; 1944. p. iv. 83.

    Google Scholar 

  44. Ryckman RE. The genus Paratriatoma in western North America. J Med Entomol. 1971;8(1):87–97.

    Article  CAS  PubMed  Google Scholar 

  45. Grundemann AW. Studies on the biology of the Triatoma sanguisuga (Leconte) in Kansas (Reduviidae: Triatominae). Kansas Entomol Soc. 1947;20:77–85.

    Google Scholar 

  46. Olsen PF, Shoemaker JP, Turner HF, Hays KL. Incidence of Trypanosoma cruzi (Chagas) in wild vectors and reservoirs in East-Central Alabama. J Parasitol. 1964;50:599–603.

    Article  CAS  PubMed  Google Scholar 

  47. Yaeger RG. The prevalence of Trypanosoma cruzi infection in armadillos collected at a site near New Orleans, Louisiana. Am J Trop Med Hyg. 1988;38(2):323–6.

    Article  CAS  PubMed  Google Scholar 

  48. Kjos SA, Snowden KF, Craig TM, Lewis B, Ronald N, Olson JK. Distribution and characterization of canine Chagas disease in Texas. Vet Parasitol. 2008;152(3-4):249–56.

    Article  CAS  PubMed  Google Scholar 

  49. Kimball BM. Conorhinus sanguisuga, its habits and life history. Kansas Acad Sci. 1894;14:128–31.

    Google Scholar 

  50. Waleckx E, Suarez J, Richards B, Dorn PL. Triatoma sanguisuga blood meals and potential for Chagas disease, Louisiana, USA. Emerg Infect Dis. 2014;20(12):2141–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Usinger RL. Descriptions of new Triatominae, with a key to genera (Hemiptera, Reduviidae). Berkeley, CA: University of California Press; 1939. p. 33–5. cover-title, 1 p. l.

    Google Scholar 

  52. Ryckman RE. The triatominae of North hand Central America and the West Indies: a checklist with synonymy (Hemiptera: Reduviidae: Triatominae). Bull Soc Vector Ecol. 1984;9:71–83.

    Google Scholar 

  53. Wood SF. The occurrence of Trypanosoma conorhini Donovan in the reduviid bug, Triatoma rubrofasciata (Degeer) from Oahu, TH. Proc Hawaii Entomol Soc. 1946;29:43–55.

    Google Scholar 

  54. Arnold HL, Bell DB. Kissing bug bites. J Clin Immunol. 1944;74:436–42.

    Google Scholar 

  55. Dias JC, Silveira AC, Schofield CJ. The impact of Chagas disease control in Latin America: a review. Mem Inst Oswaldo Cruz. 2002;97(5):603–12.

    Article  CAS  PubMed  Google Scholar 

  56. Garcia MN, Woc-Colburn L, Aguilar D, Hotez PJ, Murray KO. Historical perspectives on the epidemiology of human Chagas disease in Texas and recommendations for enhanced understanding of clinical Chagas disease in the Southern United States. PLoS Negl Trop Dis. 2015;9(11):e0003981.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Woody NC, Woody HB. American trypanosomiasis (Chagas’ disease); first indigenous case in the United States. JAMA. 1955;159(7):676–7.

    Article  CAS  Google Scholar 

  58. Greer DA. Found: two cases of Chagas disease. Texas Health Bull. 1955;9:11–3.

    Google Scholar 

  59. Cantey PT, Stramer SL, Townsend RL, Kamel H, Ofafa K, Todd CW, et al. The United States Trypanosoma cruzi Infection Study: evidence for vector-borne transmission of the parasite that causes Chagas disease among United States blood donors. Transfusion. 2012;52(9):1922–30.

    Article  PubMed  Google Scholar 

  60. Garcia MN, Woc-Colburn L, Rossmann SN, Townsend RL, Stramer SL, Bravo M, et al. Trypanosoma cruzi screening in Texas blood donors, 2008-2012. Epidemiol Infect. 2016;144(5):1010–3.

    Article  CAS  PubMed  Google Scholar 

  61. Manne-Goehler J, Umeh CA, Montgomery SP, Wirtz VJ. Estimating the burden of Chagas Disease in the United States. PLoS Negl Trop Dis. 2016;10(11):e0005033.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Bern C, Montgomery SP, Katz L, Caglioti S, Stramer SL. Chagas disease and the US blood supply. Curr Opin Infect Dis. 2008;21(5):476–82.

    Article  PubMed  Google Scholar 

  63. Buekens P, Almendares O, Carlier Y, Dumonteil E, Eberhard M, Gamboa-Leon R, et al. Mother-to-child transmission of Chagas’ disease in North America: why don’t we do more? Matern Child Health J. 2008;12(3):283–6.

    Article  PubMed  Google Scholar 

  64. Centers for Disease. C, Prevention. Congenital transmission of Chagas disease - Virginia, 2010. MMWR Morb Mortal Wkly Rep. 2012;61(26):477–9.

    Google Scholar 

  65. Murillo J, Bofill LM, Bolivar H, Torres-Viera C, Urbina JA, Benhayon D, et al. Congenital Chagas’ disease transmission in the United States: diagnosis in adulthood. IDCases. 2016;5:72–5.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Di Pentima MC, Hwang LY, Skeeter CM, Edwards MS. Prevalence of antibody to Trypanosoma cruzi in pregnant Hispanic women in Houston. Clin Infect Dis. 1999;28(6):1281–5.

    Article  PubMed  Google Scholar 

  67. Edwards MS, Rench MA, Todd CW, Czaicki N, Steurer FJ, Bern C, et al. Perinatal screening for Chagas Disease in Southern Texas. J Pediatric Infect Dis Soc. 2015;4(1):67–70.

    Article  PubMed  Google Scholar 

  68. Stimpert KK, Montgomery SP. Physician awareness of Chagas disease, USA. Emerg Infect Dis. 2010;16(5):871–2.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Schmunis GA, Yadon ZE. Chagas disease: a Latin American health problem becoming a world health problem. Acta Trop. 2010;115(1-2):14–21.

    Article  PubMed  Google Scholar 

  70. Bern C, Montgomery SP. An estimate of the burden of Chagas disease in the United States. Clin Infect Dis. 2009;49(5):e52–4.

    Article  PubMed  Google Scholar 

  71. Kapelusznik L, Varela D, Montgomery SP, Shah AN, Steurer FJ, Rubinstein D, et al. Chagas disease in Latin American immigrants with dilated cardiomyopathy in New York City. Clin Infect Dis. 2013;57(1):e7.

    Article  PubMed  Google Scholar 

  72. Traina MI, Sanchez DR, Hernandez S, Bradfield JS, Labedi MR, Ngab TA, et al. Prevalence and impact of Chagas Disease among Latin American immigrants with nonischemic cardiomyopathy in Los Angeles, California. Circ Heart Fail. 2015;8(5):938–43.

    Article  CAS  PubMed  Google Scholar 

  73. Hsia HH, Marchlinski FE. Electrophysiology studies in patients with dilated cardiomyopathies. Card Electrophysiol Rev. 2002;6(4):472–81.

    Article  PubMed  Google Scholar 

  74. Benaim G, Sanders JM, Garcia-Marchan Y, Colina C, Lira R, Caldera AR, et al. Amiodarone has intrinsic anti-Trypanosoma cruzi activity and acts synergistically with posaconazole. J Med Chem. 2006;49(3):892–9.

    Article  CAS  PubMed  Google Scholar 

  75. Kransdorf EP, Czer LS, Luthringer DJ, Patel JK, Montgomery SP, Velleca A, et al. Heart transplantation for Chagas cardiomyopathy in the United States. Am J Transplant. 2013;13(12):3262–8.

    Article  CAS  PubMed  Google Scholar 

  76. Fiorelli AI, Santos RH, Oliveira JL Jr, Lourenco-Filho DD, Dias RR, Oliveira AS, et al. Heart transplantation in 107 cases of Chagas’ disease. Transplant Proc. 2011;43(1):220–4.

    Article  CAS  PubMed  Google Scholar 

  77. Godoy HL, Guerra CM, Viegas RF, Dinis RZ, Branco JN, Neto VA, et al. Infections in heart transplant recipients in Brazil: the challenge of Chagas’ disease. J Heart Lung Transplant. 2010;29(3):286–90.

    Article  PubMed  Google Scholar 

  78. Campos SV, Strabelli TM, Amato Neto V, Silva CP, Bacal F, Bocchi EA, et al. Risk factors for Chagas’ disease reactivation after heart transplantation. J Heart Lung Transplant. 2008;27(6):597–602.

    Article  PubMed  Google Scholar 

  79. Schwartz BS, Paster M, Ison MG, Chin-Hong PV. Organ donor screening practices for Trypanosoma cruzi infection among US Organ Procurement Organizations. Am J Transplant. 2011;11(4):848–51.

    Article  CAS  PubMed  Google Scholar 

  80. Kun H, Moore A, Mascola L, Steurer F, Lawrence G, Kubak B, et al. Transmission of Trypanosoma cruzi by heart transplantation. Clin Infect Dis. 2009;48(11):1534–40.

    Article  PubMed  Google Scholar 

  81. Bern C, Montgomery SP, Herwaldt BL, Rassi A Jr, Marin-Neto JA, Dantas RO, et al. Evaluation and treatment of Chagas disease in the United States: a systematic review. JAMA. 2007;298(18):2171–81.

    Article  CAS  PubMed  Google Scholar 

  82. Afonso AM, Ebell MH, Tarleton RL. A systematic review of high quality diagnostic tests for Chagas disease. PLoS Negl Trop Dis. 2012;6(11):e1881.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Diez M, Favaloro L, Bertolotti A, Burgos JM, Vigliano C, Lastra MP, et al. Usefulness of PCR strategies for early diagnosis of Chagas’ disease reactivation and treatment follow-up in heart transplantation. Am J Transplant. 2007;7(6):1633–40.

    Article  CAS  PubMed  Google Scholar 

  84. Qvarnstrom Y, Schijman AG, Veron V, Aznar C, Steurer F, da Silva AJ. Sensitive and specific detection of Trypanosoma cruzi DNA in clinical specimens using a multi-target real-time PCR approach. PLoS Negl Trop Dis. 2012;6(7):e1689.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Centers for Disease Control and Prevention. Spotlight on CDC’s parasitic disease work. Atlanta, GA: Centers for Disease Control; 2015.

    Google Scholar 

  86. Manne J, Snively CS, Levy MZ, Reich MR. Supply chain problems for Chagas disease treatment. Lancet Infect Dis. 2012;12(3):173–5.

    Article  PubMed  Google Scholar 

  87. Alpern JD, Lopez-Velez R, Stauffer WM. Access to benznidazole for Chagas disease in the United States-Cautious optimism? PLoS Negl Trop Dis. 2017;11(9):e0005794.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Forsyth CJ, Hernandez S, Olmedo W, Abuhamidah A, Traina MI, Sanchez DR, et al. Safety profile of nifurtimox for treatment of Chagas Disease in the United States. Clin Infect Dis. 2016;63(8):1056–62.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Melissa S. Nolan .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nolan, M.S., Dye-Braumuller, K., Clark, E. (2019). Chagas Disease in the United States (USA). In: Altcheh, J., Freilij, H. (eds) Chagas Disease. Birkhäuser Advances in Infectious Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-00054-7_6

Download citation

Publish with us

Policies and ethics