The Brief

When Maira Gutiérrez was diagnosed with Chagas disease in 1997, neither she nor her primary care physician had even heard of the malady. She discovered her illness only by chance, after participating in a Red Cross blood drive organized by her employer, Universal Studios.

Red Cross tests donated blood for a range of diseases, including Chagas, which is caused by a parasite and can develop silently for decades before causing symptoms. The test detected Chagas in her body, and an MRI years later, in 2013, confirmed it had reached her heart.

“They showed me the image with the trace of the parasite to my heart. It was really scary,” Gutiérrez, originally from El Salvador, said in Spanish. Now 50, she remains healthy but undergoes a battery of tests annually to monitor for heart damage.

Trypanosoma cruzi, the parasite that causes Chagas, is transmitted through an insect called the triatomine bug, known as the kissing bug because it usually bites close to the lips. The bugs defecate on the skin, and the feces, which can contain the parasite, can enter a person’s body through the nose, mouth, or breaks in the skin.

Chagas in the U.S.

Chagas disease affects people primarily in rural Latin America, where the insect thrives in thatched roofs and mud walls. It is not transmitted from person to person, except for a mother passing it to a newborn, or through blood transfusions or organ transplants.

But it’s increasingly present in the United States, where it often goes unrecognized: The Centers for Disease Control and Prevention estimates more than 300,000 people living in the U.S. have Chagas, though lack of awareness and testing means only 1% of cases have been identified.

Doctors, researchers, and patient advocates say the nation could be doing far more to combat Chagas, which causes serious heart disease in an estimated 30% of infected people and can also lead to crippling digestive problems such as enlargement of the esophagus and colon. They are pushing for increased access to testing and treatment and are optimistic about a new drug that’s set for human trials next year. A bill in Congress to up funding for rare diseases, which supporters hope will be debated in the fall, could help too.

'Tremendous lack of awareness'

Still, in the U.S., there is “a tremendous lack of awareness about this disease,” said Rachel Marcus, a cardiologist and the medical director of the Latin American Society of Chagas, who runs a Chagas testing clinic in northern Virginia. “We were taught that it is something we don’t see in the United States.”

Left: Ronald Drew Etheridge, an assistant professor at the University of Georgia, studies the molecular tools used by the Trypanosoma cruzi parasite to make itself at home in various target environments. He is holding the kissing bug’s favorite food: blood. Right: Maira Gutiérrez discovered she had Chagas disease when she donated blood to the Red Cross in 1997. She struggled to find a doctor who knew something about the condition.

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Paula Andalo (L) and Carmen Echeverria (R)

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KFF Health News

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A large proportion of those with Chagas are from Latin America, and many are living in the U.S. without legal permission. Marcus notes that many of those most at risk from Chagas use community health centers that could be testing sites but have limited resources, and tend to focus on more common conditions such as high blood pressure and diabetes.

Chagas initially produces flu-like symptoms but can then go unnoticed for decades while it reproduces in the body. Drug treatments can sometimes eradicate the parasite, especially in its first stages, but the window for early detection is short: It does not stay in the bloodstream for long, instead migrating to tissues and organs, where it is harder to detect.

Often by the time a patient sees a doctor, that person has already developed serious complications, including heart rhythm abnormalities or a dilated heart that doesn’t pump blood well. Patients may eventually need pacemakers or heart transplants.

“It is a disease resulting from systemic failures in the health care system,” said writer Daisy Hernández, author of “The Kissing Bug: A True Story of a Family, an Insect, and a Nation’s Neglect of a Deadly Disease.”

In her book, Hernández tells the story of her aunt Dora, who was diagnosed with Chagas in the U.S. Before, in her country, Colombia, she had an exploratory surgery because of a swollen stomach and the doctors told her that she had “the intestines of 10 people” due to the amount of inflammation. No one suspected it could have been caused by the Chagas parasite.

Hernández said interviews with over 70 doctors and patients convinced her that the real barrier to Chagas care is inaction.

“While a person living in Virginia who is originally from Bolivia [where Chagas is endemic] knows that if diagnosed with Chagas, they should start saving up for a pacemaker,” Hernández said in Spanish, “here, the government does nothing and doesn’t even know what the disease is.”

Combatting the disease

Between 6 and 7 million people worldwide live with the parasite. In the U.S., two long-standing drugs have had FDA approval: benznidazole and nifurtimox, which can beat back the parasite but don’t always eradicate it. The medications can have serious side effects, and are most effective if given early: Babies born with Chagas have a 90% cure rate if treated within their first year of life.

To combat the disease, doctors familiar with Chagas recommend testing pregnant women from at-risk communities and urge earlier treatments. They also advocate screening all transplant organs. In 2018, a Connecticut man died after receiving a heart infected with the Chagas parasite, prompting a lawsuit and calls for mandatory organ screening. The organization that governs transplant policies in the U.S. recently voted to require such testing.

The infected “kissing bugs” sleep in the plastic container for two or three minutes.

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Paula Andalo

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Few facilities in the country screen for Chagas. Advocates say that with greater awareness, many healthcare providers could conduct initial screenings and, if positive, send results to the CDC for confirmation.

However, building awareness has been an uphill battle. The Center of Excellence for Chagas Disease, the only center in the U.S. dedicated to Chagas diagnosis and treatment, recently suspended operations after its longtime director, Sheba Meymandi, retired.

A pioneer in the diagnosis and treatment of Chagas, Meymandi said she is still working as a volunteer at Olive View-UCLA Medical Center in Los Angeles, where the center was based, to ensure her patients receive care.

“The political leadership has stopped supporting the center, and we no longer actively conduct tests,” Meymandi said. Now, she refers Chagas patients to the cardiology clinic.

A spokesperson for the county’s Department of Public Health wrote in a statement that the center is not technically closed, and that treatment of Chagas patients with heart conditions had been taken over by the cardiology department at the UCLA hospital. But at least for now, it is not offering general screening for Chagas infection. California has the most Chagas cases of any state.

Hope for the future

Another hope for beating Chagas lies in new drugs. Rick Tarleton, the head of the Tarleton Research Group in the University of Georgia’s Department of Cellular Biology, said his group had collaborated with Anacor Pharmaceuticals to identify and optimize compounds that could kill the T. cruzi parasites. They had found one.

“It could completely eradicate the infection in mice and in nonhuman primates,” Tarleton said.

The team tested the compound on 19 macaques at a research center in Texas that had acquired the parasite naturally. The infection was defeated, the monkeys had no significant side effects, and they are still clinically healthy after more than five years.

Left: Ruby Harrison, a postdoctoral fellow at the University of Georgia, puts triatomine bugs infected with T. cruzi parasites to sleep with gas. Right: Rachel Marcus, a cardiologist and the medical director of the Latin American Society of Chagas, runs a Chagas testing clinic in northern Virginia. “We were taught that it is something we don’t see in the United States,” she says.

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Paula Andalo

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Tarleton’s team also observed that some of the parasites can become dormant, making them resistant to drug treatment. As a result, Tarleton said, it’s critical not only to develop more effective drugs but to optimize timing of treatments.

Tarleton and his team hope to launch a clinical trial of the compound next year.

There is also some hope on the political front. Sen. Cory Booker (D-N.J.) reintroduced the Study, Treat, Observe, and Prevent (STOP) Neglected Diseases of Poverty Act in February to address the growing health problem posed by maladies like Chagas spreading in low-income communities. The list also includes dengue fever, leprosy, and chikungunya.

“Whenever we go into low-income communities and look for these illnesses, we usually find them,” said Peter Hotez, who worked with Booker’s office on the legislation and is the dean of the National School of Tropical Medicine at Baylor College of Medicine. “Tragically, too often our nation ignores or neglects these communities, and we fail to look.”

Meanwhile, Maira Gutiérrez, the patient who was lucky to have a diagnosis and a consistent treatment, has some advice for them: “Donate blood; at the very least, you’ll know if you have the parasite, and it’ll cost you nothing.”

With President Donald Trump dragging them down in the polls, California Republicans are repackaging one of his core crusades into an idea they hope will be more palatable to voters.

They are framing their successful push to get a voter ID law on the November ballot as a “common sense” measure.

“We’ve structured this initiative based on what voters across the political spectrum would want,” Republican Assemblymember Carl DeMaio of San Diego said in a March interview, adding that showing an ID at the polls shouldn’t be any different than using one to buy alcohol or pass airport security.

DeMaio and other backers point to polling that shows 56% of California voters support requiring ID at the ballot box and that most states require or recommend an ID to vote.

But even in their pursuit to appeal to moderates, GOP lawmakers haven’t given up pushing Trump’s debunked claims of widespread voter fraud.

Last month, GOP legislators held a “stop the fraud” press conference, where they alleged without proof rampant corruption across state government, from elections to homelessness programs, and urged Newsom to call a special election to “audit” the alleged fraud.

The polling they point to also shows, however, that support for requiring identification at the polls drops to 39% when voters are told it is backed by DeMaio and could suppress turnout.

Voting rights groups say the measure would create needless barriers and would stifle turnout among low-income and disabled voters.

Current law already requires counties to routinely review voter registration databases to remove anyone who is ineligible to vote in case of a move, incarceration or death.

“Those checks and that maintenance of that list is already happening,” League of Women Voters executive director Jenny Farrell said. “We don’t need to erect new barriers.”

Voter suppression concerns tank voter ID support

If passed, as many as 1 million eligible voters could be kept from voting. Another 500,000 aren’t registered and don’t have the necessary documents it would require, according to UCLA Voting Rights Project director Matt Barreto.

“There’s been a very consistent finding in almost any state, in any environment, that lower-income and working-class voters are less likely to have an updated, valid ID,” he said.

Labor groups who bankrolled Democrats’ campaign for last year’s redistricting proposal, Proposition 50, are funding a similar opposition campaign focused on Trump’s push for a proof-of-citizenship bill in Congress.

Meanwhile, Democrats want to increase penalties for violating election laws after Riverside County Sheriff Chad Bianco, a candidate for governor, seized hundreds of thousands of ballots earlier this year over baseless claims of voter fraud in the 2025 election.

Bianco, who seized the ballots in response to unproven claims from a right-wing activist group, supports voter ID.

Critics say he’s stoking fear among voters and that there are already adequate safeguards.

“We have a two-person rule where no ballots are ever in an area that’s not with at least two people observing what’s happening,” said Gail Pellerin, Democratic chair of the Assembly elections committee, at a UCLA elections panel last month.

Ramping up the base?

Experts agree voter fraud is rare.

However, fears about election integrity have risen among Republicans since Trump falsely claimed the 2020 election was stolen, spurring GOP lawmakers across the country to introduce bills seeking to tighten voter restrictions.

This is DeMaio’s third attempt at a voter ID ballot initiative. It qualified for the ballot last month.

Assemblymember Carl DeMaio announces that supporters of the CA Voter ID Initiative will submit more than 1.3 million signatures to qualify the measure for the November 2026 ballot during a press conference at the west steps of the state Capitol in Sacramento on March 3, 2026.

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Strategists say there’s little evidence that ballot initiatives actually turn out voters, but this measure is something intended to activate voters in what will likely be a difficult election year for Republicans.

“Issues like this, that are kind of red meat issues for Republicans when the governor’s race is fairly lackluster, it helps,” Stutzman said. “It’s all upside. It’s not going to hurt Republicans to have this on the ballot.”

Following bruising losses after Prop. 50 and in other states, GOP leaders are hoping to hold onto three statehouse seats they flipped in 2024 and gain others. But Trump — and his push for national voter restrictions — threatens Republicans’ success at the ballot box.

“It’s a loop that Republicans keep hammering on, either fraud or ineptitude, or waste in dollars,” Stutzman said. “It’s kind of traditional Republican messaging.”

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

The Pasadena City Council voted this week to clear the way for new apartments for low-income fire survivors. But some council members noted their hesitancy to approve the project, saying their hands were tied by state law.

The council denied an appeal from a homeowners group who opposed the project, which plans to bring 133 units of low-income housing to East Pasadena. The nearby residents said it was too tall, too dense and had too little parking.

Mayor Victor Gordo expressed reluctance about denying the appeal. He blamed state lawmakers for pitting local elected leaders against the interests of existing residents.

“We're going to see more and more of these frustrating hearings, where the local elected body essentially has little to no discretion, little to no say, and that's wrong,” Gordo said during the Monday night meeting.

The developer’s plans for the project include adapting a former office building into 50 units of permanent supportive housing for tenants, including formerly unhoused people. A new five-story building will include another 81 units of income-restricted housing. Two units will be for property managers.

Neighbors fought to block the project

Members of the Lower Hastings Ranch Association appealed an approval of the project by the city’s Design Commission. They argued the development wasn’t suitable for the neighborhood.

Ronnie Po, the association’s president, said nearby homeowners felt “blindsided” by the plans. Their appeal wasn’t really about the project’s aesthetics, he said. They were mainly opposed to the development’s height, density and reduced parking.

“I wouldn't call this a design issue,” Po said. “This project will literally rise up to the backyards of some of our neighbors up there. So this is literally in someone's backyard.”

The development team countered those complaints in a presentation to the City Council, saying the project complied with all relevant laws and did not impinge on single-family homes.

“The building is no closer than 25 feet to the nearest property line, and no closer than 110 feet away to the nearest home,” said Dana Sayles, who is with the land use firm three6ixty.

Who is the project designed to house?

The project at 600 N. Rosemead Blvd. will be reserved for renters who earn no more than 80% of the area’s median income. By current standards, that would include individuals earning up to $84,850 per year and families of four earning up to $121,150.

Many units will be set aside for renters with even lower incomes. And under state funding agreements, preference will be given to tenants displaced by the Eaton Fire.

“More than half of the units are two and three bedrooms, so this project is very much focused on families,” said Stephanie DeWolfe, a consultant on the project. “Getting family-sized units has been a challenge for the city in the past, and especially now with all the people displaced from the fires."

State law overrides local limits

Because of the state’s density bonus law — which allows larger projects when units are kept affordable — the developer is allowed to build taller than would normally be allowed under Pasadena codes. The project is within a half-mile of the Sierra Madre Villa stop on Metro’s A Line, qualifying it as near a “major transit stop” under California law.

Because it’s near a transit line, the project also qualifies for a state law that removes parking mandates. The developer is voluntarily planning to build 55 parking spaces. Many public commenters — and some council members — said more parking was needed.

“What's the assumption of where people will park their cars?” asked Councilmember Tyron Hampton.

“We live in California, by the way,” he said, drawing applause from audience members opposed to the project.

People at the meeting who expressed support for the project said many tenants, including those exiting homelessness, likely would not be in a financial position to own cars.

“I support this building since it would be perfect for people like me, who would qualify based on income limits and do not need to have parking,” said Koji Sakano. “Those who apply, like me, would tend to be those that do not wish for car parking in the first place.”

Local housing vs. new state laws

Jesse Zwick, the Southern California director of the Housing Action Coalition, said the Pasadena project’s path to approval shows city officials and residents slowly catching up to changes in state law, which in many cases override local opposition.

“The state has awarded priority to building affordable housing in places like this — that typically have resisted it,” Zwick said. “What you're seeing now is some of that resistance being up against where state law has evolved on this issue.”

Cities that have resisted state housing laws aimed at increasing development have found themselves in California’s legal crosshairs. Beverly Hills had to approve massive “builder’s remedy” projects after it failed to comply with a state requirement for cities to plan for more housing. Huntington Beach recently faced a court order to pay $50,000 for every month it continues to flout state housing laws.

Despite those risks, some Pasadena residents urged city leaders to fight back on the state’s efforts to encourage taller, denser affordable housing projects.

“The state of California has come up with these crazy laws,” said Scott Shimamoto. “We would love for the City Council and mayor to tell the state of California: Pause this.”

The Ninth Circuit Court of Appeals heard arguments in Pasadena Tuesday over whether the federal government has the right to access sensitive data about California’s 23 million voters. The court also heard a nearly identical case involving Oregon.

California is among 30 states and the District of Columbia sued by the Trump administration in an effort to get access to unredacted state voter registration rolls. The administration says it wants to make sure only citizens are voting and that states are otherwise properly maintaining their rolls, for example, by removing people who have died.

Why won’t California hand over the data?

California has offered access to its publicly available voter file, which does not include information like driver’s license and social security numbers. State election and privacy laws prohibit state officials from sharing that more sensitive data, and lawyers for California argue that federal laws do not allow the U.S. Department of Justice unfettered access to the state’s voter files.

Why does the federal government want voter rolls?

Trump administration officials have given different reasons for requesting the data over the past year. But earlier this month, a memo from the Justice Department’s Office of Legal Counsel wants to run voter rolls through the federal government’s SAVE system to check the immigration status of voters. NPR and other news outlets have reported on major flaws in the system, including improperly flagging eligible voters as non-citizens.

What happens to flagged names?

It differs in each state. Some states give flagged voters time to prove their eligibility; others suspend or cancel registration immediately. Voting rights groups worry that a large number of voters may be disenfranchised right before the midterm election.

The political backdrop

The debate has largely split along party lines, although not entirely — some Republican-led states are resisting the federal government’s demands for sensitive voter data. At least 15 states have agreed to provide their full registration lists, most of them Republican-led, according to the Brennan Center for Justice, which is tracking the issue.

What’s next

There's no specific timeline for a ruling from the Ninth Circuit. A separate appeals court is considering the Trump administration’s demand for Michigan voter data. Depending on the outcome of that and the California and Oregon cases, observers say the issue could be headed to the Supreme Court.