in june 2006 , a 74-year - old woman residing in a house in rural new orleans was bothered by a considerable number ( > 50 ) of insect bites . the woman observed many bugs in the house and showed them to a fumigator , who identified them as triatomines . an internet search showed the potential for transmission of chagas disease , and the woman sought help from a local health sciences center . serum samples from both residents of the house were tested for antibodies to t. cruzi at the centers for disease control and prevention ( cdc ) by an indirect fluorescent antibody ( ifa ) test . samples were also tested at loyola university ( new orleans , la , usa ) and then at cdc . by using an experimental dipstick assay ( trypanosoma detect ; inbios international inc . , the woman resident was positive for antibodies to t. cruzi by ifa at dilutions of 1:128 ( 4 weeks after being bitten ) and 1:64 ( 10 weeks after being bitten ) and by dipstick assay . she was positive for trypanosomes by hemoculture testing with 10 ml blood and coculture in macrophages ( 13 ) 4 months after being bitten . trypanosomes consistent with t. cruzi were observed in culture beginning on day 46 of culture , and amplification of a t. cruzi  specific 24s rrna gene target confirmed that the isolate was t. cruzi . the index resident had a history of 5 trips to areas endemic for chagas disease : zacatecas , mexico ( 1970 ) ; cozumel , mexico ( 1990 ) ; belize ( 1991 ) ; guatemala ( 19988 ) ; and costa rica ( 1998 ) , each of < 2 weeks duration , with stays in improved tourist hotels ( less likely to harbor triatomines ) except for the belize trip , which included an 1-week stay in a palm thatch - roofed cabin . she had not used intravenous drugs or had a blood transfusion or organ transplant , and she is not the daughter of latin american immigrants . except for fatigue , cardiac evaluation that included an electrocardiogram showed normal results , and she decided not to take medication . her residence of 29 years was located on 7.66 acres of bottomland hardwood forest , with many gaps that provided ready access for insects . a house inspection showed fecal streaks characteristic of triatomines on walls , which were identical to what the patient reported seeing on her nightgown . twenty dead adult triatomines were collected in the house ( after fumigation ) and in another building on the property that contained a bed . no nymphs or eggs were found , which suggests that the house had not been colonized . one live second - stage nymph was collected in a nearby armadillo burrow 50 m from the house . all triatomines collected were identified as t. sanguisuga according to the key of lent and wygodzinsky ( 6 ) ( figure ) . because all triatomines except the nymph were dead , pcr was used to determine t. cruzi infection status ( 14 ) . the last 2 segments of the abdomen were removed from each insect , placed in 200 l 1 pcr buffer ( applied biosystems , foster city , ca , usa ) , boiled for 15 min , and centrifuged . a total of 5 l of supernatant was amplified in a 50-l reaction ( 3.5 mmol / l mgcl2 and 2 u taq dna polymerase ) . the primers used anneal to the t. cruzi minicircle dna and were tc3 : 5-ttgaacgcccctcccaaaac-3 and tc4 : 5-gattggggttggtgtaatata-3. the cycling parameters were an initial denaturation step at 94c for 3 min ; 35 cycles at 94c , 55c , and 72c , each for 1 min ; and a 10-min extension at 72c ( programmable thermal controller ; mj research , watertown , ma , usa ) . twenty percent of the pcr product was subjected to electrophoresis on a 1.8% agarose gel and visualized by uv transillumination after staining with ethidium bromide . a positive control of 5 l of t. cruzi parasites boiled in 1 pcr buffer and a negative control without the dna template were included with every pcr . samples that failed to amplify were spiked with 5 l of t. cruzi parasites boiled in 1 pcr buffer and reamplified to ensure that the lack of product was not caused by inhibition of the pcr . more than half of the triatomines were positive for t. cruzi ( 56% , 10/18 ; 3 failed to amplify ) , with more positive females ( 73% , 8/11 ) than males ( 50% , 3/6 ) . plasma from the resident dog and 7 other dogs living 1 mile away all tested negative by ifa at cdc . the assertion that the patient contacted t. cruzi in louisiana is strongly supported by limited travel history to disease - endemic areas and stays mostly in improved housing ( risk for chagas disease transmission is associated with longer residence in disease - endemic areas ) , lack of other risk factors , and large numbers of infected t. sanguisuga in the house . however , the streaks on her nightgown consistent with triatomine feces indicate exposure , and the parasite could have been introduced into any of her numerous bite wounds . however , hurricane katrina had hit the area 9 months earlier and increases in domestic infestation with triatomines have been previously reported after a hurricane ( 15 ) . anecdotally , the armadillo population increased substantially in the months after hurricane katrina , and one can speculate that these hosts supported a larger bug population , who later sought other bloodmeal sources as the armadillo population returned to prestorm levels .