What Is the New Type of AIDS-like Kissing Bug Disease, Symptoms of Bites, and Prevention and Treatment

Recently, the Guangzhou Center for Disease Control and Prevention called on citizens to find and catch kissing bugs, offering a reward of 8 yuan per insect, while also looking for people bitten by these insects. So what are the symptoms of being bitten by a kissing bug? What should be done? How can it be prevented and treated?

Kissing bugs are the general name for insects of the subfamily Triatominae in the family Reduviidae, suborder Heteroptera, order Hemiptera, named for their narrow, elongated head that resembles a cone. Kissing bugs can transmit a disease called “Chagas disease”, with a latent period of up to 20-30 years, and the acute phase can cause cerebral embolism and even sudden death.

Image source: Guangzhou CDC iHealth

The Kissing Bug Incident

In 2016, in Shunde near Guangzhou, an incident of kissing bugs biting a person occurred. After investigation, this was the first discovery and record of the red-banded kissing bug in Shunde. Since kissing bugs are the vector of American trypanosomiasis, and the global spread of American trypanosomiasis currently cannot be ignored.

In fact, American trypanosomiasis already has a certain history. It was first discovered in 1909 by a Brazilian doctor named Chagas, so American trypanosomiasis was named Chagas disease. It is a potentially life-threatening disease caused by a parasite called Trypanosoma cruzi. Its vector is the kissing bug.

Because of the hidden nature of this disease, human infection is not easily discovered. If not treated in time, it will cause irreversible harm to human health and endanger life.

Once the source of infection of Chagas disease is introduced, local transmission is very likely to occur.

What does a kissing bug look like? Where does it appear?

Kissing bugs are named for their narrow, elongated head that resembles a cone. Adults are about 25 mm long, oval-shaped, with a pointed or flat tail, black or dark brown in color, and with red or yellow spots on the lateral margins of the abdomen. Both the larvae and adults of kissing bugs feed on human blood. Because they specifically bite people's faces and prefer to bite areas with thinner skin, such as the lips and eyelids, they are also called “kissing bugs”.

Kissing bugs mostly hide in walls or gaps in wooden objects and other places, and go out at night. At night, in livestock sheds, chicken coops and other places in woodlands or fields, they are easy to find. Some people also say they have found them in old wooden houses, beside their own flower pots, and beside wood piles at rural guesthouses.

Image source: Guangzhou CDC iHealth

What are the symptoms of being bitten by a kissing bug? What should be done?

The latent period of Chagas disease is as long as 20-30 years and is difficult to detect, and the prognosis for severe patients is poor. The acute phase includes fever, facial edema, lymphadenitis, anemia, etc. The chronic phase often includes myocarditis, heart failure, megaesophagitis, megacolon, and pulmonary and cerebral embolism, sudden death, etc.

So, who might get Chagas disease? The Guangzhou Center for Disease Control and Prevention stated that in areas where kissing bugs are distributed, Chagas disease can be transmitted through various routes, and people who have been to or come from Latin American regions may all be at risk of infection.

The confirmed diagnosis rate of Chagas disease is low, there is no vaccine to prevent it, and there is no specific drug in the late stage of the disease. Therefore, some scholars even call it “the new AIDS”.

Differences between Chagas disease and AIDS

1. Transmission routes

AIDS is transmitted directly from person to person, mainly through sexual transmission, while Chagas disease is mainly transmitted through kissing bugs. However, both can also be transmitted through blood or mother-to-child transmission.

2. Different pathogens

AIDS is caused by the AIDS virus, while the pathogen of Chagas disease is Trypanosoma cruzi, a protozoan parasite.

Chagas disease is actually not that frightening. But we still hope that this disease will not appear in China.

The most effective way to prevent Chagas disease is vector control.

The reward offered by Guangzhou for finding the insects is only for investigation, so there is no need to be overly nervous. At present, it is estimated that about 6 million to 7 million people worldwide are infected with Trypanosoma cruzi, mainly in Latin America. Chagas disease was once completely confined to the Americas region——mainly Latin America, but it has now spread to other continents. This “bug-finding” campaign is to find local kissing bugs, test whether they carry Trypanosoma cruzi, see whether they pose a threat to us, and provide an important scientific basis for preventing and controlling the spread of Chagas disease in China. 

This investigation work is led by the Chinese Center for Disease Control and Prevention, and Guangzhou is one of the investigation sites in Guangdong Province. 

Chagas diseaseHow to prevent it?

According to the recommendations given by the Shanghai Municipal Health and Family Planning Commission, the main prevention measures for Chagas disease are as follows:

1. Improve living conditions and housing structure, such as coating walls with lime and other paints, repairing and replacing roofs, etc., or spraying insecticides indoors, which can prevent kissing bugs from breeding and inhabiting indoors.

2. Eliminate animal reservoir hosts as much as possible. Travelers should avoid sleeping in crude accommodations and may use mosquito nets or insecticides.

3. To avoid transmission through blood transfusion, blood banks should conduct serological testing for Trypanosoma cruzi in blood, and may also add gentian violet at 1:4000 to the blood 24 hours before transfusion to kill the trypanosomes. In addition, blood donors, organ donors and pregnant women should undergo timely serological testing.

4. In the acute phase, anti-trypanosomal treatment should be carried out as early as possible. The main drugs used for treatment are benznidazole or nifurtimox.