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Bed Bugs in Schools

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Bed Bugs in Schools Dealing with Special Needs Situations Rosmarie Kelly, PhD MPH Public Health Entomologist GDPH
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Page 1: Bed Bugs in Schools

Bed Bugs in Schools

Dealing with Special Needs Situations

Rosmarie Kelly, PhD MPHPublic Health EntomologistGDPH

Page 2: Bed Bugs in Schools

What are bed bugs?

• Bed bugs are small, brownish, flattened insects that feed on the blood of people while they sleep.

• Bed bugs do not transmit disease, but they can cause significant itchiness, anxiety, and sleeplessness.

Page 3: Bed Bugs in Schools

What are bed bugs?

• Usually, bed bugs will hide during the day and only come out to feed during the night.

• Unlike head lice, they usually do not live on a person.

• They can hitchhike from one place to another in backpacks, clothing, luggage, books, and other items.

Page 4: Bed Bugs in Schools
Page 5: Bed Bugs in Schools

Bed bugs were once a common public health pest

worldwide.

•Bedbugs were originally brought to the United States by early colonists from Europe.

•Bedbugs thrive in places with high occupancy, such as hotels.

•Bedbugs were believed to be altogether eradicated 50 years ago in the United States and elsewhere with the widespread use of DDT.

Page 6: Bed Bugs in Schools

They’re Back!

Bed bugs are once again a problem within residences of all kinds, including homes, apartments, hotels, cruise ships, dormitories and shelters.

The cause of this resurgence is still uncertain, but most believe it is related to increased international travel and the use of new pest-control methods that do not affect bedbugs.

Page 7: Bed Bugs in Schools

Of the 90 or so species in the family Cimicidae, approximately 7 will feed on human blood, but only 2 are commonly found: Cimex lectularius (bed bug) and Cimex hemipterus (tropical bed bug).

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Page 8: Bed Bugs in Schools

Habits & Habitats

Bed bugs are active mainly at night; they reach peak activity before dawn.

During the daytime, they prefer to hide close to where people sleep.

Their flattened bodies enable them to fit into tiny crevices - especially those associated with mattresses, box springs, bed frames, and headboards.

Bed bugs do not have nests like ants or bees, but do tend to congregate in habitual hiding places.

Bed bugs do not fly, but can move quickly over floors, walls, ceilings and other surfaces.

Bed bugs will travel 5-20 ft. from an established harborage to feed on a host. Egg-laying females also wander.

Page 9: Bed Bugs in Schools

Bed Bug Facts

Bed bugs respond to warmth and carbon dioxide when searching for a blood meal.

All nymphal stages and adults of both sexes require blood for nutrition and development.

Bed bugs ordinarily feed within 24 hours of hatching, once between each molt and once before egg deposition; an average period of 8 days is required between molts.

Adult females will continue to take blood meals every 3-4 days depending on ambient temperature and humidity.

Bed bugs take up to 10 minutes to complete a blood meal, and will consume 2-5 times their own body weight in blood during that time.

Page 10: Bed Bugs in Schools

More Bed Bug Facts

Individual bed bugs usually do not feed every night but at intervals of a few days to a week.

Bed bugs do not remain on the host between feedings.

Once a bed bug is finished feeding, it quickly retreats back to its hiding place.

Bed bugs may also feed on small animals, such as pets.

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Page 12: Bed Bugs in Schools

Bed Bug Bites

The bite of a bed bug is painless.

The amount of blood loss due to bed bug feeding typically does not adversely affect the host.

Bed bugs feed on any bare skin exposed while sleeping (face, neck, shoulders, arms, hands, etc).

Skin reactions are commonly associated with bed bug bites, which result from the saliva injected during feeding.

Some individuals do not react to bed bug bites, while others note a great deal of discomfort often with loss of sleep from the persistent biting.

Page 13: Bed Bugs in Schools

Reactions to Bites

Common allergic reactions include the development of large welts that are accompanied by itching and inflammation.

The welts usually subside to red spots but can last for several days.

Blister-like eruptions have been reported in association with multiple bed bug bites and anaphylaxis may occur in patients with severe allergies.

Page 14: Bed Bugs in Schools

Disease IssuesDisease Issues

• Bed bugs require blood in order to reproduce and complete their life cycle.

• There is no evidence that bed bugs are involved in the transmission (via bite or infected feces) of any disease agent, including hepatitis B virus and HIV, the virus that causes AIDS.

• However, the CDC & EPA issued a joint statement saying that “Although bed bugs are not known to transmit disease, they are a pest of significant public health importance.”

• Frequent feeding can disrupt people's sleep and make them irritable.

• Seeing bites may cause emotional distress in some people.

• Heavy rates of feeding can result in significant blood loss and eventually lead to anemia, especially in malnourished children.

http://www.cdc.gov/nceh/ehs/publications/bed_bugs_cdc-epa_statement.htm

Page 15: Bed Bugs in Schools
Page 16: Bed Bugs in Schools

Could my classroom be infested?

• Actual bed bug infestations in non-residential schools are uncommon.

• More commonly, a few bed bugs will hitchhike to school from an infested home by hiding in a student’s clothing or backpack.

• Bed bugs that hitch a ride into the school in one student’s backpack could be carried home by another student, making the school a potential hub for bed bug spread.

• This is not a minor concern – bed bugs are very expensive and difficult to eradicate.

Page 17: Bed Bugs in Schools

Preparing for a Bed Bug Problem

Suggested Supplies: disposable gloves, trash bags, plastic tarps, plastic storage bins, and tape on hand to hold infested items and for moving infested items (clothing, backpacks, desks and other equipment)

Designate areas where potentially infested items can be held temporarily (several days, if necessary).

Initiate a policy of keeping all “Lost and Found” clothing, backpacks, etc. in closeable plastic storage bins (rather than in cardboard boxes) preferably in a central location.

Establish a list of primary school personnel who need to be aware of the situation immediately in order to address the problem and to deal with questions from parents, staff, and potentially the news media.

Page 18: Bed Bugs in Schools

What if I find a bed bug on a student?

• If a bed bug is found on a student, it may indicate that the student has bed bugs at home.

• However, bed bugs can crawl onto or off of a person (or their belongings) at any time, so it is also possible that the bed bug was brought to school by someone else.

Page 19: Bed Bugs in Schools

19

eggs

verify that the problem is due to bed bugs

Page 20: Bed Bugs in Schools

nymph

Page 21: Bed Bugs in Schools

female male

Page 22: Bed Bugs in Schools

http://ipm.ncsu.edu/AG369/keys.html Key to Common Pests of Man and Animals

Not Bed Bugs

Page 23: Bed Bugs in Schools

Try to determine the source

• How many bed bugs were found?

• Were they found associated with one person or more than one person (e.g., on clothing, backpack/bag, desk)?

• If more than more person is involved, are those individuals related or have something in common such as being classmates, use the same transportation, etc.

• Where were the bed bugs found in the school (classroom, lockers, office, gym or other facility, or transportation, etc.)?

Page 24: Bed Bugs in Schools

Conduct a thorough inspection – questions to ask

• Does the student/teacher switch rooms over the course of the day? Identify and inspect those rooms as well.

• Does the student participate in after school activities (athletics, band, etc.) ‐where they may have taken potentially infested personal items with them? ‐

• Where does the person keep their personal belongings during the day? • Have any new items been brought into the room/school? (e.g., boxes, bags,

“lost and found” items, etc.) • Has the individual (student, staff, etc.) experienced the same problem at

home? • Have they done any traveling (particularly involving overnight stays at a

hotel or other vacation rental property)? • Have they had any visitors stay at their home recently?

Page 25: Bed Bugs in Schools

If you suspect a student has bed bug

• The student should be discreetly removed from the classroom.

• If a confirmed bed bug was found on a student, then the school principal or nurse should contact the student’s parents or guardian.

• Educational materials should be provided to the family.

• The school should consider notifying families of the affected class or classes.

Page 26: Bed Bugs in Schools

If a bed bug infestation is suspected or a number of students are getting bitten during class, the school should contact a licensed pest management professional for assistance.

Page 27: Bed Bugs in Schools

What can I do to eliminate bed bugsfrom my classroom?

• Work with licensed pest control - DO NOT allow untrained staff to apply pesticides on school property.

• Backpacks, lunch boxes, and other items that travel back and forth to school can also be inspected daily and sealed in plastic containers to prevent bed bugs from getting into them at home.

• Hard surfaces can be cleaned with standard cleaning products.

Page 28: Bed Bugs in Schools

Control of Washables

Washing clothes at 60°C (140°F) is effective against all life stages.

Tumble drying in a hot (>40°C; 104°F) dryer for 30 minutes or freezing at –17°C (1.4°F) for 2 hours will also kill bed bugs.

Adults and nymphs can be drowned by soaking laundry, but this will not kill the eggs.

NOTE: It takes about 8 hours to disinfest 5 lbs of laundry by putting it in a freezer at –18°C (0.4°F).

Page 29: Bed Bugs in Schools

Temperature Extremes - Steam Heat

Bed bugs are very sensitive to heat, and a combination of steam cleaning and insecticide use has been found to be more effective for long-term control than insecticides alone.

The steam emission tip must usually be about 2.5-3.8 cm from the surface being steamed.

If the tip is too far away, the steam may not be hot enough to kill all the bed bugs and eggs that it contacts.

If the tip is too close, excess moisture may be injected into the treated material, which may lead to other problems

Page 30: Bed Bugs in Schools

Temperature Extremes - “Dry” Heat

For heat treatment to be effective, it is critical that high temperature and low relative humidity be attained for a minimum length of time (49-52oC [120-125oF] and 20-30% relative humidity for 20-30 minutes).

Heat treatment provides no residual effect, and bed bugs can re-occupy any site so treated immediately after temperatures return to suitable levels.

Laundering infested linens or cloth items in hot water with detergent, followed by at least 20 minutes in a clothes dryer on high heat, should kill all life stages of bed bugs but would not prevent their reinfestation.

Page 31: Bed Bugs in Schools

Temperature Extremes - Cold

Exposure to low temperatures can kill bed bugs if they are kept cold enough long enough.

Bed bugs can tolerate -15oC (5oF) for short periods and, if acclimated, they can survive at or below 0oC (32oF) continuously for several days.

Freezing furniture or other items within containers or chambers [e.g., below 0oF (-19oC) for at least four days] may be a practical alternative for limited infestations or to augment other control measures.

A new commercial technology uses CO2 from cylinders deposited as a “snow” to kill bed bugs and a variety of pests by rapid freezing.

Page 32: Bed Bugs in Schools

Pesticides - THE LABEL IS THE LAW

With the exception of dry heat, non-chemical products and techniques are incapable of efficiently or quickly controlling or eliminating established bed bug populations.

Precise placement of a suitably labeled, registered and formulated chemical insecticide is still the most practically effective bed bug control.

The choice of chemical products and specific application techniques can depend on many factors, including the physical location and structural details of the bugs’ harborages, the product’s labels (which can vary by political jurisdiction), the immediate environment, and local or national laws.

Page 33: Bed Bugs in Schools

• Residual Applications

• Crack-and-Crevice Applications

• Dusts

• IGRs

• Fumigation

• ULVs, Aerosols, & Foggers

http://www.techletter.com/Archive/Technical%20Articles/bedbuginsecticides.html

Pesticides Available for Bed Bug Control

This list is changing fairly rapidly as more products are relabeled for use in bed bug control.

http://cfpub.epa.gov/oppref/bedbug/

Page 34: Bed Bugs in Schools

These devices release insecticide in small droplets that land on exposed surfaces and do not penetrate the cracks and crevices where bed bugs hide.

This results in increased pesticide exposure to the resident and poor control of these pests.

This has been linked to pesticide resistance and suspected repellency to bed bugs, causing them to spread.

The use of “bug bombs” or total release foggers is NOT advised.

Page 35: Bed Bugs in Schools

Control Update• The resurgence of common

bedbugs is partly due to their increase resistance to insecticides — like many other nuisance species, they’ve evolved to develop an immunity to the toxins.

• A team of researchers at the University of Pennsylvania say they may have discovered the key to effective biocontrol of the nuisance bugs — a natural fungus that causes disease in insects.

Page 36: Bed Bugs in Schools

Control Update• As anyone who has ever had bed bugs can attest, the tiny,

blood-sucking parasites are a big pain to get rid of. But a new study suggests there might soon be a new weapon in the fight against the household pests.

• Stromectol, a Merck brand of the drug ivermectin, which is already used to fight worm parasite diseases, such as river blindness and elephantitis, killed three out of five bed bugs in a study presented at the annual meeting of the American Society of Tropical Medicine and Hygiene on Nov. 12, Bloomberg News reports.

• The bugs fed on ivermectin-laced blood and began to get sick and die within three hours.

Page 37: Bed Bugs in Schools

Special Situations

• Transportation• Wheelchairs• Therapy equipment

Page 38: Bed Bugs in Schools

Buses and Other Transportation

• When buses (or other transportation services) are involved, ask the student where he/she sat on the school bus that morning.

• The school transportation coordinator should contact the operator to bring the bus immediately to the school or maintenance facility for inspection.

• Check if the bus was used subsequent to dropping off the students.

• If the problem is noticed late in the day, the seat occupied by the student and those in adjacent rows, should be inspected before allowing students to board the bus.

• Do not allow students/staff to use potentially infested items.

• Parents should be encouraged to inspect the contents and contact their child’s school if they have questions or concerns.

Page 39: Bed Bugs in Schools

Wheelchairs• While transporting a client from a bed bug infested home, take

measures to protect the car used. – Use large garbage bags to contain the client’s personal items and to

line the car seats.– If the client has a wheelchair that must be transported, use large

garbage bags or a small tarp to cover the wheelchair. – If the infestation is high, ask the client to wear coveralls while

traveling in the car. • After the client and the client’s belongings have been transported:

– Vacuum the car. – Wipe down the seat belts and seat seams with wet wipes to remove

any bed bugs.

Page 40: Bed Bugs in Schools

Steam Cleaning a Wheelchair

• http://youtu.be/Mh3WydbqDDE

Using hot steam is an effective and safe method to get rid of bed bugs on a wheel chair.

Page 41: Bed Bugs in Schools

What if one of my students has an infestation at home?

• When a student is dealing with an infestation at home, it is important to be sensitive to their problem.

• Although bed bugs have nothing to do with cleanliness or socioeconomic status, there is still a stigma that can come with having bed bugs.

• As a result, parents may be hesitant to admit to having bed bugs, and students may not want others to know they have an infestation at home.

• Students living in an infested home may also feel anxious or tired during the school day.

Page 42: Bed Bugs in Schools

What if one of my students has an infestation at home?

• Determine if the infested home is being treated.

• In an infested home, parents should store their child’s freshly laundered clothing in sealed plastic bags until they are put on in the morning.

• Backpacks, lunch boxes, and other items that travel back and forth to school can also be inspected daily and stored in sealed plastic containers at home to prevent bed bugs from getting into them.

• At school, the student could be provided with plastic bags or bins in which to store their belongings in order to prevent any bed bugs from spreading to other students’ belongings.

• Continue to use these measures until successful treatment of the home has been verified.

Page 43: Bed Bugs in Schools

The University of Florida teamed up with the Jacksonville Bed Bug Task Force to create the “Bed Bugs and Book Bags” curriculum for grades 3-5 (the kids that seem to bring the most bed bugs to school).

The "Bed Bugs and Book Bags" curriculum follows learning standards for science and health educators, but many housing authorities have on-site after school programs that could use the activities. Any organization that works with kids should know about these lessons.

Check out the curriculum at http://entnemdept.ufl.edu/bug_club/Bed_bugs.html.

Bed Bugs and Book Bags

Page 44: Bed Bugs in Schools

Resources

• http://www.michigan.gov/documents/emergingdiseases/Bed_bugs_schools_293498_7.pdf

• http://www.vdacs.virginia.gov/pesticides/pdffiles/bb-schools1.pdf

• http://www.afpmb.org/pubs/tims/TG44/TG44.pdf

• http://ento.psu.edu/extension/bedbugs

• http://schoolipm.ncsu.edu/documents/Bed%20Bug%20Protocol.pdf

• http://www.cdc.gov/nceh/ehs/Topics/bedbugs.htm

• http://www.ca.uky.edu/entomology/entfacts/ef636.asp

• http://www.mayoclinic.com/health/bedbugs/DS00663

• http://www.nysipm.cornell.edu/publications/bed_bugs/files/bed_bug.pdf

• http://centralohiobedbugs.org/school.html

• http://www.idph.state.il.us/envhealth/BedBugs_Schools_DayCareCenters.pdf

• http://schoolipm.ifas.ufl.edu/Florida/bedbugpests.htm

• http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/bedbugs/documents/bed-bugs.pdf

Page 45: Bed Bugs in Schools

Any Questions?

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Rosmarie Kelly, PhD MPH2 Peachtree St NW

Atlanta

Office: 404-657-2912Cell: 404-408-1207

[email protected]

http://health.state.ga.us/epi/zvbd/infest/index.asp


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