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Bed BugsRosmarie Kelly

Public Health EntomologistGDPH

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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.

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They’re Back!Bed bugs are once again becoming 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.•In the last few years, the use of baits rather than insecticide sprays is believed to have contributed to the increase.

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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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Life CycleFemale bed bugs deposit 3 to 8 eggs at a time; a total of 200-500 eggs can be produced by one female over her 10 month life span.The eggs hatch in 4-12 days. Bed bugs go through 5 nymphal stages before reaching maturity. This usually takes 35-48 days.

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Habits & HabitatsBed 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.

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Bed Bug FactsBed bugs respond to warmth and carbon dioxide when searching for a blood meal, but not to odors. 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.

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More Bed Bug FactsIndividual 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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Really Weird FactBed bugs have a unique form of mating called “traumatic insemination”. The male penetrates the female’s abdomen with his external genitalia, inseminating into her body cavity. This sexual activity produces a wound in the female and probably endangers her longevity and productivity.

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Movement

Spending a night (or longer) in an environment which is already infested by bed bugs (hotels, homes, international flights, etc). Having someone visit from such an infested environment (bed bugs can be transported in luggage). Renting furniture or buying used furniture or bedding. Picking up discarded bedding or furniture from a curbside, trash collection point or dumpster.

Some of the most common ways new bed bug infestations may be introduced include:

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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.

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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.

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More on BitesDepending on bite intensity and frequency, there are typically five post-bite effect stages: no reaction (no or too few antibodies developed), delayed reaction, delayed plus immediate reaction, immediate reaction only, and no visible reaction (due to excess circulating IgG antibodies).  Typical symptoms include a raised, inflamed, reddish wheal at each bite site, which may itch intensely for several days.  “Immediate” immune reactions may appear from one to 24 hours after a given bite and may last 1-2 days. "Delayed” immune reactions usually first appear one to three (up to 14) days after a bite and may last 2-5 days.  Humans who are frequently bitten by bed bugs may develop a sensitivity “syndrome” that can include nervousness, almost constant agitation (“jumpiness”), and sleeplessness. 

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Bite Summary

Allergens from bed bugs may be associated with asthmatic reactions.Reactions to the bites may be delayed up to 14 days before lesions appear. Reactions may be accompanied by severe itching that lasts for several hours to days. Scratching may cause the welts to become infected.Bed bugs have never been proven to biologically transmit any human pathogen.

When you stay at a When you stay at a hotelhotelDO NOT BRING ANYTHING

INTO THE ROOM UNTIL YOU DO AN INSPECTION

Bed bugs prefer wood, fabric, and paper surfaces:

•Check bed first: mattress seams, under labels, buttons, corner protectors

•Behind headboard•Hanging pictures

•Bedside furniture•Loose wallpaper •Baseboards

•Curtains

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INSPECTIONIf the inspection site is a hotel, it is important that the housekeeping staff be interviewed. Efforts should be concentrated on dark, isolated and protected areas. Bed bugs prefer wood, paper and fabric surfaces and so these materials should receive special attention during the inspection process. The mattress should be the first site inspected and the seams, beading, under buttons, labels, and corner protectors (if not previously removed) should be examined closely. If headboards are attached to the wall, they should be removed. Removing headboards from the wall is important, as this may be the first place bed bugs will be found when the infestation is light.

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Where to Look - Most Everywhere

It can take 1-2 hours to thoroughly check a space for bed bugs. Be thorough!

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Check the BedRemove all the sheet, checking for blood spots.Stand the mattress up. Remove the box spring and flip it

over.

1.Inspect the mattress closely, paying close attention to the seams.

2.Inspect inside the box spring and under it (where it meets the bed frame). Shine a flashlight through the bottom of the box spring.

3.Check any head and foot boards as well as anything stored under the bed.

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Check the Rest of the Room

Check inside all drawers, crevices, and narrow spaces. Look under electronics, behind pictures, and in stacks of clothing. Bed bugs are often found hiding in tack strips under wall-to-wall carpeting and behind baseboards. Bed bugs tend to crawl up, so check check drapes and wall decorations.

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Check All Furniture

Remove sofa cushion, and check all seams and crevices. Tip back couches and chairs and look underneath, particularly behind skirts.

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In any infestation, the adjoining rooms, both sides, and above and below, should be inspected.Common rooms, such as a lounge, should not be overlooked.

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“New” Technology

bed bug sniffing dog

Ability of Bed Bug-Detecting Canines to Locate Live Bed Bugs and Viable Bed Bug EggsMARGIE PFIESTER, PHILIP G. KOEHLER, AND ROBERTO M. PEREIRAJ. Econ. Entomol. 101(4): 1389-1396 (2008)http://sleeptightllc.biz/184846.pdf

Responses You Will Get

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HOTEL Manager/Owner• It’s just bed bugs, big

deal (in some areas of the world bed bugs are so numerous that babies become anemic from being fed on)

• That isn’t a bed bug!• You brought that in

here!• I will call my pest

control company right now.

Hotel Customer• Get it off! Get it off! Get it off!• I’m suing!• ARRRRGGGGHHHHHHH!

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Taking PrecautionsDon’t bring bed bugs home with you.•Place service kit and equipment in an open area away from walls and furniture

•Assume beds, furniture, and other items you are about to inspect or treat are infested and act accordingly.

•Avoid laying across, leaning against, or sitting on potentially infested beds or furniture and minimize direct contact with any potentially infested materials such as drapes, rugs, piles of dirty clothes.

•Bring a minimum of equipment into the room. If you carry an inspection kit or service kit, place it in an open area away from walls and furniture.

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DO NOT DO THIS

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More Precautions

■ Remove your clothes over a non-carpeted floor and be ready to immediately capture and destroy any bug you see.

■ If you are concerned that your clothes might contain bed bugs, launder them in hot water as soon as possible. Take off your clothes as soon as you get home.

■ If you have been in a severely infested building or feel that you may have interacted with bed bugs, you may want to change and bag your clothes before leaving the site and have the clothes in question laundered (this assumes that you have an extra set of clothes available).

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Know What You Are Looking For

female male

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nymph

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Not Bed Bugs

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

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Swallow Bug

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Treatment & Control - Phase One

If bed bugs are found, the hotel management needs to consult a licensed pest control professional. A written integrated pest management (IPM) plan should be requested from the pest control operator. This plan should detail the methods and insecticides to be used by the pest control operator and describe the efforts expected by the building manager. Generally, pesticides will need to be applied in conjunction with any non-chemical means of control; non-chemical options should be considered as management tools only.

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Treatment & Control - Phase Two

Good housekeeping practices and a reduction in possible harborages such as clutter, cracks, and crevices will discourage repeat infestations. As bed bugs are good at concealing their location, complete control is often difficult to achieve with the first treatment. This is especially so heavy infestations and thus a post control treatment evaluation is always advisable.

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Physical RemovalWhere infestations are heavy, treatment and removal of infested furniture and mattresses may be necessary. If bed bug numbers are small, they can be physically removed from mattresses and harborage sites by vacuuming. After bed bugs are removed, cracks in plaster need to be repaired and loosened wallpaper glued down to eliminate bed bug harborage sites. Bed bug exclusion covers can be used on mattresses and bed springs to prevent re-infestation.

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Temperature Extremes - Steam HeatBed 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

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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.

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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.

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Pesticides - THE LABEL IS THE LAW Currently, 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.

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• Residual Applications• Crack-and-Crevice Applications• Dusts• IGRs• Fumigation• ULVs, Aerosols, & Foggers

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FOLLOW-UPTo avoid spreading the bed bugs, the room or rooms should not be used until they have been found to be bug-free. The local Environmental Health Specialist should recheck the room(s) after they have been treated and re-evaluated by the licensed pest control professional to ensure that steps were taken to eliminate and prevent the bug infestation. Glue boards placed close by harborage areas may help monitor bed bug activity by catching bed bugs as they move about at night.

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More FOLLOW-UPMany times the first application does not seem to give complete or immediate control. Additional treatments may be necessary in 7 to 14 days. At least one follow-up inspection of infested sites should be conducted at a suitable interval (e.g., 1 week) after each control effort or treatment in order to detect any of the typical signs of continued infestation, such as live bugs, cast skins (after those present earlier had been removed), fecal spots on bed linens or harborages, and unhatched eggs.

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A Few Useful References

http://www.ces.ncsu.edu/depts/ent/notes/Urban/bedbugs.htm http://www.afpmb.org/pubs/tims/TG44/TG44.htmhttp://www.techletter.com/bedbugalert.htmlhttp://health.state.ga.us/epi/zvbd/infest/index.asp

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RecapHotel responsibility

Follow up on all complaintsWork with environmental health and a licensed pest control companyFollow clean up recommendations precisely Do not use infested rooms until given an “all-clear”

Environmental Health responsibilityFollow up on complaintsKnow what a bed bug looks likeCommunicate with hotel and pest controlRe-inspect

State Entomologist’s Responsibility

• Training/education

• Support• Mapping

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Any Questions?

Good Night.Sleep Tight.Don’t let the bed bugs bite.