How do you find them?

• Small, difficult to find• Cracks, crevices, wall

plates, baseboards, mattress seams, head-boards

• Prefer wood and fiber to plastic and metal

The start of an infestation

A bad infestation

Bed Bug Signs:Blood spots

• Blood spots are bed bug droppings

Live bed bugs & cast skins on a mattress seam

Bed Bug Signs:Shed skins

Bed Bug Signs:Dead bed bugs

Ventral Dorsal

Inspecting For Bed Bugs

• Usually found near beds– Mattresses

– Bed frames

– Headboards

– Nightstands

• Upholstered furniture– Couches

– Chairs

• Baseboards

• Wall/ceiling junctures

02 FEB 201120 OCT 2010

Where bed bugs live

= Hot Spot

Beds, sofas, bedside tables, recliners, picture frames…

What’s on the other side of the wall?

How do bed bugs spread?• Through walls along wires and pipes• On anything coming from an infested unit

(furniture, backpacks, laundry…)

Mattress disposal

Inspecting For Bed Bugs

• In their natural environment

Bed Bug!

Blood spots!

Inspecting For Bed Bugs• Screw holes, recessed bolts, knotholes, and

oh, so much more.

Truth:Bedbugs do not directly spread diseases, but if their bites are not properly cleaned and treated, skin can become infected and cause additional problems.

Another Truth: A bedbug engorged with blood can burst, spreading blood. Take appropriate precautions when coming into contact with blood.

Bed bugs have never been shown to pass diseases to

humans

What are the health risks?Bites

Reactions to bites vary widely Most common symptom is

itchy welts

Secondary Infection• Scratching welts may cause

infection• Allergic Reaction• Asthma

Psychological• Anxiety and unhealthy

stress• Sleeplessness• Phantom Itching

Anemia in children and older adults who have been severely bitten

Common Skin Reactions

• Timing of reaction may change with repeated exposures

• Commonly– No reaction w/barely visible punctum

• Some evidence that older individuals have depressed reaction to bed bug bites

– 2-5 mm pruritic maculopapular, erythematous lesions• Usually itch and, if not abraded, resolve within a week

– Some patients experience complex cutaneous reactions

Treatment of Bite Symptoms

• Patients may present to medical facilities with bites– Care for bites is supportive– Antihistamines, Corticosteroids, Antibiotics– Bed bug bites may be indistinguishable from bites of

other arthropods

• Goddard and deShazo (2009) – most patients w/symptom resolution ~2wks

• Elimination of the infestation at home or in care facility is only way to “cure” bites

No Topical Treatment to “Cure” Bed Bugs

• Topical treatments such as those used for head lice or scabies are INEFFECTIVE against bed bugs.– Bed bugs DO NOT live on

people, they live in our environment

– Prescription of these creams to patients suffering from bed bug bites is NOT INDICATED

– The use of these products may be dangerous to patients if used more often than label recommendations

Extreme Measures – Don’t Let This Happen!

No Repellant• There is currently no evidence to

support the effectiveness of insect repellents against bed bugs

• **Encasing mattress/boxspring and isolating the bed can be effective while treatment is ongoing

Risks Associated with Environmental Treatment

• MDCH and health agencies concerned about acute pesticide exposure:– Eliminating an infestation is difficult for the layman– Professional treatments are expensive

• Market is also ripe for unscrupulous people to take advantage and offer “economical” treatments that are likely to be ineffective at best and dangerous at worst.

– Desperate people will try to treat the problem on their own• Total release foggers or BUG BOMBS• Alcohol being touted as sound pest management tool• “More is better”• Home remedies, internet scams, applying products not intended for

indoor use, etc.

Examples of Products Found on the Internet

Examples of Products Found at Home Improvement Stores

CommonHouseholdProducts

“Green”Products

“Bug Bombs”or

Total ReleaseFoggers

Responsible Use of Insecticides• If you are going to try your own pest management –

always follow label directions – “The label is the law”

• “MORE” is not better!

• Beginning in 2011, the labeling of “Bug Bombs” or total release foggers will state:

“Not effective for treatment of bed bugs”

Mis-application Examples

Boric Acid-not very effective for bed bug control

Drione Dust-pyrethrin-piperonyl butoxide

Washington, DC, August 2008

San Diego, CA, July 1992

Augusta, GA, March 2008

Total release foggers (there’s a reason they’re called bombs!)