Goodnight…Sleep Tight…Don’t Let the Bed Bugs Bite

by Brenton Bauer, MD 2012 | bauer@myhousecallmd.com

I want you to think to yourself for a second.  Have you ever said “sleep tight…don’t let the bedbugs bite” to address someone (probably a child) before going to bed.  Chances are you probably have, and there is an implied understanding that we are simply wishing a person a good night sleep.  But what really are these bedbugs that “lie” at the end of this common colloquialism?  If you have watched the news or read a newspaper anytime in the past year, you were bound to see headlines of a bedbug epidemic that the citizens of New York City are still battling tooth and nail.  Furthermore, since the announcement of the NYC “epicenter” there have been numerous large urban cities across the country stricken by their own epidemic.  It is obvious that these creatures are our common enemy (especially if you have seen the exterminator bill after an eradication treatment), but what makes them such a formidable opponent?  More importantly, what are the medical ramifications of an infestation and recurrent bites?

What are Bedbugs?

The common bedbug, or Cimex lectularius, is an arthropod that survives as a human parasite feeding off of human blood.  The typical bedbug is a reddish-brown color, has no wings, and on average is between 1-7mm in length.  The lifecycle of a bedbug involves an egg stage followed by five nymph stages (with each stage separated by a blood meal and subsequent molting) and finally the adult stage, which can survive up to 10 months if it has access to sufficient nutrition (aka you!).

Can I get a disease from Bedbugs?

Current research and summary analyses developed by the Centers for Disease Control (CDC) have shown no data supporting the role of bedbugs being human disease vectors; meaning they don’t transmit diseases to humans.

Then…what do they do to me?

Apart from being absolutely creepy that these “suckers” (pun intended) are living with you, there are a few items of medical concern.  First off, when a bedbug bites you it injects a bit of its saliva, which contains both an anesthetic and an anticoagulant (just like mosquitoes).  These agents prevent you from feeling the bite (evolutionary advantage so you don’t squash them) and prevent your blood from clotting so that they can feed from the bite site, respectively.  Since these two agents are foreign proteins being put into your body, an allergic response might develop causing an inflammatory response.  For most individuals the bites go unnoticed, but for others they find multiple bite marks with redness and swelling around the site and a strong itching sensation similar to a mosquito bite.  Very rarely have there been severe complications reported such as anaphylaxis (a systemic allergic response), anemia from chronic blood loss (lots of bites for long periods of time), or a secondary skin infection (bacteria that can contaminate the open bite).

More troublesome than the actual physical harm that bedbugs inflict on people are the psychological effects that they can invoke in sufferers and everyone else in the community attempting to avoid an infestation.   Commonly people report suffering from states of chronic anxiety, an elevated level of stress, and disturbed sleep patterns/sleeplessness.

I’ve been bitten!  How should I treat the bite?

Typically, bedbug bites are benign and self-resolving within a period of about 3-10 days.  There is no necessary medical treatment for the bite itself, but some people might choose to use a triple antibacterial ointment (like they might on any scrape/cut) to prevent a secondary skin infection or a topical antihistamine to relieve the constant itching.  The only true treatment for bedbugs is eradication from the home and further prevention of another infestation down the line.

OK…so I’ve got’em…now how do I get rid of them?

I should just spray a bunch of pesticide in places where I see them hiding…right?  NO!  The best practice for elimination of bedbugs is the utilization of the philosophy of Integrated Pest Management (IPM). IPM involves combining multiple methods in a logical manner to enhance effectiveness, protect the environment, and prevent unnecessarily high levels of pesticide exposure to humans and animals.  The practices of IPM and detailed steps that should be taken before a pest control team comes into your home can be found at the following website from Cornell University.

Remember that when looking for a pest management company make certain that they are:

  1. Licensed/insured by the state
  2. Their technicians are fully licensed/insured
  3. They are members of and practice the measures of IPM
  4. Their technicians are familiar with the successful management and eradication of bedbugs
  5. They do not simply apply gallons of pesticide and immediately leave the premises

Well, I don’t have a problem but I certainly don’t want to.  How do I prevent an infestation?

First of all, bedbugs are masters of hiding and prefer to hide in places where they will be close to human hosts.  They prefer paper and wood surfaces rather than metal or plastic, and also prefer porous surfaces for the purpose of laying their eggs.  Therefore, a lot can be done with simple adjustments in furniture choices and encasements around mattresses.  For instance, if you have wicker furniture pieces it is best to replace them with metal as the wicker provides ample hiding places for bedbugs in spaces that aren’t easily identifiable.  We admit that rearranging a whole bedroom set is labor intensive and financially straining, so at the minimum ensure that you have a high quality “bug-proof” mattress/box-spring encasement for prevention of bedbug infestation and ease of identification when suspicions of an infestation arise.  The following points will give you a fighting chance in preventing an infestation but is by no means an exhaustive list for total protection against bedbugs:

  • Eliminate wood bed frames and replace with metal based frames to dissuade egg laying within the bed frame itself
  • Completely eliminate head boards as bedbugs absolutely love headboards
  • Use white sheets/bedding so early infestations can be identified and dealt with swiftly
  • Purchase and utilize high quality mattress and box spring encasements
  • Don’t ignore other rooms in your home from a thorough inspection
  • Be careful when traveling to hotels as bed bugs are commonly make their way home in suitcases.  Be vigilant (but not paranoid) about your surroundings since you could unknowingly be bringing friends home with you from your vacation. Check the bed when you first get there and keep your suitcase away from the bed during your stay.
  • Check the National Bed Bug Registry before traveling or moving into a new home/apartment to make sure that the place is bed bug-free.
  • If you are at high risk of picking up bedbugs from your workplace (eg. housekeepers, medical/social workers, facilities managers, etc.) then take proper precautionary measures including bringing an extra change of clothes and a plastic bag for worn clothes that are to be washed and dried on hot cycles ASAP.

Your Take Home Message

Fear is sweeping the country with regards to the “bedbug epidemic.”  While we don’t want to belittle the problem, we certainly do not want people to be living in a state of constant anxiety out of fear of a potential infestation.  Therefore, make certain to practice good preventive measures whenever possible and, if you suspect an infestation, get a good pest management team onboard early to inspect your place and evict your new (and unwanted) bed mates as soon as possible!


Questions? E-mail the Author: bauer@myhousecallmd.com

References

  1. “Joint Statement on Bed Bug Control in the United States from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Environmental Protection Agency (EPA)”. Centers for Disease Control.  Last Updated 10/24/10. Accessed 11/5/10. Available at: http://www.cdc.gov/nceh/ehs/publications/bed_bugs_cdc-epa_statement.htm
  2. “Bedbug Fact Sheet”. New Jersey Department of Health and Senior Services Consumer and Environmental Health Services Public Health, Sanitation and Safety Program. Accessed 11/1/10. Available at: http://www.nj.gov/health/eoh/phss/documents/bedbugfactsheet.pdf
  3. “Guidelines for Prevention and Management of Bed Bugs in Shelters and Group Living Facilities”. New York State Integrated Pest Management Program & Cornell University. Accessed 10/30/10. Available at: http://www.nysipm.cornell.edu/publications/bb_guidelines/

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