How do you find them Small difficult to

How do you find them? • Small, difficult to find • Cracks, crevices, wall plates, baseboards, mattress seams, headboards • Prefer wood and fiber to plastic and metal

Bed Bug Signs: Blood spots • Blood spots are bed bug droppings A bad infestation The start of an infestation

Bed Bug Signs: Shed skins Live bed bugs & cast skins on a mattress seam

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

Where bed bugs live Beds, sofas, bedside tables, recliners, picture frames… = Hot Spot 0220 FEB OCT 2011 2010

How do bed bugs spread? • Through walls along wires and pipes • On anything coming from an infested unit (furniture, backpacks, laundry…) What’s on the other side of the wall? 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.

Bedbugs Cause Truth: Disease: FALSE 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.

What are the health risks? Bites § Reactions to bites vary widely § Most common symptom is itchy welts Psychological • Anxiety and unhealthy stress • Sleeplessness • Phantom Itching Secondary Infection Anemia in children and older adults who have been • Scratching welts may severely bitten cause infection • Allergic Reaction • Asthma Bed bugs have never been shown to pass diseases to humans

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 de. Shazo (2009) – most patients w/symptom resolution ~2 wks • 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 Common Household Products “Green” Products “Bug Bombs” or Total Release Foggers

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 Drione Dust -pyrethrin -piperonyl butoxide Boric Acid -not very effective for bed bug control

Total release foggers (there’s a reason they’re called bombs!) San Diego, CA, July 1992 Augusta, GA, March 2008 Washington, DC, August 2008