Bring in only what is needed, and avoid sitting or placing coats and other items on beds, floors and sofas where the bugs commonly reside. Essential items can be placed on a tabletop or other hard surface, preferably away from bedrooms and sleeping areas. Better to sit on a hard (non-upholstered) chair than on sofas and recliners. Also try to avoid leaning or brushing against beds and upholstered furniture. If such items are carried out of infested dwellings (e.g., by sanitation workers or firefighters), it’s best to wrap them in plastic or at least not hold them against your body during transport. Emergency Medical (EMS) personnel may need to take additional precautions, such as removing a patient’s bed bug-infested shoes or clothing, or installing plastic sheeting before transporting them in the emergency vehicle.    
A bedbug will pierce the skin of its host with its mouth part. It first injects saliva that is a mixture of an anesthetic, so that the host feels nothing, and an anticoagulant so that the blood flows out freely. It then sucks out blood until it is full. The bites are not noticeable until after the skin reaction has occurred. According to the Centers for Disease Control and Prevention (CDC), it can take up to 14 days for bites to appear.
Next, vacuum and steam along baseboards, window sills, and the edge of the carpet. When you’re done vacuuming, the bag or canister should be cleaned or discarded to limit exposure of bed bugs to other parts of the home. The steamer can also be used to treat sofas, chairs, furniture, and cabinets. When applying steam, remember to move the nozzle slowly (about one inch per second) to ensure that all bed bugs and eggs are killed.
Application entails treating all areas where the bugs are found or tend to hide or crawl. This takes considerable effort and follow-ups are usually needed. Companies typically treat seams, folds and crevices of bed components, chairs and sofas, but usually will not spray the entire sleeping surface or seating area. They also do not spray bed sheets, blankets or clothing, which instead should be hot washed or heated in a dryer. 
Conventional insect repellents, like those used to deter ticks and mosquitoes, do not appear to be as effective against bed bugs. Therefore, attempting to avoid being bitten by applying insect repellent at bedtime is not recommended. Sleeping with the lights on is also not likely to deter hungry bed bugs, as they will adjust their feeding cycle to the host’s sleeping patterns. 
Bed bugs are a growing problem in schools and daycares. Typically they are introduced by students or staff living with an infestation at home. Pinpointing where the bugs exist can be challenging in such environments since there are no beds or sleeping areas for the insects to congregate. (Similar challenges occur when bed bugs are found in offices, libraries and retail stores.) Usually only small numbers of bed bugs are spotted, often on a student’s clothing, backpack, chair or desk. While this does not necessarily confirm that the child’s residence also has bed bugs, the parents should be notified that the home should be inspected, preferably by a professional. Teachers, nurses, and staff should be educated about the bugs and what they look like. Bed bugs should also be considered if a student frequently has reddened itchy welts --but keep in mind such reactions can be for reasons other than bed bugs. 
Pay attention to when the bites occur. Consider, for example, if you notice the bites after waking up when previously you hadn't noticed them. However, this can also be difficult to determine because each person's reaction time can vary significantly. Symptoms that result from the bite can manifest at any point from a couple of hours to more than a week after the bite occurred.
Human infestation with bedbugs, lice, and mites are common causes of dermatologic symptoms. Although these organisms thrive in conditions of overcrowding and decreased sanitation, Americans of all socioeconomic backgrounds may be at risk for infestation. Clinicians must maintain high suspicion in the appropriate set of clinical circumstances to identify and treat infestations, as they can cause substantial dermatologic and psychological discomfort for patients. Images courtesy of the US Centers for Disease Control and Prevention.

Some bed bug species are parasites of bats or birds, and may bite people if the wild hosts are no longer available. Although similar in overall appearance, the species of bed bugs that normally feed on bats, swallows, chimney swifts, pigeons or other wild hosts can be differentiated from those that prefer humans. Entomologists and knowledgeable pest managers can make this determination. If bat bugs or bird bugs are present, roosting and nesting sites should be the primary focus, and the animals should be removed and excluded from the building. 
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