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.
People don't often consider bed bugs until they've left their mark. The appearance of flat, red welts in zigzag lines or small clusters is a key sign of bed bugs on humans. Bed bugs can also leave their bites in straight rows and, while they don't spread diseases to humans, their bites are quite irritating and scratching them can lead to bleeding and infection.
Most people have never seen a bed bug. Adults are wingless, about one-fourth of an inch long, and flat to fit in cracks and crevices where they hide by day. Females typically lay three to five adhesive eggs per day in crevices and depressions. Eggs and newly hatched nymphs are somewhat translucent and only about one-sixteenth of an inch long. After feeding, nymphs become bright red.
The size of bed bug bites varies with a number of different factors. Bed bugs inject an anti-coagulant along with their saliva when they pierce the skin to take a blood meal. This anti-coagulant is mostly responsible for how a person reacts to the bite and determines the size of the bug’s bite. Since people will have various sensitivities to the bed bug’s bite, the size of the bite will vary, as well. Another factor that influences the size of a bed bug reaction is the number of times a person is bitten. Bite reactions of people bitten many times are also variable, and their response may be either more or less intense as the number of bites increases.
Bedbugs do, however, have a unique bite pattern. Although some bites may appear alone, most bites occur in a row of three to five bites (termed "breakfast, lunch, and dinner") or in a cluster of red bumps (a rash called bedbug dermatitis). The bites often appear in a zig-zag formation, but may appear in a straight line if the bugs bite you in the morning.
An adult bed bug is about 1/5 inch long and 1/8 inch wide. Its reddish brown to mahogany-colored body is greatly flattened and oval shaped. After feeding, the bug's body enlarges considerably, becoming longer and much less flattened. Although the body is covered with tiny hairs, these hairs are so small that they are almost invisible to the naked eye, so the general body appearance is shiny. Bed bugs have piercing-sucking mouthparts that enable them to pierce the skin and suck blood from their hosts.
Discourage bed bug infestation by keeping clutter picked up, washing bedding and upholstery routinely and not buying used furniture. When you’re traveling, lower your risk of bringing bed bugs back home by opening your suitcase on a hotel desk or luggage rack instead of on the bed; keeping your belongings in your suitcase, not unpacked in dresser drawers; sealing dirty laundry in plastic bags that can be taken straight to the laundry room at home; and inspecting your luggage for bed bug activity before you bring it into your bedroom.
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.
Some firms want beds stripped and furniture moved before they arrive, while other firms prefer to inspect first and perform these tasks themselves. Clutter and belongings on floors (especially beneath beds) must be removed since they impede treatment and afford additional places for bugs to hide. Bedding and garments normally will need to be laundered and/or hot dried (120°F minimum) since they cannot be treated with insecticides. An effective and efficient alternative to laundering is to simply place bedding, clothing, toys, shoes, backpacks, etc., in a clothes dryer set at medium-to-high heat for 10 to 20 minutes. This can be done in lieu of washing and will kill all bed bug life stages.
Bedbug bites don’t normally require treatment by a doctor, though there are a few precautions you should take at home. (8) Start by cleaning the area with soap and water to lower your risk of infection and to relieve itchiness. If the bites are itchy, pick up a corticosteroid cream at your local drugstore and apply it to the area. The bites generally will heal within a couple of weeks. (9)
Insecticide Application This is the most common way to get rid of bedbugs, Lazarus says. Oftentimes, the professional will use several different products to effectively treat the area, though it may take a few rounds to ensure removal. “The advantage to this method is that the residual insecticide will continue to offer protection for a period of time,” Lazarus says. “The biggest drawback is that the preparation for service is time-consuming and must be repeated prior to each service.”
Caregivers, firefighters, and other service providers are sometimes required to enter and work in bed bug-infested dwellings. In doing so, there is the potential to transport some bugs home or to the workplace. It should be noted that bed bugs do not fly, nor jump onto people/pets as fleas do. During the day, bed bugs usually remain hidden and immobile, becoming more active at night when seeking a host. Consequently, the chance of picking up bed bugs by merely walking into an infested dwelling during the day is unlikely. The risk may increase while providing care but can be lessened by taking some precautions.
But the bites will look different from person to person, and some people won’t develop any reaction whatsoever. “The same bedbug could bite two different people and one could have no reaction at all and the other can have an extreme reaction with a swollen arm or itchy rash,” says Eric Braun, a board-certified entomologist and business manager for the national pest control company Rentokil Steritech, who is based in Redding, Pennsylvania. Some people end up developing a rash that looks like eczema. (5)
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Bed bugs multiply quickly, and in just six months, a few can turn into a full-on infestation of 13,000 or more. Detection is critical to break the bed bug life cycle before they become a bigger problem. Orkin Bed Bug Detection Service gets to the root of the problem with targeted inspections of common bed bug hiding places in your home and ongoing monitoring to ensure the pests never return.
Nightstands and dressers may need to be emptied and examined inside and out, and tipped over to inspect the woodwork underneath. Oftentimes the bugs will be hiding in cracks, corners, and recesses. Other common bed bug hiding places include: along and under the edge of wall-to-wall carpeting, especially behind beds and sofas; cracks in wood molding; ceiling-wall junctures; behind wall-mounted pictures, mirrors, outlets and switch plates; under loose wallpaper; clothing and clutter within closets; and inside clocks, phones, televisions and smoke detectors.
Amazingly, these sneaky little bloodsuckers dine on you without waking you. You don't feel their stealthy bite because they inject a numbing agent into your body, along with an anticoagulant to keep your blood flowing as they suck. The first sign of bedbugs may be itchy, red bites on the skin, usually on the arms or shoulders. Bedbugs tend to leave straight rows of bites.
Start in the corners and along edges of an open wall. With the card, see if you can dig things out of the cracks and crevices. Work your way along the cracks and crevices. For example, if you are checking a baseboard along the floor, see if you can get the card between the baseboard and the floor, as well as the top of the baseboard and the wall. If you have a bare tile or wood floor, consider using a damp cloth or map to wipe the floor. Don’t use too much water as floors can be slippery. Look for anything moving after you wipe the floor. If you have carpeted areas vacuum the clean area. See Vacuuming Items to Capture Bed Bugs. Don’t forget to check pictures and other items on this wall.
The main reason people seem to favor the essential oil option is that it’s considered a natural and chemical-free alternative to pesticide sprays. What they don’t realize is that today’s home pesticides are carefully regulated by the EPA to make sure that they’re safe for indoor use. The EPA also requires that health and safety guidelines are included in the product label and MSDS, to ensure that anyone who uses a spray has instructions on how to use it safely and effectively. When used correctly, even our strongest bed bug sprays won’t have any effect on you, but they will kill bed bugs more effectively than any mixture of household items like herbs or oils.
It’s perfectly natural to want to eliminate a bed bug infestation without spending a ton of money on professional-grade products or a treatment by a pest control operator. When people discover that they have bed bugs, they often turn to do-it-yourself recommendations from discussions on the Internet. These suggestions might include household items, some of which are recommended more often than others. Let’s take a closer look at some of the most popular items and how they might be used against bed bugs:
First up is the most commonly recommended tool by far: rubbing alcohol diluted in water. This is suggested because alcohol can kill bed bugs on contact, and evaporates shortly after, so it’s considered safe for use pretty much anywhere in a home. A recurring theme in these recommendations are household items that are considered to be safer for people than mainstream chemicals.
Instead, get written quotes from three licensed exterminators detailing their course of action, including pesticides, traps, and/or heat treatments they'll use and how and where they'll use them. "You should ask lots of questions to the companies you interview, because a good company will answer them and will never pressure you to make an appointment," says Dunham.
As per mentioned, when you shift your furniture to located these bed bugs, you alert them and they may move from one infested room to another, which could be spared from in the first place. Therefore, when you spot signs of bed bugs early, be careful not to shift furniture, drawers and closets around too much. Wait for your pest control expert to advice.
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New tactics may be needed for this escalating public health concern in locations with high occupant turnover, such as hotels, hospitals, and nursing homes.  Indeed, in the past decade bedbugs have become a worldwide urban pest, with the number of American households affected markedly increased.  Genetic data suggest that C lectularius may be undergoing lineage divergence through host association. 
Once the mattress and box spring are dry, encase them in sealed bed bug encasements. Encasements are crucial, as they prevent bed bugs from entering or escaping the mattress and box spring, cutting off key hiding places. Remember to leave the encasements on for at least 18 months to ensure that any bed bugs already inside have starved to death. Once the encasements have been applied, you can put your mattress and box springs back on your treated bed frame, and put your laundered bedding back on your bed.