Rosmarie KellyPublic Health EntomologistGDPH - Atlanta

Bed bugs are true bugs in the order Hemiptera e.g. aphids, scales, cicadas.

Hemiptera is from the Greek hemi ("half") and pteron ("wing"), referring to the forewings of many hemipterans which are hardened near the base, but membranous at the ends.

Hemipteran mouthparts have evolved into a proboscis, sheathed within a modified labium to form a "beak" or rostrum that is capable of piercing tissues and sucking out liquids. Most hemipterans feed on plants, but some feed on animals.

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One theory is that bed bugs originated from bugs that fed on bats living in caves. When man moved into the caves the bugs adapted to feed on them; when man left, the bugs went with them.

Commonly referred to as chinches by grand folks. Mahogany flats and red coats were also used.

An assortment of treatments used for control.

(Insects Injurious to the Household, G. Herrick, 1914)*

Iron or brass bedsteads are better for controlling bed bugs than wood

Kerosene oil, gasoline, or benzene will kill bedbugs if forced into cracks and crevices with a feather or with a hand syringe. Sometimes legs of bed were placed into cans of oil or kerosene to prevent bugs from climbing into the bed.

A mixture of corrosive sublimate (one ounce), alcohol (one pint) and spirits of turpentine (one-fourth pint) painted into the cracks of a bedstead with a feather

Boiling water poured over the parts of a bedstead that have been carried where they may be liberally treated.

Sulfur candles for fumigating

Hydrocyanic acid gas chemical reaction between potassium cyanide, water, and sulfuric acid, a deadly poison to human beings and other animals

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Bed Bugs and PesticidesCommon pest in the US at the turn of the century

Essentially eradicated in 1940-50 due to DDT

Resistance documented to DDT, malathion, carbamates and pyrethroids

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Bedbugs hide in cracks and crevices during the day and come out at night to suck blood. Hence, DDT spray must be directed toward their daytime hiding places. Apply the DDT spray to the bedsteads, paying particular attention to cracks in the wood and joins. Spray the springs and mattresses. Strip the mattress and spray all sides and the edges, especially any crevices in which bedbugs might hide and behind any loose paper where they might congregate.*

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Bed bugs began to be reported as problems during mid 90s mainly by travelers staying at hotels/motels

Lately severe problems are being reported from schools, apartment complexes and rental home property in all over the US.

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Why are Bed Bugs Back in the US?Increased International travel?

Immigrant populations?

Reduced baseboard spraying?

Prevalence of baits

Resistant populations?

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Baumgartner (EPA R5): Bed Bugs EPA R5 Review**

Classification of True BugsKingdom:AnimaliaAnimalsPhylum:Arthropodajoint-leggedClass:Insectasix-leggedOrder:Hemipterahalf-wingSuperfamily Cimicoidea Family:Cimicidaebed bugs

Polyctenidaebat bugs

about 70 other families: some are plant feeders, some are predators, some feed on blood**

Of the 90 or so species in the family Cimicidae approximately 7 will feed on human blood, but only 2 are commonly found: Cimex lectularius (bed bug) and Cimex hemipterus (tropical bed bug).

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Bed bug - Cimex lectulariusBat bug - Cimex adjunctusPoultry bug - Haematosiphon inodorusSwallow Bug - Oeciacus vicariusChimney Swift Bug - Cimexopsis nyctalis

These are insects in the order Hemiptera makingthem true bugs. Specimens must be identifiedin order to determine the appropriate treatment.*

Bed bug Bat bug*

Swallow Bug*

http://www.ext.colostate.edu/pubs/insect/05574.html *

Not Bed Bugshttp://ipm.ncsu.edu/AG369/keys.html Key to Common Pests of Man and Animals*

Life CycleFemale bed bugs deposit 3 to 8 eggs at a time; a total of 200-500 eggs can be produced by one female over her 10 month life span.The eggs hatch in 4-12 days. Bed bugs go through 5 nymphal stages before reaching maturity. This usually takes 35-48 days.

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Incomplete metamorphosis - bugs hatching from egg look just like very small adults. There are three stages of development:

Eggs. Females lay one to five eggs a day over a period of two to 10 months, producing about 200 total. They deposit the 1mm white eggs intermittently each day in protected places near their hosts' sleeping quarters, cemented to bedding or in cracks. The eggs hatch in one or two weeks, depending on temperature.

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Incomplete metamorphosis - bugs hatching from egg look just like very small adults. There are three stages of development:

Nymphs. Tiny and colorless at first, nymphs resemble small adults. They require a blood meal between each of five molts. Blood meals take about three to 10 minutes, at which time the nymphs inject saliva containing an anticoagulant. The nymphal stage can last for several weeks under favorable conditions or as long as a year when temperatures or host availability are low.

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Incomplete metamorphosis - bugs hatching from egg look just like very small adults. There are three stages of development:

Adults. About 1/4 inch long, 3/16 inch wide and reddish-brown in color. The flattened oval bodies are adapted for hiding in narrow spaces. The head has a pair of four-segmented antennae and piercing-sucking mouthparts that fold to lie between the first pair of legs. The tiny wings are represented only by pads. The body may become greatly enlarged and blood-red in color during a blood meal but turns a dirty brown subsequently. Females can live nearly a year without food. Males and females both feed on blood.

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Know What You Are Looking Forfemalemale*

Habits & HabitatsBed bugs are active mainly at night; they reach peak activity before dawn.During the daytime, they prefer to hide close to where people sleep. Their flattened bodies enable them to fit into tiny crevices - especially those associated with mattresses, box springs, bed frames, and headboards. Bed bugs do not have nests like ants or bees, but do tend to congregate in habitual hiding places. Bed bugs do not fly, but can move quickly over floors, walls, ceilings and other surfaces. Bed bugs will travel 5-20 ft. from an established harborage to feed on a host. Egg-laying females also wander.

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Bed Bug FactsBed bugs respond to warmth and carbon dioxide when searching for a blood meal, but not to odors. All nymphal stages and adults of both sexes require blood for nutrition and development. Bed bugs ordinarily feed within 24 hours of hatching, once between each molt and once before egg deposition; an average period of 8 days is required between molts. Adult females will continue to take blood meals every 3-4 days depending on ambient temperature and humidity. Bed bugs take up to 10 minutes to complete a blood meal, and will consume 2-5 times their own body weight in blood during that time.

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More Bed Bug FactsIndividual bed bugs usually do not feed every night but at intervals of a few days to a week. Bed bugs do not remain on the host between feedings. Once a bed bug is finished feeding, it quickly retreats back to its hiding place. Bed bugs may also feed on small animals, such as pets.

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Really Weird FactBed bugs have a unique form of mating called traumatic insemination. The male penetrates the females abdomen with his external genitalia, inseminating into her body cavity. This sexual activity produces a wound in the female and probably endangers her longevity and productivity.

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MovementSpending a night (or longer) in an environment which is already infested by bed bugs (hotels, homes, international flights, etc). Having someone visit from such an infested environment (bed bugs can be transported in luggage). Renting furniture or buying used furniture or bedding. Picking up discarded bedding or furniture from a curbside, trash collection point or dumpster.

Some of the most common ways new bed bug infestations may be introduced include: *

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Bed Bug Bites The bite of a bed bug is painless. The amount of blood loss due to bed bug feeding typically does not adversely affect the host. Bed bugs feed on any bare skin exposed while sleeping (face, neck, shoulders, arms, hands, etc). Skin reactions are commonly associated with bed bug bites, which result from the saliva injected during feeding. Some individuals do not react to bed bug bites, while others note a great deal of discomfort often with loss of sleep from the persistent biting.

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Bites typically occur at night while person is in bed. Bites are on exposed areas of skin. Sometimes occur in linear groups of 3, called breakfast, lunch, and dinner. Individuals may react differently to bites in terms of itching and discomfort.Numerous bites may cause systemic reaction Treatment topical hydrocortisone, oral antihistamines, or corticosteroids for numerous bites and antibiotic cream for secondary infections.

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Reactions to BitesCommon allergic reactions include the development of large welts that are accompanied by itching and inflammation. The welts usually subside to red spots but can last for several days. Blister-like eruptions have been reported in association with multiple bed bug bites and anaphylaxis may occur in patients with severe allergies.

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More on BitesDepending on bite intensity and frequency, there are typically five post-bite effect stages: no reaction (no or too few antibodies developed), delayed reaction, delayed plus immediate reaction, immediate reaction only, and no visible reaction (due to excess circulating IgG antibodies). Typical symptoms include a raised, inflamed, reddish wheal at each bite site, which may itch intensely for several days. Immediate immune reactions may appear from one to 24 hours after a given bite and may last 1-2 days."Delayed immune reactions usually first appear one to three (up to 14) days after a bite and may last 2-5 days. Humans who are frequently bitten by bed bugs may develop a sensitivity syndrome that can include nervousness, almost constant agitation (jumpiness), and sleeplessness.

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Individual bites may cause itching/irritationSecondary infection of bites possibleSystemic effects from numerous bitesLoss of sleepEmotional distressPathogens have been isolated, but bed bugs are not know to transmit diseases

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Bite SummaryAllergens from bed bugs may be associated with asthmatic reactions.Reactions to the bites may be delayed up to 14 days before lesions appear. Reactions may be accompanied by severe itching that lasts for several hours to days. Scratching may cause the welts to become infected.Bed bugs have never been proven to biologically transmit any human pathogen.

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Inspecting for Bed BugsCrucial part of control!*

Hotels/motels Apartments/homesVacation rentalsHomeless sheltersTheatersFurniture rentalsCollege dormsSchools

and the list goes on*

INSPECTIONIf the inspection site is a hotel, it is important that the housekeeping staff be interviewed. Efforts should be concentrated on dark, isolated and protected areas. Bed bugs prefer wood, paper and fabric surfaces and so these materials should receive special attention during the inspection process. The mattress should be the first site inspected and the seams, beading, under buttons, labels, and corner protectors (if not previously removed) should be examined closely. If headboards are attached to the wall, they should be removed. Removing headboards from the wall is important, as this may be the first place bed bugs will be found when the infestation is light.

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Infestations are usually centered around bedTypically the victim will find bugs in bed.Bed bugs can be found hiding in crevices along the mattress and box springs such as ticking, tags, buttons, and rips. The gap between mattress and box spring is a very good inspection site. Check crevices and openings along the bed frame.Dark spots on mattress and other surfaces results from blood that has been digested and defecated.As infestation grows, bugs may be found hiding further from the bed - behind pictures, baseboards nightstands, under carpet or wallpaper. Adjoining rooms may become infested.

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Where to Look - Most EverywhereIt can take 1-2 hours to thoroughly check a space for bed bugs. Be thorough!Light infestations are extremely difficult to detect.*

In any infestation, the adjoining rooms, both sides, and above and below, should be inspected.Common rooms, such as a lounge, should not be overlooked.

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Check the BedRemove all the sheet, checking for blood spots.Stand the mattress up. Remove the box spring and flip it over.

Inspect the mattress closely, paying close attention to the seams.

Inspect inside the box spring and under it (where it meets the bed frame). Shine a flashlight through the bottom of the box spring.

Check any head and foot boards as well as anything stored under the bed.

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Check the Rest of the RoomCheck inside all drawers, crevices, and narrow spaces. Look under electronics, behind pictures, and in stacks of clothing. Bed bugs are often found hiding in tack strips under wall-to-wall carpeting and behind baseboards. Bed bugs tend to crawl up, so check check drapes and wall decorations.

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Check All FurnitureRemove sofa cushion, and check all seams and crevices. Tip back couches and chairs and look underneath, particularly behind skirts.

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New Technologybed bug sniffing dog

Ability of Bed Bug-Detecting Canines to Locate Live Bed Bugs and Viable Bed Bug EggsMARGIE PFIESTER, PHILIP G. KOEHLER, AND ROBERTO M. PEREIRAJ. Econ. Entomol. 101(4): 1389-1396 (2008)http://sleeptightllc.biz/184846.pdf A well-trained dog and handler are 98% likely to find bed bugs where there is an infestation.*

Responses You Will GetHOTEL Manager/OwnerIts just bed bugs, big deal (in some areas of the world bed bugs are so numerous that babies become anemic from being fed on)That isnt a bed bug!You brought that in here!I will call my pest control company right now.

Hotel CustomerGet it off! Get it off! Get it off!Im suing!ARRRRGGGGHHHHHHH!

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Taking PrecautionsDont bring bed bugs home with you.Place service kit and equipment in an open area away from walls and furniture

Assume beds, furniture, and other items you are about to inspect or treat are infested and act accordingly.

Avoid laying across, leaning against, or sitting on potentially infested beds or furniture and minimize direct contact with any potentially infested materials such as drapes, rugs, piles of dirty clothes.

Bring a minimum of equipment into the room. If you carry an inspection kit or service kit, place it in an open area away from walls and furniture.

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DO NOT DO THIS*

More Precautions

Remove your clothes over a non-carpeted floor and be ready to immediately capture and destroy any bug you see. If you are concerned that your clothes might contain bed bugs, launder them in hot water as soon as possible. Take off your clothes as soon as you get home.If you have been in a severely infested building or feel that you may have interacted with bed bugs, you may want to change and bag your clothes before leaving the site and have the clothes in question laundered (this assumes that you have an extra set of clothes available).*

Identify bugs to determine if they are bed, bat or bird. Eliminate bird or bat sources of bugs. Clean room and remove clutter to eliminate bed bug harborage.Vacuum to remove bugs and eggsLaunder clothing and bedding in hot cycle to kill bugs and eggsSteam clean carpet and furniture to kill bugs and eggs.Heat treatment of mattresses may be available.Two-sided tape or band of petroleum jelly on bed legs discourages bugs from climbing.Mattress cover makes it more difficult for bugs to hide. Easier to clean. Treat bed frame and head board as permitted by insecticide label. PCO might not want to treat mattress or might use pyrethroids. Treat cracks and crevices with a residual insecticideHeat entire room to over 200o F

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Treatment & Control - Phase OneIf bed bugs are found, the hotel management needs to consult a licensed pest control professional. A written integrated pest management (IPM) plan should be requested from the pest control operator. This plan should detail the methods and insecticides to be used by the pest control operator and describe the efforts expected by the building manager. Generally, pesticides will need to be applied in conjunction with any non-chemical means of control; non-chemical options should be considered as management tools only.

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Treatment & Control - Phase TwoGood housekeeping practices and a reduction in possible harborages such as clutter, cracks, and crevices will discourage repeat infestations. As bed bugs are good at concealing their location, complete control is often difficult to achieve with the first treatment. This is especially so with a heavy infestations; a post control treatment evaluation is always advisable.

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Physical RemovalWhere infestations are heavy, treatment and removal of infested furniture and mattresses may be necessary. If bed bug numbers are small, they can be physically removed from mattresses and harborage sites by vacuuming. After bed bugs are removed, cracks in plaster need to be repaired and loosened wallpaper glued down to eliminate bed bug harborage sites. Bed bug exclusion covers can be used on mattresses and bed springs to prevent re-infestation.

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Temperature Extremes - Steam HeatBed bugs are very sensitive to heat, and a combination of steam cleaning and insecticide use has been found to be more effective for long-term control than insecticides alone.The steam emission tip must usually be about 2.5-3.8 cm from the surface being steamed. If the tip is too far away, the steam may not be hot enough to kill all the bed bugs and eggs that it contacts. If the tip is too close, excess moisture may be injected into the treated material, which may lead to other problems

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Temperature Extremes - Dry Heat For heat treatment to be effective, it is critical that high temperature and low relative humidity be attained for a minimum length of time (49-52oC [120-125oF] and 20-30% relative humidity for 20-30 minutes). Heat treatment provides no residual effect, and bed bugs can re-occupy any site so treated immediately after temperatures return to suitable levels. Laundering infested linens or cloth items in hot water with detergent, followed by at least 20 minutes in a clothes dryer on high heat, should kill all life stages of bed bugs but would not prevent their reinfestation.

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Temperature Extremes - ColdExposure to low temperatures can kill bed bugs if they are kept cold enough long enough. Bed bugs can tolerate -15oC (5oF) for short periods and, if acclimated, they can survive at or below 0oC (32oF) continuously for several days. Freezing furniture or other items within containers or chambers [e.g., below 0oF (-19oC) for at least four days] may be a practical alternative for limited infestations or to augment other control measures. A new commercial technology uses CO2 from cylinders deposited as a snow to kill bed bugs and a variety of pests by rapid freezing.

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Pesticides - THE LABEL IS THE LAW Currently, non-chemical products and techniques are incapable of efficiently or quickly controlling or eliminating established bed bug populations.

Precise placement of a suitably labeled, registered and formulated chemical insecticide is still the most effective bed bug control.

The choice of chemical products and specific application techniques can depend on many factors, including the physical location and structural details of the bugs harborages, the products labels (which can vary by political jurisdiction), the immediate environment, and local or national laws. *

Residual ApplicationsCrack-and-Crevice ApplicationsDustsIGRsFumigationULVs, Aerosols, & Foggers

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FOLLOW-UPTo avoid spreading the bed bugs, the room or rooms should not be used until they have been found to be bug-free. The room(s) should be rechecked after they have been treated and re-evaluated by the licensed pest control professional to ensure that steps were taken to eliminate and prevent the bug infestation. Glue boards placed close by harborage areas may help monitor bed bug activity by catching bed bugs as they move about at night. Monitors NightWatch; CDC300; BB Alert; Interceptor; Bug Dome

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More FOLLOW-UPMany times the first application does not seem to give complete or immediate control. Additional treatments may be necessary in 7 to 14 days. At least one follow-up inspection of infested sites should be conducted at a suitable interval (e.g., 1 week) after each control effort or treatment in order to detect any of the typical signs of continued infestation, such as live bugs, cast skins (after those present earlier had been removed), fecal spots on bed linens or harborages, and unhatched eggs.

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What about bed bugs in schools?http://web.pccs.k12.mi.us/schoolhealth/pdf/bed-bug-school-response-flowchart.pdf *

Any Questions?*

A Few Useful Referenceshttp://www.ces.ncsu.edu/depts/ent/notes/Urban/bedbugs.htm http://www.afpmb.org/pubs/tims/TG44/TG44.htmhttp://www.techletter.com/bedbugalert.htmlhttp://health.state.ga.us/epi/zvbd/infest/index.asphttp://www.BedBugBMPs.org

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Baumgartner (EPA R5): Bed Bugs EPA R5 Review**

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