Bed Bugs
To view the entire topic, please log in or purchase a subscription.
Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
Description
- Nocturnal obligate blood parasites residing in furniture and bedding
- 5 to 7 mm oval, reddish brown, flat, wingless morphology
- Microscopic evidence suggests a mature bed bug, Cimex lectularius, is approximately the size of an apple seed (1).
Epidemiology
Incidence- Bed bug infestations are increasing in incidence and becoming more difficult to treat (2)
- Resurgence due to changes in pesticide, increased travel, use of secondhand furniture, and high turnover rates of hotel guests
Prevalence
- Infestations have increased by 10–30 % across the United States (1) in public places (schools, hospitals, hotels/motels, aircraft) over the past decade (3).
- The global population of bed bugs (C. lectularius and Cimex hemipterus, family Cimicidae) has undergone a significant resurgence since the late 1990s. This is likely due to an increase in global travel, trade, and the number of insecticide-resistant bed bugs. The global bed bug population is estimated to be increasing by 100–500% annually (4).
- There are over 75 species of Insecta: Hemiptera: Cimicidae (“bed bugs”) with the 2 genera and species implicated in human infestations being C. lectularius and C. hemipterus (1).
- C. lectularius lives in urban environments and C. hemipterus lives in tropical climates.
Etiology and Pathophysiology
- Insect family Cimicidae
- Three species bite humans: C. lectularius, C. hemipterus, and Leptocimex boueti (3)[B].
- Most prevalent species is C. lectularius (3)[B]
- Found in tropical and temperate climates
- Hide in crevices of mattresses, box springs, headboards, and baseboards
- Infestations occur in hotels/motels, hospitals, cinemas, vehicles, aircraft, and homes.
- Unlike other infestations, they are not associated with hygienic deficiencies.
- Reactions range from an absent or minimal response to the typical pruritic, erythematous maculopapular rash. Less commonly, there is an urticarial or anaphylactoid response.
- Skin reactions are due to host immunologic response to parasite salivary proteins.
- Urticarial reactions are mediated via immunoglobulin (Ig) G antibody response to salivary proteins (5)[B].
- Bullous reactions caused by an IgE-mediated hypersensitivity to nitrophorin in bug saliva (5)[B]
- Bugs are attracted to body warmth and exhaled carbon dioxide (6).
- Bites do not transmit other known pathogens.
Risk Factors
- Immunocompromise
- High hotel turnover
- Secondhand furniture in home
General Prevention
- Traps typically use carbon dioxide and heat to attract and trap bugs but can be cost prohibitive (7)[B].
- Vector control: Vacuum regularly, reduce clutter, seal cracks in walls, inspect luggage and clothing.
- Launder all bedding and clothing in >130°F (50°C) for 2 hours or place in 20°F (−5°C) or cooler environment for at least 5 days.
- If present in the home, eradicate using professional extermination services. Some pest control companies use canines to detect live bed bugs and eggs based on pheromones from the bed bugs (7)[B].
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
- Nocturnal obligate blood parasites residing in furniture and bedding
- 5 to 7 mm oval, reddish brown, flat, wingless morphology
- Microscopic evidence suggests a mature bed bug, Cimex lectularius, is approximately the size of an apple seed (1).
Epidemiology
Incidence- Bed bug infestations are increasing in incidence and becoming more difficult to treat (2)
- Resurgence due to changes in pesticide, increased travel, use of secondhand furniture, and high turnover rates of hotel guests
Prevalence
- Infestations have increased by 10–30 % across the United States (1) in public places (schools, hospitals, hotels/motels, aircraft) over the past decade (3).
- The global population of bed bugs (C. lectularius and Cimex hemipterus, family Cimicidae) has undergone a significant resurgence since the late 1990s. This is likely due to an increase in global travel, trade, and the number of insecticide-resistant bed bugs. The global bed bug population is estimated to be increasing by 100–500% annually (4).
- There are over 75 species of Insecta: Hemiptera: Cimicidae (“bed bugs”) with the 2 genera and species implicated in human infestations being C. lectularius and C. hemipterus (1).
- C. lectularius lives in urban environments and C. hemipterus lives in tropical climates.
Etiology and Pathophysiology
- Insect family Cimicidae
- Three species bite humans: C. lectularius, C. hemipterus, and Leptocimex boueti (3)[B].
- Most prevalent species is C. lectularius (3)[B]
- Found in tropical and temperate climates
- Hide in crevices of mattresses, box springs, headboards, and baseboards
- Infestations occur in hotels/motels, hospitals, cinemas, vehicles, aircraft, and homes.
- Unlike other infestations, they are not associated with hygienic deficiencies.
- Reactions range from an absent or minimal response to the typical pruritic, erythematous maculopapular rash. Less commonly, there is an urticarial or anaphylactoid response.
- Skin reactions are due to host immunologic response to parasite salivary proteins.
- Urticarial reactions are mediated via immunoglobulin (Ig) G antibody response to salivary proteins (5)[B].
- Bullous reactions caused by an IgE-mediated hypersensitivity to nitrophorin in bug saliva (5)[B]
- Bugs are attracted to body warmth and exhaled carbon dioxide (6).
- Bites do not transmit other known pathogens.
Risk Factors
- Immunocompromise
- High hotel turnover
- Secondhand furniture in home
General Prevention
- Traps typically use carbon dioxide and heat to attract and trap bugs but can be cost prohibitive (7)[B].
- Vector control: Vacuum regularly, reduce clutter, seal cracks in walls, inspect luggage and clothing.
- Launder all bedding and clothing in >130°F (50°C) for 2 hours or place in 20°F (−5°C) or cooler environment for at least 5 days.
- If present in the home, eradicate using professional extermination services. Some pest control companies use canines to detect live bed bugs and eggs based on pheromones from the bed bugs (7)[B].
There's more to see -- the rest of this entry is available only to subscribers.