- 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).
- 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
- 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). It will be interesting to see what (if any) impact the COVID-19 travel restrictions have on the incidence of infestation.
- There are over 75 species of Insecta: Hemiptera: Cimicidae (“bed bugs”) with the two 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
- 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, bed bug infestations are not associated with alterations in personal hygiene.
- 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.
- Bugs are attracted to body warmth and exhaled carbon dioxide (6).
- Bites do not transmit other known pathogens.
- High hotel turnover
- Secondhand furniture in home
- 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.
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