How to Deal with Bed Bugs
Dr. Mohammed El Damir
Technical and Training Director
Adam's Pest Control, Inc
Bed Bug History & Resurgence
• Bed bugs are an old
problem since the
times of cave dwellers.
• When people moved
out of caves, so did
the bed bugs.
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Bed Bug History & Resurgence
• In the 18th century,
severe bed bug
infestations were
documented in
Europe, the English
colonies and in
Canada, but not in
Indian villages.
– “In the 1880s it was
estimated that over
75% of Britain's homes
were infested with bed
bugs.
Bed bug illustration 18th centaury
M ajor, Ralph H., A History of M edicine. Springfield, IL: Charles C. Thomas, 1954
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Bed Bug History & Resurgence
• Old sailing ships were
severely infested with
bed bugs.
• During the early 20th
century, bed bugs
were considered
among the top three
pests in and around
structures in the USA
until the 1950's.
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Bed Bug History & Resurgence
• After World War II, bed bug infestations
were significantly decreased (because of
the extensive usage of the DDT).
• Recently, in the USA, bed bug infestations
have increased by 500 percent over the last
few years, according to Congress' "Don’t
Let the Bed Bugs Bite Act of 2009."
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Bed Bug History & Resurgence
• A new survey from the National
Pest Management Association
(NPMA) and the University of
Kentucky has found that 95% of
professional pest control
companies have encountered
bed bug infestations in the past
year (2010 Comprehensive
Global Bed Bug Study).
• Bed bugs are found in 50 sates
in all kinds of residences.
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Bed Bug History & Resurgence
• Apartments
– “Bed bugs become a
major challenge to
most apartment
building management
companies”.
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Bed Bug History & Resurgence
• Hotels & Motels
“A woman found these on
her arm after a brief stay at
a hotel in Merrillville,
Indiana”.
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Bed Bug History & Resurgence
• Cruise Ships
A Florida couple was
treated after being bitten
by hundreds of bed bugs
during a vacation cruise
on a Royal Caribbean
cruise ship, according to
Local 6 News.
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Bed Bug History & Resurgence
• Dormitories
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Bed Bug History & Resurgence
• Shelters
In a Boston YMCA, USA
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Bed Bug History & Resurgence
• Schools
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Bed Bug History & Resurgence
• Hospitals & Medical
Centers
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Bed Bug History & Resurgence
• “Bitten people feel violated and want millions”.
With files from CTV's John Vennavally-Rao
and The Associated Press
“A Chicago woman is
suing a New York hotel
for $20 million for 500
bed bug bites.
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Bed Bug History & Resurgence
• The cause of this resurgence is still
uncertain, but it is thought to be related to a
number of reasons.
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What Is Causing The Current
Bed Bug Resurgence?
• Increased international travelers & immigration
from infested areas.
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What Is Causing The Current
Bed Bug Resurgence?
• Changing in pest
management strategies.
– Decreased use of general
and long lasting residual
pesticides
– More label restrictions
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What Is Causing The Current
Bed Bug Resurgence?
Although banned in the US in
1972, DDT was sprayed in US
aircraft until 1989.
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What Is Causing The Current
Bed Bug Resurgence?
• DDT had effectiveness against the mosquito that spreads
malaria and lice that carry typhus.
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What Is Causing The Current
Bed Bug Resurgence?
• Evaluations of populations
from across the United
States show that
resistance to modern
pesticides (I.e., pyrethroid
insecticides) is already
widespread.
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What Is Causing The Current
Bed Bug Resurgence?
• Lack of bed bug awareness and education.
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Bed Bug Update
• EPA’s National Bed Bug
Summit - April 14th and
15th, 2009.
• Objectives
– Research
– Role of Government (all
levels)
– Consumer Education and
Communication
– Pest Control Operator
Education and Training
– Role of Property Owners
and Property Managers
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Bed Bug Trend
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Bed Bug Registry
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Bed Bug Registry
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How to Identify Bed Bug
Infestation
• First, you need to
know what bed bugs
are, their habits and
life cycle.
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What Are Bed Bugs?
• True Bugs.
• Ectoparasites (do not
live within the body of
their hosts”.
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What Are Bed Bugs?
• Adults and nymphs
have piercing sucking
mouthparts and feed
externally on warm
blooded animals
including human, bats,
birds, etc.
• They have cryptic
behaviors.
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What Are Bed Bugs?
Number of Bed Bugs Captured
35
30
25
20
15
10
5
0
13:30
16:30 19:30
22:30
1:30
4:30
7:30
10:30
13:30
Time (Summer)
Activity of bed bugs during 3 hours intervals (Mellanby 1939)
• Bed bugs are nocturnal, but opportunistic.
• They are most active between 3 a.m. and 6 a.m.
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What Are Bed Bugs?
• They usually suck blood for
5-15 min.
• Become engorged three
times its body weight.
• During or after feeding, they
deposit fecal materials as
rusty spots where they are
feeding or in their harborage
areas.
• Hide in concealed areas
while digesting the blood
meal for 3-10 days.
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What Are Bed Bugs?
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What Are Bed Bugs?
Bed Bug Tough Hiding Places
Inside books
Behind window sills
Behind shelves
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What Are Bed Bugs?
Bed Bug Tough Hiding Places
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What Are Bed Bugs?
Bed Bug Tough Hiding Places
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What Are Bed Bugs?
• Eggs are white and
approximately 1/32 inch
long.
• Nymphs are nearly
colorless when hatched,
becoming brownish as
they mature.
– 1st Instar: 1.3 mm
– 2nd Instar: 2.0mm
– 3rd Instar: 3.0 mm
– 4th Instar: 3.7 mm
– 5th Instar: 4-5 mm
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What Are Bed Bugs?
Fed nymph
Unfed nymph
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What Are Bed Bugs?
• Adults are reddish brown
in color.
• They are about 6-7 mm
(3/16-1/4 inch).
• They have flattened
bodies from top to bottom.
• They have four
segmented antennae.
• They cannot fly (reduced
wings).
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What Are Bed Bugs?
• Bed bugs are attracted by:
– Heat
– Carbon dioxide (CO2)
– Chemical lure (I.e., 1-Octen3-01 and 1-Lactic acid)
• 1-Octen-3-01: Is the
odorant that is responsible
for the typical metallic smell
of metals and blood coming
into contact with skin.
• 1-Lactic acid: a component
of sweat.
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What Are Bed Bugs?
• Other bed bug related species may be encountered and
confused with the common bed bugs. If the hair is longer
that the width of eye it is bat bug.
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What Are Bed Bugs?
• Adults live about 10 months. Females lay
approximately 200-500 eggs (5-8 eggs/day).
• Lifecycle depends on temperature and moisture
conditions, as well as blood availability.
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Days to complete one generation
What Are Bed Bugs?
250
236 7.8 months
200
150
125
4 months
100
61 2 months
50
34
0
59.8
64
73
82
Temperature °F
(Johnson 1942)
• Bed bugs lifecycle at different temperatures.
• Temperature of 120 F (45 C) is a thermal death point.
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What Are Bed Bugs?
100
87
90
80
19%
80
33%
60%
75%
72.4
70
62.6
Days
60
50
40
25.5 27
30
29 30
30
32
27.7
21.6
24.6
20.4
18.1
20
12.2 13.4
16.5
9.6 11
10
0
55.4
(Jones 1930)
73
80
86
91
Temperature °F
Average lifespan for the bed bug 1 st instar nymphs without food
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What Bed Bugs Do?
• Never proven that bed
bugs can transmit
infectious pathogens.
• BUT their bites can
impact people's quality
of life.
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What Bed Bugs Do?
• Their bites are
painless, but sensitive
people develop
allergic reactions to
the bed bug saliva as
reddish, irritated itchy
skin marks. This will
cause:
–
–
–
–
Sleeplessness
Anxiety
Delusions
Panic or depression
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What Bed Bugs Do?
• Different people react
to bed bug bites in
different ways.
– No Allergic Reactions
– Immediate Allergic
Reactions
– Delayed Allergic
Reactions
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What Bed Bugs Do?
• No Allergic Reactions
– No bite symptoms appear after bites at all.
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What Bed Bugs Do?
• Immediate Allergic Reactions
– Bite symptoms appear immediately after bites.
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What Bed Bugs Do?
• Delayed Allergic Reactions
– Bite symptoms appear within 12 hours - 14 days after
bites.
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What Bed Bug Bites Look
Like?
• Red itchy swelling
marks on any exposed
areas of skin.
• Bed bug bites may
vary from one person
to another.
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What Bed Bug Bites Look
Like?
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What Bed Bug Bites Look
Like?
• Sever Allergic Reactions
– In sensitive people, blisters develop necrotic lesions
after a few days.
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What Bed Bug Bites Look
Like?
• Mosquito or bed bug
bites?
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What Bed Bug Bites Look
Like?
• Do bed bug bites have a
pattern?
– No, bed bug bites can be:
•
•
•
•
In groups
In a line
In a circle
Single
– Bite patterns can be related
to:
• The disturbance of bed
bugs during feeding
• Searching for the good vein
• The presence of several
bed bugs hiding along the
mattress seams.
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What Bed Bug Bites Look
Like?
• Flea bites can be
mistaken for bed bug
bites.
– Bites around ankle and
waist.
– Red area in the center
surrounded by a
reddish halo.
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What Bed Bug Bites Look
Like?
• Scabies can be mistaken for bed bug bites.
– Pimple-like irritations.
– Wavy burrows or rash marks.
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What Bed Bug Bites Look
Like?
• Allergic rashes,
especially urticaria
(hives) can be
mistaken for bed bug
bites.
– People may get allergic
reactions when they
are exposed to some
pesticides or
chemicals, and then
they blame the bed
bugs.
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What Bed Bug Bites Look
Like?
Deer fly or Bed bug bites?
Scabies or Bed bug bites?
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How Do Bed Bugs Spread?
• Bed bugs are skilled
hitchhikers, they can
easily spread with
second hand furniture,
mattresses, box
springs & clothes, etc.
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How Do Bed Bugs Spread?
• Traveler’s clothing,
luggage, bedding and
suitcases facilitate bed
bugs to travel and
spread.
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How Do Bed Bugs Spread?
• Bed bugs spread to
adjacent rooms or
apartments (20-30% of
adjacent rooms could
be infested).
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How Do Bed Bugs Spread?
• Seats of airplanes, buses
and other means of public
transportations.
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What If I Find A Bed Bug On
A Patient
• Act soon
– Immediately try to
collect a specimen and
keep it as intact as
possible for correct
identification.
– Carefully, follow your
bed bug policy.
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What If I Find A Bed Bug On
A Patient
• One key element to
successful teamwork is
communication.
– Notify the environmental
services.
– Contact the infection
prevention, bed bug in
charge/expert, etc to confirm
the bed bug sample.
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What If I Find A Bed Bug On
A Patient
• If possible, remove the patient
clothing and double bag in plastic.
• Although, bed bugs do not live in
human’s skin, showering the
patient may help in assessing the
presence of more bugs and bites.
• Isolate the patient
• Interview the patient to determine
the extent of the infestation.
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If Bed Bugs Infestation Is
Confirmed
• Immediately implement policy to
control the spread of bed bugs
and eliminate the infestation.
– Make sure that all infested clothing
items are double paged until they are
ready for the dryer treatment. If the
patient clothing will be sent home,
provide instructions.
– Isolate the infested patient from
other residents until he/she is free of
bed bugs.
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If Bed Bugs Infestation Is
Confirmed
• Close off all areas patient
has visited
– areas where bed bugs have
been found (ER units,
patient units, main lobby
and offices, etc.
• Any bed bug signs (i.e., life
stages, shed skins, feces,
etc.) found should be
removed and collected for
identification.
– the ambulance (if the patient
was transported to the
hospital via an ambulance).
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If Bed Bugs Infestation Is
Confirmed
• Communicate with the bed
bug team (I.e,
environmental services,
infection prevention, etc.)
for guidance on cleaning
and preparation for
treatment.
– Be careful, bed bugs can
spread easily during this
process.
– The effectiveness of the
treatment depends on this
process.
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If Bed Bugs Infestation Is
Confirmed
• Discuss the treatment options with your PMP.
– Medical centers are considered sensitive locations
where employees and patients have no tolerance to
pesticides or their residues.
– Bed bugs are resilient pests, for this reason, their
management may require the employment of both nonchemical and chemical pest management tactics,
especially if all non-chemical methods prove insufficient
to solve a bed bug problem.
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Heat Treatment
• Heat treatment (the use the
lethal temperature limits to
destroy all life stages of
bed bugs) is an effective
way to eliminate bed bugs
in sensitive locations, such
as hospitals.
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Heat Treatment
• Steam Treatment
– Localized steam
treatment to kill all life
stages of bed bugs.
– Thoroughness.
– Proper tools.
– Moisture problems.
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Heat Treatment
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Heat Treatment
•
Dry Heat Treatment
– This consists of the
following steps:
1.
Preparation by removing/modifying all
heat sensitive materials, tools and
equipment (very important step).
2. Setup
3. Heat Up
4. Monitor
5. Circulating Hot Air Heat
6. Critical Holding Period at 120 for 2-3
hours
7. Cooling Down
8. Take Down
9. Documenting The Process
10. Follow Up: Usually 14-21 days after
the treatment
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Heat Treatment
• For patient clothing and
small belonging Items:
– Place in hot dryer at
temperature of ≥ 120 F for
1-2 hours.
– Place in freezer
• at 32 F (0 C), adults and
nymphs die within 7-10
days; while, eggs dies in 30
days.
• at -15 F , instant kill of all
life stages of bed bugs.
– Read the item’s label before
treatment.
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Chemical Treatment
•
If pesticide treatments
are needed:
1. Discuss the application
methods, preparation
instructions, safety
measures before and
after treatment, and the
use of non-chemical
methods with your
PMP.
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Chemical Treatment
2. Collect all bedding and
patient clothing, and then
bag them firmly in double
plastic bags.
•
These items cannot be
treated with insecticides and
must be properly discarded
or dried in a hot dryer for at
least one hour, as
applicable.
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Chemical Treatment
3. All bed bug hiding places
must be carefully identified
by your PMP and treated.
– Eliminating bed bugs from
mattresses and box
springs can sometimes be
challenging because:
•
•
•
•
particular pesticides can
only be used.
certain restrictions may
apply.
there are many/complex
tough hidden places for
bed bugs
Liability .
An air mattress
infested with bed
bugs
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Chemical Treatment
– If mattress & box spring
need to be treated with
approved pesticides, we
recommend using mattress
& box spring encasements
approved and designed for
bed bug prevention.
•
•
•
•
•
•
•
Prevent direct contact with the residual
insecticide on treated mattress and box
spring.
Eliminate the use of pesticides on
encased mattress and box spring.
Trap any bed bugs that may have been
missed or will hatch after the treatment.
Prevent bed bugs from getting inside the
mattress and box spring.
Increase the efficacy of the management
and reduce the inspection time.
Bed bugs will not have complex hidings
places in the mattress and box spring.
Expand the life time of the mattress and
box spring.
Copyright © Residex,
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Chemical Treatment
– Because some bed bug populations have
developed a resistance to pyrethroid
insecticides, the use of various approved liquid
treatments on surfaces and dusts in void areas
should be thoroughly implemented.
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Chemical Treatment
4. Follow up treatment evaluation is highly
recommended.
•
Your PMP will perform follow up evaluations 2-3
weeks after the initial treatment.
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Keep Monitoring
• Regularly check
mattresses, box
springs, bedding, etc
for bed bug signs.
Night Watch Trap
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Be Prepared
The moment
before the
pain begins
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Be Prepared
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Questions?
Thank You!
Dr. Mohammed El Damir
Technical and Training Director
Adam’s Pest Control, Inc
Tel: 763-478-9810
Fax: 763-478-6715
[email protected]
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