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January 30, 2013
If You are Warm and Breathing, You Are a Bedbug Magnet, Says Loyola Specialist
MAYWOOD, Ill. - Bedbugs are on the rise and $1,000-per-day ordinances are being suggested in cities like Chicago to enforce combat of the pests.
“Know thy enemy,” said Jorge Parada, MD, medical director, Infection Control, Loyola University Health System. “There are lots of myths out there about bedbugs and people may be getting caught up over nothing."
Dr. Parada offers these top 10 facts on bedbugs to keep them at bay:
Bedbugs are attracted by warmth and carbon dioxide. “If you are alive, warm and breathing, then you are a bed bug magnet,” Parada said.
Just because you don’t see them doesn’t mean they’re not there. “Look closely because bedbugs are very hard to see. Bedbugs love to hide in the cracks and crevices associated with mattresses, cushions, bed frames and other structures. They are rarely seen out in the open or on the resting surface of beds or chairs,” said Parada, who also is a medical spokesman for the National Pest Management Association. “Bedbugs are champions of hide-and-seek. It is not uncommon to miss bedbugs altogether, so also look for telltale signs of bedbug infestation. These may be suspected if specks of blood or feces are found on the linens, mattresses or behind wallpaper."
What does a bedbug look like? “There is more than one type of bedbug and in the United States the vast majority of infestations are due to Cimex lectularius. These bedbugs have flat oval bodies, are reddish-brown in color and are similar in size to a dog tick,” Parada said. “Bedbugs are sometimes described as appearing like an apple seed. Adult bedbugs range in size from 5-7 mm (less than 1/4 inch), while nymphs (juveniles) may be as small is 1.5 mm (1/16 of an inch). With feeding, they enlarge, or engorge, with blood. The adults turn from more brown to more red in color, while the translucent nymphs may become bright red."
Bedbugs typically bite at night on exposed areas of skin, such as the face, neck, hands and arms. “The bite itself is painless and usually goes undetected at the time,” Parada said. “Bedbugs inject an anticoagulant (a blood thinner) as they feed (about 5-10 minutes), which both makes feeding easier for the bedbug and less detectable to you."
Bedbug bites can look a lot like other insect bites. “Clues that can suggest the presence of bedbugs include finding red, itchy bites upon awakening, especially if the bites line up in a row on the skin,” Parada said. “However, while some people develop a bite reaction immediately, others may take two to three days before a reaction becomes noticeable, and not all people react to bites. A bedbug bite can appear as a tiny puncture wound without a surrounding reaction and can easily be missed (30 percent of individuals living in bedbug-infested dwellings report a lack of bites or skin reactions). This appears to be more common amongst the elderly. On the other hand, some people have exuberant reactions, with large, red, raised and itchy welts. This is especially true if one becomes sensitized to bedbug bites, so that with repeated bites there may be an exaggerated reaction to the bite."
With persistent exposure, bedbug bites may appear in crops. “Given that bedbug bites usually take three to six weeks to heal, as long as the infestation is still present, new bites may accumulate even as the older ones disappear,” Parada said. “Thus, people may have bite reactions in various stages of evolution at the same time."
Bedbug bites do not typically require treatment. “Clean the bite site(s) with soap and water and avoid scratching so as to prevent infection. If secondary infection occurs, it should be managed with antibiotics as appropriate,” Parada said. “Progressive swelling, warmth, tenderness and sometimes (albeit rarely) fever may be signs of a secondary infection. Much more common are complaints of itching. For severe itching it is reasonable to try topical steroid creams or oral antihistamines for relief."
Unlike mosquitoes and ticks, bedbugs are not associated with disease transmission. “It is bad enough if you get bedbugs. At least you won’t get anything else from them!” Parada said. While some pathogens have been detected in and on bedbugs – including hepatitis B, and exotic organisms such as Trypanosoma cruzi (cause of Chaga’s Disease, not found in the U.S.) or Wolbachia – bedbugs have not been found to transmit disease.
Bedbugs do not transmit MRSA. “There have been reports of people developing methicillin-resistant Staphylococcus aureus (MRSA) infections, such as a boil or abscess, associated with bedbug bites, but it turns out the bedbugs really weren’t at fault,” Parada said. “Rather, MRSA infections associated with bedbug bites are actually an example of scratching leading to minor skin trauma and subsequent secondary bacterial infection. In these cases, people who are carriers of MRSA scratch at the bites and provide a port of entry for the MRSA (that was already present on their skin) to get in and under the skin and cause the secondary infection. The bedbug can be blamed for the itch but not for the infection.
Some people experience anxiety, sleeplessness and unease as a result of having had bedbugs. “Bedbug infestations are understandably significant psychosocial stressors and some people may experience sleeplessness as they worry about bugs biting them or their family members,” Parada said. “People have been known to self-isolate, avoiding family and friends out of concern for spreading the infestation, or (if word gets out that they had bedbugs) they may be avoided by friends or others in the community, or find they have problems at work. As a result, victims of bedbug infestations may experience moderate to severe levels of stress, anxiety and depression and should seek treatment as required."
Finally, when it comes to controlling bedbugs this is definitely not a case of “do it yourself."
“Bedbugs are notoriously difficult to eradicate and there is good reason to get professional help,” Parada said. In fact, the Centers for Disease Control and Prevention has endorsed hiring experienced pest management professionals and recommends that victims be advised against attempting control measures themselves.
Loyola University Health System (LUHS) is a member of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. The medical center campus is conveniently located in Maywood, 13 miles west of the Chicago Loop and 8 miles east of Oak Brook, Ill. The heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as the LUC Stritch School of Medicine, the LUC Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.