Currently, we are having an increase in the incidence of bed bugs. I have seen many cases of bed bug bites in my office. Oftentimes they appear as itchy red bumps on the skin in clusters and can be mistaken for hives or mosquito bites. Here are some common questions people have about them.
What are they? Bed bugs (Cimex lectularius) are insects about the size of a sesame seed that crawl and live in beds, box springs, mattresses, sofas, upholstery, rugs, luggage and sheets. They feed on blood of humans and pets primarily at nighttime. Unlike ticks, they do not cling to people after they feed. Instead they prefer to hide in inanimate objects ready to feed again the following night.
How do they spread? Bed bugs migrate by attaching themselves to clothing and luggage. They can also crawl under the crevices of a baseboard and move from one room to the next. Infestations often spread in apartment buildings where the bedrooms of two apartments are separated by a wall. Bed bugs rarely attach to people after they feed, so person to person transmission is rare.
How do bed bug bites differ from mosquito bites? Bed bugs are crawling creatures. They bite, then they move on. They classically feed 2-3 times each night and their bite marks look like three dots in a row or three dots in a triangle pattern. Mosquitoes are flying insects and will feed on blood in one area and then fly off and find another area of your body far away. For example, you may notice a bite on your neck and another behind your right leg. Rarely will they stay in the same area and bite multiple times. If you were bitten by a swarm of mosquitoes that could look like a very bad bed bug infestation. Another distinguishing characteristic is that with bed bugs, you will see new lesions every morning. Unless you leave the windows open at night and you don’t have a window screen, it is unlikely new itchy lesions in the morning could be anything but bed bugs.
If you are not sure, look around your bed, mattress, and box spring for small insects that look like flat sesame seeds with legs. You may also find their droppings which look like poppy seeds or dark stains. If you have light-colored sheets, you can look for maroon-ish red spots which are dried blood from the bed bugs feeding overnight. They tend to be messy eaters and secrete an anticoagulant when they feed, which means you may bleed for a short time after they have finished feeding. You can also visit your healthcare provider or dermatologist for an evaluation of the rash, or bring any bed bugs you may find in a plastic bag for identification.
I have never heard of bed bugs growing up as a child, why are they such a problem now? We don’t have an exact answer for this, but some experts suggest that pesticides are much weaker now than before since many of the older pesticides were found to be toxic to the environment and to children and were banned in the 1980’s. Others cite the increase in world travel and a population that is staying in hotels and traveling more than ever.
Does having a bed bug infestation mean the place is unclean? Bed bugs have been found in all types of establishments including many big name five star hotels. Bed bug infestations are not a marker for a dirty home or hotel. It just means the bugs have found a way into the bed. Would you be alarmed if you found a mosquito in your hotel room? Certainly, there needs to be a thorough cleaning after an infestation is found and the establishment should make sure there are no remaining bed bugs before the room is used again.
What happens if I get bitten? People have different reactions to bed bugs. Some people have no reaction to them at all! Others develop large itchy raised pink lesions that look like mosquito bites.
What can I do to stop the itching? The reaction from a bed bug bite is primarily a histamine-mediated reaction similar to a mosquito bite or seasonal runny nose. Antihistamines such as Claritin (loratadine) or Zyrtec (cetirizine) are helpful in preventing the itching. If the itching is severe at nighttime, a dose of benadryl (diphenhydramine) can help reduce the itching and help you fall asleep as this medication can cause drowsiness. Try not to scratch the areas. The more you scratch, the more histamine is released. If you feel the urge to scratch, apply a cool compress (an ice pack or a cool moist towel) to the area. You can also apply over-the-counter hydrocortisone cream 1% to the areas twice a day. If the itching is severe or the rash becomes painful, you may need to see your healthcare professional for other medications.
Can I get any diseases from bed bugs? Bed bugs are not known to spread any serious diseases. However, the bites can get infected if they are not kept clean. Make sure to apply bacitracin or Neosporin to the areas and keep them clean.
How did I get them? Bed bugs love upholstery, luggage and bedding. Most people bring bed bugs home after staying in hotels or as a guest in someone’s house. Almost every college has had infestations in their dorms. During holiday season, some students unknowingly bring bed bugs to their homes. I often will see a peak of bed bug cases amongst their parents following the winter holidays. In recent years, bed bugs have also been found in movie theaters seats, clothing stores, and even the finest hotels.
How can I prevent myself from getting bed bugs? Bed bugs like to travel from place to place in our luggage. Don’t let them stow away in your roller board! When you arrive at a hotel, do not place your luggage on the bed to pack or unpack. Instead, place your luggage on the tile floor in the bathroom, remove the clothes and place them in the dresser or closet. When you are ready to pack up, do the reverse. After you arrive home, unpack your suitcase in your kitchen or bathroom where you have tile. Immediately put all clothes into the washer machine to be cleaned. Place your empty suitcase into a garbage bag and seal it shut. Store your baggage in a hallway closet far away from the bedroom. After you have guests stay with you, immediately throw all the sheets in the washer. Advise your guests not to place luggage on the bed.
Why do my bites itch, but no one else has the same reaction? Bed bug bites trigger an immune reaction which results in itching. In certain people, they will not have as strong of an immune reaction to the bites and so they may not experience any itching after being bitten.
I have bed bugs in my bedroom, and I have no where else to go what can I do to prevent myself from getting bitten? Bed bugs must be able to crawl on bare skin to be able to bite. If you cover up exposed skin on your body, you lessen the chances of them biting you. For example, you could wear pajama pants and tuck them into socks. Instead of a tank top, you could wear a long sleeve t-shirt to bed. You may also try spraying exposed areas with an insect repellant containing DEET (25% concentration or higher, sold under the name Deep Woods OFF), though I wouldn’t recommend this as a long term solution as this chemical has been known to cause cancer in high doses.
How can I get rid of bed bugs? I would recommend thoroughly cleaning the sheets in hot soapy water and drying them out in a hot dryer. Look for small black specks with a magnifying glass on the mattress, box spring, and bed. Removed rugs and shampoo carpets in the room. Move the bed away from the wall as bed bugs can sometimes live in the small crevice where the wall meets the floors. Thoroughly clean your pet and don’t allow the pet to enter into the bedroom. Sometimes, bed bugs may crawl from one apartment to another through these cracks or even between floors. For small infestations (if you only just started to get bitten), you may want to try eliminating them yourself. There are products such as bed bug traps (sticky traps), insecticides, and diatomaceous earth which you can use on those areas. Try to avoid sleeping in that room for a while. For larger infestations, you will need to hire an exterminator who specializes in bed bugs. They may bring a dog to your house to sniff them out. If you rent your apartment or house, these costs may be paid by your landlord depending on your local laws.
Bed bugs are becoming a common nuisance. Protect yourself and your family. Take precautions and learn how to spot an infestation before it gets out of hand.