BED BUGS!IN MEDICAL FACILITIES

Lee GreenMedical EntomologistIndiana State Department of Health

Ill. From “Monograph on Cimicidae”, by R.L. Usinger

•Order Heteroptera

•Adults 3-4 mm in length

•Common worldwide

•Simple metamorphosis: egg, nymphs, adult

•Crack/crevice harborage; furniture, bedding

Bed Bug Biology

Bed bug Biology

Introduced via luggage, furniture, bedding

Lay 2-3 eggs daily, glued in place (250/lifetime)

Both males and females feed on blood

Peak feeding time before dawn.

Take blood meal every 3-10 days

May feed on non-human hosts

May survive 10 months without blood meal

May move to adjacent rooms/units to feed

Resurgence as a result of increased travel and changes in cockroach treatment techniques

CDC

CDC

Eggs, Nymphs and Adults

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Lee Green ISDH

Lee Green ISDH

Adult Bedbug

Medical Symptoms

Bites in rows of three

Welts, Itchiness, Swelling

Inflammation, sensitivity over time

Anxiety, Annoyance, Insomnia, entomophobia

Overuse of skin care products

Fortunately, there is no disease threat

From bed bug infestation

Feeding a “Rearing Jar”

ISDH

Immediate Bite Reactions

ISDH

Delayed Reactions (> 24 hrs.)

ISDH

Signs of Infestation

Fecal spots on mattress seams

Exuviae (shed skins) in harborage areas

Blood spots on bedding

Sweet, musty “bug” smell in heavy infestations

Appearance of the bugs themselves

Fecal stains on mattress

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Fecal spots and bed bugs in box spring

Lee Green ISDH

Bed bug in head board

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Blood spots on bed

ISDH

ISDH

More blood spots

ISDH

Bed bug habitat and harborage areas

•Crevices behind mouldings•Joints in hardwood floors•Behind picture frames•Joints in bed-frames•Joints in furniture•Electrical outlets•Behind loose wallpaper•Behind paneling or joinery•Mattress seams•Pillows

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What if bed bugs have made it into the hospital? 1. Don’t over react!

Panic leads to hysteria and poor decisions.

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Introduction vs. Infestation

Introduction

Finding a bed bug on a patient or their belongings is most likely an introduction.

Infestation

Multiple life cycle stages may be present.

Bed bugs in hospitals

Be proactive

Develop a bed bug action plan

Educate staff on bed bugs

The faster staff can recognize a problem, the easier it is to fix it.

www.Medscape.com

Monitor for bed bugs

Utilize monitoring technology

Maternity, LTC, waiting rooms, hospice, and ER’s

Luggage and personal effects

Check beds and bed frames when turning a room.

Quarterly thorough inspections

ISDH

ISDH

Responding to a bed bug incident Collect specimens for professional ID

Responding to a bed bug incident Confine the patient

Contain their belongings

Check for loose bed bugs.

Photo: http://www.bedbugs.umn.edu/control-bed-bugs-residences-information-pest-management-companies/ ThinkStock

Responding to a bed bug incident Washers/dryers are our best friends

30 minutes on high heat

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Responding to a bed bug incident If a room is suspected to be INFESTED, call a

licensed pest control company.

Bottom Line…

Photo: http://flickrhivemind.net/Tags/bugs,chinches

Questions?

Lee Green

legreen@isdh.in.gov

http://www.in.gov/isdh/24955.htm

http://www.extension.entm.purdue.edu/publications/E-249.pdf

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