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Clinician’s Corner: BEDBUGS

BEDBUGS (Cimex lectularius) are wingless insects about the size of an apple seed that feed on warm blooded animals. Bedbugs become active at night and hide during the day. Bedbugs are associated with unsanitary conditions but may be found in the cleanest of homes, hotels, or other buildings and have occurred in all social and economic classes. Infestations most often occur where there is a high turnover of occupants, such as hotels, motels, cruise ships, dormitories, apartment complexes, and shelters.

Bedbug Basics:

  • Bedbugs feed on a blood meal for about 10 minutes, injecting a blood thinner.  Females need a blood meal at least every 14 days to produce eggs. Females lay one to three eggs per day, and up to 500 eggs in a lifetime. Males also need a blood meal every 14 days to mate.
  • Unlike fleas or ticks, they do not live on their food source. They hide near their host, and bite during the night.
  • Adult bedbugs can live without feeding for 2 or 3 months which makes getting rid of them such a challenge.  (Not like lice that are dead in 10 days without a human host)
  • Presentation: The bite reaction usually presents as a red bump smaller than half an inch and does not usually have a red puncture mark in the middle. The bites can occur in lines or clusters of three or four.

Where to look: Around the bed, they can be found near the piping, seams and tags of the mattress and box spring, and in cracks on the bed frame and headboard.

If the room is heavily infested, you may find bed bugs:

    • In the seams of chairs and couches, between cushions, in the folds of curtains.
    • In drawer joints.
    • In electrical receptacles and appliances.
    • Under loose wall paper and wall hangings.
    • At the junction where the wall and the ceiling meet.
    • Even in the head of a screw.

The role of DDT

DDT’s history parallels closely the presence of bedbugs. DDT (dichloro-diphenyl-trichloroethane) was developed as the first of the modern synthetic insecticides in the 1940s.

Initially used effectively to combat malaria, typhus, and the other insect-borne human diseases among both military and civilian populations.  My brother-in law remembers the DDT truchs in the Altoona area that sprayed a thick fog every summer.

DDT was also effective for insect control in crop and livestock production, institutions, homes, and gardens. My grandfather had his own bag, and told me “this stuff is so good, they don’t make it any more!” DDT was banned in 1972, was considered to be the first victory for the environmentalist movement.

DDT is still present in the environment

  • will accumulate in fatty tissues, and
  • can travel long distances in the upper atmosphere
  • DDT is one of 12 pesticides recommended by the WHO for indoor residual spray programs.

Because of DDT use in the 1940’s, bedbugs were virtually eliminated. After the year 2001, they have come back, as the DDT has “worked out” of the environment.

Next week we will discuss Treatment and Prevention of Bedbugs.