Re-emergence of bed bugs in the U.S. Abelardo C. Moncayo, Ph.D. Vector-Borne Disease Section Tennessee Department of Health

Historical perspective Bed bugs have plagued humans for thousands of years Origin of relationship remains unclear Originally a problem for the wealthy Enhanced by fire and heated homes Present in literature as far back as 400 B.C.E.

Decline of bed bugs Three major factors: DDT use in 1950s Improved vacuum cleaners Changes in home construction

Current status targeted pest treatments + bans, frequent travel have led to a bed bug resurgence in the U.S. 300% increase in cases from 2000 to 2001 70% increase in cases in 2002 and 2003 Orkin had a 20% increase in bed bug calls in 2004 Reports of bed bugs in 43 states last year Chemical companies are reluctant to enter the bed bug market because of failure to control Difficult to detect, to treat, and often to identify

Family Cimicidae : The bed bugs About 91 species in 22 genera 12 genera only parasitize bats 9 genera only parasitize birds 3 species parasitize humans Cimex lectularius (worldwide) Cimex hemipterus (tropics) Leptocimex boueti (West Africa) Other species of concern (may bite people) Bat bug (Cimex adjunctus) Swallow bug (Oeciacus vicarius) Chimney Swift Bug (Cimexopsis nyctalis) Question of origin Humans in caves Bats in homes

Human-biting bed bugs

In Tennessee ?? 1 possible species Most likely 3 species Cimex lectularius Bed Bug Cimex adjunctus Bat Bug Cimexopsis nyctalis Chimney Swift Bug Oeciacus vicarius Swallow Bug 1 possible species

Identification BED BUG Adults 1/4 to 3/8” long Brown to reddish brown Oval shaped Flattened Beak-like mouthparts Small, stubby, nonfunctional wing pads “Obnoxiously sweet” odor BED BUG

Habits External parasites that feed on blood Humans are the preferred host ! However - also feed on birds, rodents, bats, pets Feed during the night with peak activity occurring just before dawn Seek refuge during daylight in dark, protected areas Prefer dry fabric, wood, and paper surfaces Fast-moving

Injury Painless bite Reaction to the injected saliva (individual variability) Swelling Rows of welts Severe itching (hours to days) No conclusive evidence of disease transmission Hepatitis B Chagas’ Disease Anxiety

Immediate Bite Reactions

Delayed Reactions (> 24 hrs.)

Life Cycle Egg Female can lay 1-12 eggs per day Deposited on rough surfaces or in cracks and crevices Hatch in 6-17 days

Life Cycle Nymph 5 instars Require a blood meal to molt

Life Cycle Adult May live for 12-18 months Total developmental time takes 21 days @ 86F and 120 days @ 65F Nymphs and adults can survive for more than a year without Food !!

Feeding - Several Instars

Engorged Nymphs-1 & 2

Engorging Adults & N - 2

Prevention Don’t bring infested items into the home Inspect clothing and baggage of travelers Inspect secondhand beds, bedding, and furniture Exclude alternative hosts (birds, bats, rodents, etc.) Caulk cracks & crevices in building’s exterior Repair or screen openings

Integrated Pest Management (IPM) Correctly identify the pest Thoroughly inspect the premises to locate harborage sites Encourage sanitary conditions Apply insecticides to targeted sites

Inspection tips: recognize common signs Blood stains from crushed bugs Fecal spots Shed skins & eggshells Offensive, sweet, musty odor

Inspection tips: common harborage sites Cracks and crevices Mattress, box springs, bed frame Window and door frames Baseboards Carpet tack boards Electrical boxes Wall hangings Drapery pleats Loosened wallpaper Ceiling moldings

Sanitation Vacuum mattress and premises Scrub mattress seams ** (dispose of vacuum bag) ** ?? Scrub mattress seams Dry clean or launder bedding and clothing in hot water - Dry on high heat. Repair plaster cracks Glue loosened wallpaper Remove wild animal roosts and nests

Chemical control Hundreds of products ‘registered’ for use on bed bugs in US Formulations 196 pressurized liquids 90 ready-to-use solutions 53 emulsifiable concentrates 47 dusts Chemicals 196 Permethrin 140 Pyrethrins 12 variations of ‘-thrins’

Insecticides Residual insecticides Spot treat harborage sites Dust formulations useful for wall voids and attics Use only an appropriately labeled insecticide on mattresses No insecticides are labeled for use on bedding or linens

Misconceptions Foreigners Poor Homeless Reports Type O blood, etc…

Bed Bug Emergency Response Plan (BBERP)