1. Bed Bugs

3. Overview Characteristics Myths and facts What is being done about bed bugs Where they hide Protecting your work and home Equipment and personnel clean up Controlling and eradicating infestations

4. Characteristics There are 7 stages from egg to nymph to adult Each stage requires a blood host to molt to the next Humans are preferred host Hosts can also include dogs, cats, birds and bats Female lays approximately 5 eggs per day Eggs are held in place on surfaces with a glue like substance Eggs hatch in 4 – 12 days

5. Life cycle

7. Characteristics Approximately ¼” in size Do not fly but are adept, fast crawlers Scatter when disturbed Transparent apperance until they feed

8. Characteristics Can live for up to 18 months without feeding They do not transmit disease Bites can create an allergic reaction from their saliva Bites may itch but not always Scratching welts may lead to secondary skin infection Anesthetic and anticoagulant is injected as feeding begins Nymphs feed for 3 minutes, adults 10 – 15 minutes

9. Welts from bites

10. Characteristics Bed bugs leave tell-tale signs such as blood stains near the bite site Dark deposits (fecal spots) occur on sheets, mattresses and walls In severe infestations, a sweet, musty odor from their scent glands may be present

11. Microscope enhanced

12. Myths Only “dirty people” get bed bugs Bed bugs are only found in places like homeless shelters and army barracks Bed bugs are only a problem for low income people Bottom line: regardless of hygiene, financial or social status or place of residence, bed bugs can infest your home or work place

13. Facts Bed bugs were controlled, but never completely eradicated in the USA after WWII Many of the insecticides that were effective, like DDT are either ineffective or simply not available any more Increased international travel, immigration and import of goods has contributed to the spread of bed bugs

14. What is Being Done United States Environmental Protection Agency is considering allowing more pesticides to be used to kill the bugs Increased awareness Increased education

15. Some places where they hide Seams of mattresses Cracks and creases in furniture

16. Some places where they hide Behind baseboards Under carpeting

17. Bedbugs have also been found in Senior housing Nursing homes Apartment buildings Hotels & motels Schools Churches Movie theatres Dorm rooms Firehouses including vehicles

18. Protecting your home and workplace

20. Keep a vigilant eye for tell tale signs of infestation such as sweet odor, feces, exoskeletons Avoid wearing duty uniforms home at the end of your shift Avoid setting jump bags and other equipment on floors and furniture. Use hard, flat surfaces when available Launder uniforms at work Water temperature of 120 ○ F is known to kill bed bugs

21. Protecting your home and workplace Launder work bedding frequently At work and home perform daily, routine inspections of all mattresses, box springs, couches, chairs etc.

22. After the call and clean up procedure Remember that bed bugs do not transmit disease Bed bugs prefer nooks, crannies, folds in material, creases and seams Bed bugs will rarely if ever stay on hard, flat surfaces such as cabinet doors and walls of the ambulance

23. After the call and clean up procedure “Clean up” should focus on routine disinfection per department procedure and visual inspection for signs of bed bugs With the increasing prevalence of bed bugs, crews should perform a routine tertiary inspection for the bugs after each call

24. Procedure for known or obvious patient infestation Notify your company officer that clean up may be slightly extended due to the need for a diligent visual inspection Company officer should notify the shift commander / battalion chief Police officers who were on the scene should be given a courtesy call

25. Procedure for known or obvious patient infestation Cab, cabin and compartments  Shine a bright flash light in creases of seats, behind seats, behind radios, computers, etc. while inspecting. Bedbugs are easily startled and this may “flush” them out if they are present  Disinfect seats, radio, turn signals, door handles, cables, BP cuffs, stethoscope, grab rails, stretcher, etc. as usual  Do not use harsh chemicals, bleach, pesticides, or other chemicals

26. Use of RID The active ingredient in RID, which is used to treat head lice, is also effective in killing bed bug eggs RID is available at most pharmacies/drug stores and should be used after treating and/or transporting obviously infested patients

27. Controlling and eradicating infestations Bed bugs are very difficult to kill “Bug bombs” designed to kill flying insects only scatter bed bugs Treatment of homes and workplaces requires licensed pest control experts Multiple treatments may be required Reduce clutter Encase mattresses and box springs in plastic covers

28. Controlling and eradicating infestations Store belongings, especially bedding and clothing, in tightly closes plastic containers Vacuum and empty collection receptacle daily After travel, immediately wash all clothing Be cautious when bringing used furniture into your home Never give away or accept used mattresses or box springs Dispose of infected furniture

29. Sources Centers for Disease Control Illinois Department of Public Health DuPage County Health Department Central Ohio Bed Bug Task Force Bedbuginfestation.info

30. Thank you for this information!! Shelly Carbone, EMT-P/FF – EMS Coordinator – Tri-State Fire Protection District