1. What is Waiting Behind the Door

3. What is Public Health? Population based focus on preventative initiatives Population based focus on preventative initiatives Implementing and evaluating population based strategies to promote health and prevent disease Implementing and evaluating population based strategies to promote health and prevent disease Enforcing health related laws and regulations Enforcing health related laws and regulations

4. Challenges of Today’s Emerging Issues Impact by limited resources: Impact by limited resources: A dollar only stretches so farA dollar only stretches so far Limited awareness to emerging issues and the target populations being affected: Limited awareness to emerging issues and the target populations being affected: Hot topic of the dayHot topic of the day Who pays for Prevention? Who pays for Prevention? Assessment for fallsAssessment for falls Rx drug awareness educationRx drug awareness education Hoarding awareness now that it is a recognized issue thanks to Dr. Phil & OpraHoarding awareness now that it is a recognized issue thanks to Dr. Phil & Opra

5. One Question Does anyone know a client who has fallen, is a hoarder, takes more than 7 prescription pills a day and is dealing with a bed bug infestation? Does anyone know a client who has fallen, is a hoarder, takes more than 7 prescription pills a day and is dealing with a bed bug infestation?

6. What is Aging In Place? According to the Journal of Housing for the Elderly, it is not having to move from one’s present residence in order to secure necessary support services in response to changing needs. The opportunity to experience and enjoy the core values of life long independence in your home. The opportunity to experience and enjoy the core values of life long independence in your home. Understanding and securing the resources available in maintaining an independent lifestyle. Understanding and securing the resources available in maintaining an independent lifestyle.

7. How Does this Relate to Independent Living? Topics I will be covering today are a results of collaborative initiatives aimed at ensuring those populations in need can remain in their homes. Topics I will be covering today are a results of collaborative initiatives aimed at ensuring those populations in need can remain in their homes. Linking people to existing services and developing a resource network/base for those emerging issues impacting the lives of those we are trying to assist. Linking people to existing services and developing a resource network/base for those emerging issues impacting the lives of those we are trying to assist.

8. Bed Bugs Are Back Biting Arthropods Biting Arthropods Long history of association with humans Long history of association with humans Origin probably with humans and bats living in cavesOrigin probably with humans and bats living in caves Originally a problem for the wealthy dating back to Greece in 400 B.C. Originally a problem for the wealthy dating back to Greece in 400 B.C.

9. Resurgence  International travel and commerce  Pesticide use has changed:  Licensing  Baits instead of broad spectrum  Resistance New chemicals are baits and require that the pest EAT the bait

10. Habits Fast-moving Cannot fly or jump Cling tightly to surfaces Flattened easily External parasite that feed on blood Human preferred host Feed during the night but are opportunistic parasites

11. Hiding Areas

12. Bed Bug Bites

13. Prevention  Don’t bring infested items into the home  Inspect clothing and baggage of travelers  Inspect secondhand beds, bedding, and furniture Bed bugs are good hitchhikers

14. No evidence that bed bugs transmit disease No evidence that bed bugs transmit disease Can cause irritation and the risk of secondary infection Can cause irritation and the risk of secondary infection Feed on limbs, trunk, and face – characteristic “bite line” Feed on limbs, trunk, and face – characteristic “bite line” Wheals/welts similar to mosquito bites or chigger bites - Wheals/welts similar to mosquito bites or chigger bites - reaction to salivary substances reaction to salivary substances May cause restless sleep, chronic sleep May cause restless sleep, chronic sleep deprivation, emotional stress deprivation, emotional stress Cost to individuals Cost to individuals Public Health Importance

15. Protection Tips: Field Workers Use separate clothes and shoes for field work Use separate clothes and shoes for field work Try not to bring personal items inside home Try not to bring personal items inside home Shake clothes outside before entering car Shake clothes outside before entering car Change clothes at work Change clothes at work Seal field clothes in clear plastic bag for laundering Seal field clothes in clear plastic bag for laundering Bring a portable stool with you and sit towards the middle of the room Bring a portable stool with you and sit towards the middle of the room Only use a spray labeled for bed bug use Only use a spray labeled for bed bug use

16. Inspection tips: recognize common signs  Blood stains from crushed bugs  Fecal spots  Shed skins & eggshells  Offensive, sweet, musty odor  Use of dogs

17. 1) To reduce the number of homes, schools, public buildings, hotels, and medical buildings that could become infested with bed bugs; 2) To create and convey a consistent message; 3) To coordinate enforcement efforts; 4) To overcome public apathy, and to reduce stigma; 5) To find ways to educate the public without alarm; 6) To find sources of funding for education and outreach; 7) To reach and educate the medical community; 8) Public education and outreach, including a Task Force web site and public service announcements. Goals: