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Diseases and Conditions
Bedbugs
From MayoClinic.com
Special to CNN.com

Introduction

How many times have you heard "Sleep tight, don't let the bedbugs bite"?

The catchiness of the rhyme doesn't diminish the creep factor of bedbugs, the tiny six-legged insects that hide throughout your home during the day and feast on your blood at night.

The common bedbug is a reddish-brown insect that doesn't grow much more than a half centimeter (cm) in length. Bedbugs inject an anticoagulant to keep your blood flowing as they suck, along with an anesthetic agent to keep you from feeling them when they're at work.

To date, bedbugs aren't known to spread disease to humans. However, they're experiencing a resurgence in Western countries, primarily due to an increase in foreign travel and changing pest-control practices.

Treatment of bedbug bites usually involves steps you can take on your own, but in more severe cases you may need to see your doctor.

Signs and symptoms

Bedbug-bite signs and symptoms will usually only affect the surface of the skin, revealing themselves as small itchy red bumps known as papules or wheals. You might find the lesions in a linear or clustered fashion, indicative of repeated feedings by a single bedbug.

Some individuals may develop allergic reactions or larger skin reactions such as:

  • Large, itchy wheals up to 20 cm across
  • Blister-like skin inflammations
  • Groups of small, swollen sacs of pus
  • Skin rashes similar to hives

Causes

Bedbugs will feed on any mammal, including cows and dogs. In North America, migratory bird species and bats have been sources of infestation.

More recently, as world travel has increased, bedbugs are finding vehicles into the home through luggage and clothing worn abroad.

Another contributor to the resurgence of bedbugs in the West is changing pest-control practices. Sixty years ago the common use of DDT — which kills most insects — nearly eliminated bedbugs in the United States. Exterminators also commonly treated headboards in the bedroom.

Today the use of DDT is being phased out due to human toxicity concerns. Further, current extermination practices are more insect-specific — what's toxic to a cockroach may not kill a bedbug.

Risk factors

Factors that will increase your chances of suffering a bedbug infestation:

  • Climate. Bedbugs thrive in tropical areas, although they can be found in all climates.
  • Type of housing. Infestation is more likely in apartments and homeless shelters — which have high turnover — than in single-family homes.
  • Living with pets. Cats and dogs can carry bedbugs into the home.

When to seek medical advice

If you experience allergic reactions or severe skin reactions to your bedbug bites, see your doctor for professional treatment.

Screening and diagnosis

Diagnosis of bites requires a history of your exposure and a physical examination of the bite areas. Because the bites can be mistaken for those of other insects or other skin problems, your doctor will need to rule out fleas, body lice and scabies before determining a diagnosis of bedbugs.

Diagnosis of a bedbug infestation in your home can be more difficult, since bedbugs work primarily at night. If you have signs or symptoms, immediately inspect your home for the insects. Thoroughly examine crevices in walls, mattresses and furniture. You may need to perform your inspection at night when bedbugs are active.

Look for these signs:

  • Discrete bloodstains on sheets and mattresses
  • Specks of blood behind wallpaper or other sites of heavy infestation
  • Insect excrement at the entry to hiding places in furniture crevices, walls
  • An intense, sweet odor caused by bedbugs' oil secretions

Complications

You're likely to suffer only from the itchy skin welts that bedbugs cause while feeding. However, some people develop more complicated reactions to bedbug bites, such as clusters of inflamed red bumps, dilation of the capillaries under the skin, formation of pus-filled blisters and giant hives.

In rare cases, anaphylactic shock may occur as an allergic reaction to the substances the bedbug injects while feeding.

Treatment

Treatment of your bedbug bites is aimed at relieving your symptoms, and they'll usually resolve themselves within one to two weeks without treatment.

  • Apply a topical cream, such as cortisone, to relieve itching.
  • Apply an antiseptic or antibiotic ointment to any breaks in the skin to prevent secondary infections.
  • Consult your doctor if you suffer severe reactions. An oral antibiotic or oral corticosteroidmay be recommended.
  • Take antihistamines if needed to help relieve allergic reactions.

Once your symptoms are treated, you must tackle the underlying infestation. This difficult task usually requires a professional inspection of the bedbug habitat and subsequent extermination.

Prevention

If bedbugs are already present in your home, you can help ward off bites by wearing nightclothes that cover as much skin as possible.

To help prevent bedbugs from becoming residents in your home:

  • Inspect antiques and secondhand furniture thoroughly before bringing them into your home.
  • Employ the regular services of a professional exterminator.
  • Use bednets impregnated with permethrin to ward off infestation in tropical areas.
  • Inspect any room you're about to inhabit while traveling.
  • After you return from a trip, check your luggage for any insects that might have hitched a ride.
  • Change linens at least once a week, and wash in hot water of at least 115 F.
  • Vacuum around the home at least once a week, paying special attention to areas surrounding bed and furniture posts.
  • Caulk holes in the floor and walls.
  • Dismantle and either treat with insecticides or discard any old furniture, including bed frames and mattresses. Use sprays, such as dichlorvos, permethrin and malathion, around cracks and crevices in your home.
  • Eliminate any neighboring bird and bat habitats that may serve as a refuge for bedbugs, especially following an extermination attempt.

Self care

Self-care during a bedbug infestation primarily involves comfort care for bites.

However, you may experience psychological effects due to a bedbug infestation, such as imagined itching. This is normal, but realize that a bedbug infestation is nothing to be embarrassed about. Even the cleanest, most meticulous individual can suffer from a bedbug problem in the home.

Should you suspect bedbugs in your home, treat any bites quickly and take immediate steps to eliminate the infestation.

February 06, 2006

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