The Painful Bed Bug Bites
Authored by Dr.AM Mohan Rao
Introduction Bedbugs are small parasitic brown and flat hematophagous insects that infest houses and feed on blood of mammals and birds. There are several species of bedbugs which comes from the cimicidae family of insects. Cimex lectularius and Cimex hemipterus, feed on humans and/or domestic animals. These are flat, oval shaped, reddish brown in color and hide in the cracks of the furniture.
Bedbugs are wingless, but they can move rapidly over walls, floors and ceilings. Female bugs can lay hundreds of eggs in a life time and can produce more than 3 generations per year. It takes one month for complete development of a bedbug under favorable conditions. They can live more than a year without feeding, but most adults and nymphs can survive for not more than six months without a meal. Although they are troublesome, they are not linked with any disease transmission. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial or hives reactions (skin rash) and anaphylaxis (severe life threatening allergic reaction) can also occur. Causes Presence of bedbugs are the cause of their bites, they need a warm host and enough spaces to hide themselves. They might enter your home through luggage that was carried from a hotel, travelling
(bus/train seats) or a relative’s home called “passive dispersal”. Bedbug eradication from an infested site is a challenge: Insecticide resistance has been demonstrated experimentally and is an increasing problem.
Symptoms Bedbugs are active at night time and bite humans while they are sleeping. These insects pierce the skin to withdraw blood through an elongated beak. Blood feed time may range in between 3 to 10 minutes, after which the insect crawls away unnoticed. Bedbugs are suspected of transmitting infectious agents but this is not confirmed yet. However, several authors have postulated that these species could transmit pathogens to humans. Bedbug bites, also known as cimicosis, are virtually similar to the bites of other insects. During a bite, this insect injects its saliva that contains anesthetics and anti-coagulants due to which; it does not cause pain at first. However, after a period of time, the affected area becomes itchy with red or dark red spots in the centre. These spots are arranged in a line or in a cluster on any area of the body but most commonly seen on the face, neck, arms and hands. Localized swelling and formation of blisters may also be seen. When to see a doctor? Some people do not get affected at all by bedbug bites, while others encounter severe allergic reactions. A doctor should be consulted if you experience severe skin reaction. Diagnosis To diagnose the condition, these insects are searched at home, as symptoms are not specific. Night time is appropriate to search for bedbugs as they are active during this time. A bedbug molts five times before turning into an adult, as a result their skin’s light brown colored exoskeleton can be seen in sleeping environment at home. Also look for blood smears on bed sheets where a bedbug has been crushed accidentally. Who are at Risk? The places that are highly likely to carry Bedbugs are: • Homeless shelters • Hotels • Dormitories • Refugee camps • Military barracks Treatment It usually takes a week or two for the itchy red spots to disappear. However, you can reduce this duration by using drugs, which can either be applied or can be administered through oral route. • Topical creams with hydrocortisone can be applied on the affected skin surface. • Anti-histaminic is prescribed for oral administration. • If a skin infection is developed from scratching the affected site, an antibiotic can be helpful. Integrated Pest Management (IPM) approach is required to control bedbugs. Lifestyle recommendations: • Wash your clothes in hot water not less than 49°C to kill bedbugs. • Thoroughly vacuum cracks or crevices to physically remove the insects.
Throw out mattresses or couches if these items are found to be heavily infested by bedbugs. • In terms of cost and effectiveness, encasing mattresses and box springs is a better option than using pesticides. • Heating items in a hot dryer for 20 minutes can kill bedbugs. • Abrupt change of temperature can also kill bedbugs. • Repair cracks in the furniture and plasters to get rid of places where bedbugs can hide. • Bedbug interceptors (plastic trays with an inner and outer ring placed under bed legs) can trap bedbugs when they attempt to climb on bed. Prevention • Cover windows and other ventilators at your home with mosquito nets • Wear full clothes to avoid bites • Inspect used upholsteries before getting it into your home • Place your luggage on a safe place instead of floor, when residing in hotels •