This file has a presentation pdf you can look at bed-bugs-rosana

This file has a presentation pdf you can look at bed-bugs-rosana

This file has a presentation pdf you can look at bed-bugs-rosana

What you need to know BED BUGS Rosana Pellizzari, MD, CCFP, MSC, FRCPC No conflicts to declare.

This file has a presentation pdf you can look at bed-bugs-rosana
By the end of this session, participants will:
  • Understand the biology, risk and epidemiology of bed bugs;
  • Learn how to determine when bed bug infestations are present;
  • Understand the prevention and control of bed bug infestations;
  • Acquire the knowledge and expertise to respond effectively to various clinical scenarios involving bed bugs.
This file has a presentation pdf you can look at bed-bugs-rosana
Overview of what patients are told:
  • Reports of bed bugs in Ontario and across Canada are on the rise.
  • It’s important to know the facts.
  • Anyone, anywhere can get bed bugs.
  • But...they can be prevented and controlled.
This file has a presentation pdf you can look at bed-bugs-rosana

THE BASICS

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What are Bed Bugs?

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Bed Bugs Do Bite

This file has a presentation pdf you can look at bed-bugs-rosana
  • Naming History
  • Ancient Rome, bed bugs were called Cimex (meaning “bug”), while the species designation lectularius referred to a bed or couch.
  • Early Greek term for bed bug was Coris, meaning “to bite,” from which the word coriander comes. Coriander (cilantro) is one of the world’s oldest spices.
  • England, bed bugs were simply referred to as “Bugs”.
  • Early Spanish word for bed bug — “chinche” is especially relevant today since Spanish-speaking customers often refer to bed bugs as chinches or chinche de cama — bug of the bed.
  • Other names used include wall louse, bed louse, wallpaper flounder, night riders, red coats and crimson ramblers.
  • Bed bugs did not occur in North America before the arrival of European settlers, thus there is no word for them in the language of Native Americans.
This file has a presentation pdf you can look at bed-bugs-rosana

Family Cimicidae ~ 91 species – bat hosts – 13 genera, 61 species – bird hosts (swallows and swifts) - 26 species – mammals and birds – 2 species – hosts unknown – 2 species

This file has a presentation pdf you can look at bed-bugs-rosana

Cimex lectularius Cimex adjunctus

  • Quick Facts...
  • The human bed bug (Cimex lectularius) and its relatives (Cimicidae) form a small group of bloodsucking Insects.
  • It has never been demonstrated that bed bugs transmit any human disease (including Hep A and HIV/AIDS).
  • Because of the different habits of the various bed bugs, proper identification determines where to direct controls to be most effective.
  • The bite of these bugs often is painless, but a toxic saliva injected during feeding will later cause severe itching and an inflamed welt. However, individuals may vary widely in sensitivity to these bites. Often, a series of two to three welts are produced in close proximity following feeding by bed bugs. Pictures to follow...
  • Bed bugs have a short broad head, broadly attached to the prothorax, and an oval body.

  • Medical Importance
  • Naturally infected with >41 human pathogens
  • Never proven to transmit any human disease
  • Several species feed on humans Common & Tropical Bed Bugs, Bat Bugs & “Bird” Bugs
  • Salivary proteins cause “sensitivity” to repeated bites by large numbers of bed bugs
  • Serious social stigma to “having” an infestation
  • Secondary infection

Biology Life Cycle – Females can lay ~200-500 eggs – Eggs hatch in 1-2 weeks – Nymphs start to feed immediately – Nymphal stage is 14-30 days – Entire life cycle is 4-9 weeks – Adults can survive, conditions dependent, up to 12-18 months, or longer, without feeding – May migrate if it ‘senses’ a potential food source © Orkin Inc.

Lifecycle

Eggs

1st Instar

1st Instar

Feeding

Longevity (mean in days) in Once-fed Bed Bugs (70-75%RH) (Omori, 1941) Stage 10C 18C 27C 37C Instar 1 275 114 28 17 Instar 2 399 171 46 30 Instar 3 413 214 71 35 Instar 4 433 235 73 37 Instar 5 485 161 40 33 Female 425 277 87 32 Male 402 176 43 29

  • Feeding
  • Adults/Nymphs feed ‘usually’ at night
  • Nymphs – 3 min average 1st instar; Adults – 10 to 15 min
  • Saliva causes the allergic reaction
  • Digest blood meal; molts and feeds again when its ready or ‘wait’ until host present
  • They do not stay on the host longer than it takes to get a blood meal
  • “Bites” – usually in two to three spatially close welts

WHAT CAN YOU DO?

Identify Worried you may have bed bugs? Get a hair dryer (set on hot), a vacuum, thin knife or credit card, and search their favourite hiding spots: – Mattresses – Box spring/bed frame – Cracks/crevices on or near bed – Bedroom baseboards – Nightstands – In or near clutter

Fecal Matter/Blood Spots M Potter, 2004

Bedbug Evidence M Potter, 2004

M Potter, 2004

CLINICAL DIAGNOSIS

Characteristic ‘Immediate’ Reaction

Delayed Reaction (>24 hours)

  • Bedbug Prevention
  • Be wary of acquiring secondhand beds, bedding, clothing, books, electronics and furniture, anything that can carry a bed bug on/in it
  • Vacuum suitcases after returning from a vacation (put in freezer to slow them down then into hot dryer)
  • Repair cracks in plaster and glue down loosened wallpaper
  • Remove and destroy wild animal roosts and bird nests when possible (Bat Bugs)
  • Check furniture, bedding or normal sleeping areas regularly
  • Clean and vacuum regularly as per normal home sanitation measures
Take Action If you find bed bugs in your home, don’t wait – take action:
  • Tell your landlord or building maintenance person at once.
  • Don’t try to do it yourself. Insect foggers will not get rid of bed bugs.
  • To control bed bugs you will need a licensed professional pest control operator with bed bug experience.
Take Action What you need to do before the pest control operator arrives:
  • Wash all bedding in hot water or dry clean. Place pillows in the dryer on high heat for a minimum of 30 minutes.
  • Steam clean, wet vacuum or shampoo carpeting and furnishings.
  • Vacuum mattresses, bed frames, baseboards and objects close to the bed. Discard the vacuum bag in a tightly sealed garbage bag before disposal.
  • Empty all dressers and closets - including linen closets. Clean articles should be placed in the dryer on high heat for a minimum of 30 minutes.
  • All soiled articles need to be washed in hot water and dried on high heat.

Remove all clutter, such as: books, magazines, toys and home accessories. Clutter is home to bed bugs. Place all items in tightly sealed garbage bags and leave them in the room to be treated.

  • Control of Bedbugs Non-chemical control (not an all inclusive list) – Sticky Traps/Double-sided tape – Mattress covers – Allerzip, Gardex; Bed posts in BB Cans/traps – Heat clothes in dryer for 15-20 min.; will kill all stages (>120°F) – Hot steam along baseboards, wallpaper etc. – Vacuum often with strong suction – Use a scrub brush along the seams of mattresses – Heat (> 130°F/55°C) (put in heat box, rooms, buildings etc) – Expose bugs to cold temperatures below 32°F/0°C Generally Does Not Work : Chilling period must be maintained for many days (adults) greater than -20°C; colder than most freezers
  • Eggs - NOT a control option
  • Overall, it is NOT an effective control option and is not recommended
  • Control of Bedbugs
  • Chemical control – Various aerosol sprays, liquids, and dust products are available – Permethrin (Prelude/Dragnet), Cyfluthrin (Tempo), Bendiocarb (Ficam), and Diatomaceous earth – Linens and mattresses should not be sprayed unless products are registered/labeled for this use

Why they are a control challenge? 1. Often hard to detect in small numbers (small, generally nocturnal, cryptic, & fairly mobile). 2. No reliable attractant available (currently). 3. Readily detect (& avoid) many chemicals. 4. Adults can live > 1 yr.

without feeding. [Nymphs fed > once can live > 3 mo. w/o feeding]. 5. Insecticide resistance newly documented. 6. Very easily re-introduced and/or spread.

  • Challenges to Effective Control
  • Hoarding Issues
  • Laundry
  • Lack of client co-operation due to cost, mistrust of technician, lack of education
  • Room not properly prepared for treatment
  • Client embarrassed does not tell anyone with an active infestation or re-introduction

The Social Impacts of an Infestation Dr. Elizabeth Comack Department of Sociology University of Manitoba

  • More than just itchy bites
  • Loss of belongings
  • Health problems exacerbated
  • Insecticide exposure
  • Social Stigma
  • Social Isolation
  • Negative impact on identity

MYTHS

Myth #1 Throwing out my bed will get rid of bed bugs FACT. Bed bugs can occupy almost any dark crack or crevice in a room. Almost everything including clothing, bedding, furniture and electronics can be treated to remove bed bugs.

Myth #2 Bed bugs are only found in low-income neighborhoods. FACT. Bed bugs happen to anyone, anywhere. You get bed bugs simply by coming into contact with them.

Myth #3 Bed bugs cannot survive in Canada due to cold winters. FACT. Even with our cold winters bed bugs continue to survive in all parts of Canada.

Bed bugs can be found in almost every country and region. They are a global pest.

Myth #4 I don’t travel very much, so I’m safe. FACT. Travel, whether overseas or in Canada, is not the only possible source of bed bugs. Situations such as riding public transit, having a houseguest or purchasing a piece of secondhand furniture can offer bed bugs a free ride into your home.

Myth #5 My partner seems to have signs of bites, but I do not – so we don’t have bed bugs. FACT. Two people sleeping in the same bed may both be bitten by bed bugs but react in a different way. Some people immediately have a reaction to the bites while others show little or no sign.

Myth #6 There are over-the-counter treatments available for bed bugs. FACT. Such remedies are considered to be ineffective and some are fire hazards. The best way to get rid of bed bugs is to hire a licensed pest control expert and follow their instructions.

Myth #7 I have a metal bed, so I have nothing to worry about. FACT. Although metal beds are less hospitable to bed bugs, simply replacing all beds with metal ones will not solve a bed bug problem. In some cases, metal beds may cause bed bugs to hide in less obvious areas of the bed, making the matter worse.

TENANTS

  • Information for Tenants
  • If you find bed bugs, here is what you should do: – Tenants: Immediately inform your landlord, superintendent, or property manager. – Landlords are responsible for maintaining the unit so it is fit for habitation, and complies with health standards. – If landlord fails to act, a tenant may make a complaint to the municipality. – You are responsible for cooperating with efforts to control bed bugs.
  • Tenants
  • What you should know: – Landlords have right to enter to inspect and maintain rental units (written notice, 24 hours in advance). – Landlords are responsible for the cost. Only licensed pest control companies should be used. – You will need to prepare (eliminate clutter, clean your belongings, moving furniture, etc.).

Naming and Framing the Problem: Bed Bugs are Serious Threat to Public Health Encountering Bed Bugs Social stigma, Social isolation, Stress Compromised Health Social and Economic Marginalization (lack of resources and control over living conditions)

  • For More Information
  • To learn more about bed bugs, and what you can do to prevent, identify and treat them, visit: – www.bedbugsinfo.ca – Contact your local public health unit – visit: http://www.health.gov.on.ca/english/public/contact/phu/phuloc _mn.html
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