1. How do you find them? Small, difficult to find Cracks, crevices, wall plates, baseboards, mattress seams, head- boards Prefer wood and fiber to plastic and metal

2. The start of an infestation A bad infestation Bed Bug Signs: Blood spots Blood spots are bed bug droppings

3. Live bed bugs & cast skins on a mattress seam Bed Bug Signs: Shed skins

4. Bed Bug Signs: Dead bed bugs Ventral Dorsal

5. Inspecting For Bed Bugs Usually found near beds –Mattresses –Bed frames –Headboards –Nightstands Upholstered furniture –Couches –Chairs Baseboards Wall/ceiling junctures

6. 02 FEB 201120 OCT 2010 Where bed bugs live = Hot Spot Beds, sofas, bedside tables, recliners, picture frames…

7. What’s on the other side of the wall? How do bed bugs spread? Through walls along wires and pipes On anything coming from an infested unit (furniture, backpacks, laundry…) Mattress disposal

8. Inspecting For Bed Bugs In their natural environment Bed Bug! Blood spots!

9. Inspecting For Bed Bugs Screw holes, recessed bolts, knotholes, and oh, so much more.

10. Truth: Bedbugs do not directly spread diseases, but if their bites are not properly cleaned and treated, skin can become infected and cause additional problems. Another Truth: A bedbug engorged with blood can burst, spreading blood. Take appropriate precautions when coming into contact with blood.

11. Bed bugs have never been shown to pass diseases to humans What are the health risks? Bites  Reactions to bites vary widely  Most common symptom is itchy welts Secondary Infection Scratching welts may cause infection Allergic Reaction Asthma Psychological Anxiety and unhealthy stress Sleeplessness Phantom Itching Anemia in children and older adults who have been severely bitten

12. Common Skin Reactions Timing of reaction may change with repeated exposures Commonly –No reaction w/barely visible punctum Some evidence that older individuals have depressed reaction to bed bug bites –2-5 mm pruritic maculopapular, erythematous lesions Usually itch and, if not abraded, resolve within a week –Some patients experience complex cutaneous reactions

14. Treatment of Bite Symptoms Patients may present to medical facilities with bites –Care for bites is supportive –Antihistamines, Corticosteroids, Antibiotics –Bed bug bites may be indistinguishable from bites of other arthropods Goddard and deShazo (2009) – most patients w/symptom resolution ~2wks Elimination of the infestation at home or in care facility is only way to “cure” bites

15. No Topical Treatment to “Cure” Bed Bugs Topical treatments such as those used for head lice or scabies are INEFFECTIVE against bed bugs. –Bed bugs DO NOT live on people, they live in our environment –Prescription of these creams to patients suffering from bed bug bites is NOT INDICATED –The use of these products may be dangerous to patients if used more often than label recommendations

16. Extreme Measures – Don’t Let This Happen!

17. No Repellant There is currently no evidence to support the effectiveness of insect repellents against bed bugs **Encasing mattress/boxspring and isolating the bed can be effective while treatment is ongoing

18. Risks Associated with Environmental Treatment MDCH and health agencies concerned about acute pesticide exposure: –Eliminating an infestation is difficult for the layman –Professional treatments are expensive Market is also ripe for unscrupulous people to take advantage and offer “economical” treatments that are likely to be ineffective at best and dangerous at worst. –Desperate people will try to treat the problem on their own Total release foggers or BUG BOMBS Alcohol being touted as sound pest management tool “More is better” Home remedies, internet scams, applying products not intended for indoor use, etc.

19. Examples of Products Found on the Internet

20. Examples of Products Found at Home Improvement Stores Common Household Products “Green” Products “Bug Bombs” or Total Release Foggers

21. Responsible Use of Insecticides If you are going to try your own pest management – always follow label directions – “The label is the law” “MORE” is not better! Beginning in 2011, the labeling of “Bug Bombs” or total release foggers will state: “Not effective for treatment of bed bugs”

22. Mis-application Examples Boric Acid -not very effective for bed bug control Drione Dust -pyrethrin -piperonyl butoxide

23. Washington, DC, August 2008 San Diego, CA, July 1992 Augusta, GA, March 2008 Total release foggers (there’s a reason they’re called bombs!)