Identification & Management of Bed Bugs Michelle McElroy RN, CIC Infection Prevention Coordinator References: CDC, TSICP

What are bed bugs Cimex lectularius Ectoparasites True Bug Related to stink bugs Cimex lectularius Family Cimicidae Ectoparasites Feed externally on a host (do not live in or on the host)

Bed Bug Identification Dark brown to reddish 1/4 – 3/8 inch Wingless Flattened body Fast moving

Bed Bug Identification Easily confused for: Brown Dog Tick Dermestid Beetle

BED BUG BIOLOGY Lifespan – 10-18 months Incomplete metamorphosis Lay 1-5 eggs per day 200-500 in lifetime Incomplete metamorphosis Egg, Nymph Adult Eggs hatch within 6-17 days Sticky substance, sticks to surfaces Look like grains of salt

BED BUG BIOLOGY Hide close to food Can crawl up to 100 feet to get food Eventually spread Neighboring rooms, apartments

LIFECYCLE

LIFECYCLE

BED BUG IDENTIFICATION Shed skin as they grow = molt

BED BUG IDENTIFICATION Require blood meal Hide from light (seam of mattress, inside headboards) Live 20 days-2 months without feeding Migrate to feeding area (sleeping areas since they mostly feed at night)

BED BUG BITES Feed on exposed skin Bite in a line Bites at night DO NO NOT always mean bed bugs! Need actual ID for confirmation

BED BUG BITE: MEDICAL CONCERNS Not everyone reacts the same No significant blood loss Anxiety, insomnia, emotional distress Poorly nourished children vulnerable to anemia Irritant – may exacerbate asthma Do not vector diseases

BED BUG PREVENTION Be aware of your surroundings Be careful where you place belongings (yours as well as consumers) Be careful where you sit/lean Remember that bed bugs can hide anywhere Especially in fabric

BED BUG PREVENTION When going in suspected homes, wear booties on shoes (tuck hem of pants into shoes/booties or rubber band bottom of pants) Carry/Wear gloves in home if possibility you will be having direct contact with participant, environment, etc. Stand instead of sit if feasible If sitting, use metal or plastic chairs Avoid fabric or leather covered chairs

BED BUG PREVENTION Recommendations: To Avoid Taking Them Home When you arrive home, take off work cloths Place in dryer Run on Heat for 20 minutes on regular setting Place bags, shoes, other items of concern in dryer too For items that cannot be put in dryer, may place in sealed bag and lay out in sun

BED BUG PREVENTION Bed bugs do not discriminate Bed bugs do NOT equal poor sanitation, not clean, etc. Bed Bugs do NOT equal low income Lower income individuals have it harder Cannot afford a pest management professional More likely to use second hand items Bed Bug Infestations: will worsen in next 5-10 years

BED BUG PREVENTION Know your responsibilities: STAY CALM Proper Identification If possible catch a picture of the bug prior to sealing in a bag Bag Items (bag must be sealed) Notify Supervisor Contact Infection Control Coordinator Do Not Remove Items from an area of infestation, rather contain the items Michelle McElroy RN, CIC Infection Prevention Coordinator mdmcelroy@starcarelubbock.org (806) 445-4594