Bedbugs are a source of discomfort for many people, and are difficult to control. Possibly (though not highly likely) they are also a public health concern - see Bedbugs #Disease transmission.
In most observed cases, bites consist of a raised red bump or flat welt, and are often accompanied by intense itching. The red bump or welts are the result of an allergic reaction to the anesthetic contained in the bedbug's saliva, which is inserted into the blood of its victim. Bedbug bites may appear indistinguishable from mosquito bites, though they tend to last for longer periods. Bites may not become immediately visible, and can take up to nine days to appear. Bedbug bites tend to not have a red dot in the center such as is characteristic of flea bites. A trait shared with flea bites, however, is tendency towards arrangements of sequential bites. Bites are often aligned three in a row, giving rise to the colloquialism "breakfast, lunch and dinner." This may be caused by the bedbug being disturbed while eating, and relocating half an inch or so farther along the skin before resuming feeding. Alternatively, the arrangement of bites may be caused by the bedbug repeatedly searching for a blood vein. People react very differently to bedbugs, and individual responses vary with factors including skin type, environment, and the species of bug. In some rare cases, allergic reactions to the bites may cause nausea and illness. In a large number of cases, estimated to 50% of all people, there is no visible sign of bites whatsoever, greatly increasing the difficulty of identifying and eradicating infestations.
People commonly respond to bed bug infestations and their bites with anxiety, stress, and insomnia. Individuals may also get skin infections and scars from scratching the bedbug bite locations.
It is important not to scratch the bites, as this will make itching worse and possibly lead to scarring. Try the ideas below or elsewhere, to reduce the itch rather than scratching.
Antihistamines have been found to reduce itching in some cases, but they do not affect the appearance and duration of the lesions. Topical corticosteroids, such as hydrocortisone, have been reported to expediently resolve the lesions and decrease the associated itching. Most patients who are placed on systemic corticosteroids to treat the itching and burning often associated with bed bug bites find that the lesions are poorly responsive to this method of treatment.
Many patients also experience temporary relief of itching and inflammation with the application of hot water to the bite. The water should be quite hot (about 120 degrees F or 44 deg C) because if it is not hot enough it may cause aggravation of the symptoms. The water should be hot enough to cause minor discomfort, but care must be taken not to burn the skin and this treatment should only be self-administered in order to reduce the risk of a burn. Itching and inflammation can be relieved for several hours by applying hot running water, a hot washcloth, or even using a blowdryer to heat the area of the bite, for 10 seconds to 1 minute (or longer if desired). There is disagreement as to why heat causes the symptoms to abate. Some hypotheses propose that heat overwhelms the nerve endings that signal itch, that heat neutralizes the chemical that causes the inflammation, or that heat triggers a large release of histamine causing a temporary histamine deficit in the area.
Question: Do creams and ointments such as aloe vera help to ease the itching sensation?[expansion needed]
Bedbugs are known for being elusive, transient, and nocturnal, making them difficult to detect. While individuals have the option of contacting a pest control professional to determine if a bedbug infestation exists, there are several do-it-yourself methods that may work equally well.
The presence of bedbugs may be confirmed through identification of the insects collected or by a pattern of bites. Though bites can occur singularly, they often follow a distinctive linear pattern marking the paths of blood vessels running close to the surface of the skin. The common bite pattern of three bites often around the ankle or shin close to each other has garnered the macabre colloquialism "breakfast, lunch & dinner."
A technique for catching bedbugs in the act is to have a light source quickly accessible from your bed and to turn it on at about an hour before dawn, which is usually the time when bedbugs are most active. A flashlight/torch is recommended instead of room lights, as the act of getting out of bed will cause any bedbugs present to scatter before you can catch them. If you awaken during the night, leave your lights off but use your flashlight/torch to inspect your mattress. Bedbugs are fairly fast in their movements, about equal to the speed of ants. They may be slowed down if engorged. When the bedroom light is switched on, it may temporarily startle them allowing time for you to get a dust pan and brush kept next to the bed and sweep the bugs into the pan then immediately sweep them into a cup or mug full of water where the bugs drown quickly. Dispose of the water down the sink or toilet. Disinfect the mattress, skirting boards and so on regularly.
Glue traps placed in strategic areas around the home, sometimes used in conjunction with heating pads or balloons filled with exhaled breath offering a carbon dioxide source, may be used to trap and thus detect bedbugs. This method has varied reports of success. There are also commercial traps like 'flea' traps whose effectiveness is questionable except perhaps as a means of detection. Perhaps the easiest trapping method is to place double-sided carpet tape in long strips near or around the bed and check the strips after a day or more.
Also, bedbug infestation give a very distinct odor.
A recent trend in bed bug control is utilizing canine detection teams to pinpoint infestation areas, because hiding places can be very hard to find. A trained dog and handler can detect and pinpoint a bedbug infestation within minutes. This is a fairly costly service that is not used in the majority of cases, but can be very useful in difficult cases.
It is possible to create makeshift temporary barriers from the insects around a bed. Although bedbugs cannot fly or jump, they have been observed climbing a higher surface in order to then fall to a lower one, such as climbing a wall in order to fall onto a bed. Barrier strategies nevertheless often have beneficial effects: an elevated bed for example, can be protected by applying double-sided sticky tape around each leg, or by keeping each leg on a plastic furniture block in a tray of water.
Bed frames can be effectively rid of adult bedbugs and eggs by use of steam or by spraying rubbing alcohol on any visible insects, although this is not a permanent treatment. Small steam cleaners are available and are very effective for local treatment. A suspect mattress can be protected by wrapping it in disposable plastic sheeting, sealing shut all the seams and putting it on a protected bed after a final visual inspection. Bedding can be sanitized by a 120 °F (49 °C) laundry dryer. Once sanitized, bedding should not be allowed to drape to the floor. An effective way to quarantine a protected bed is to store sanitized sleeping clothes in the bed during the day, and bathing before entering the bed.
Alternative treatments that may actually work better and be more comfortable than wrapping bedding in plastic that would cause sweating would be to encase your mattress and box springs in impermeable bed bug bite proof encasements after a treatment for an infestation. There are many products on the market but only some products have been laboratory tested to be bedbug bite proof. Make sure to check to see that the product you are considering is more than an allergy encasement, but is bed bug bite proof.
Vermin and pets will complicate a barrier strategy. Bedbugs prefer human hosts, but will resort to other warm-blooded hosts if humans are not available. Some bedbug species can live up to eighteen months without feeding at all. A co-infestation of mice can provide an auxiliary food source to keep bedbugs established for longer. Likewise, a house cat or human guest might easily defeat a barrier by sitting on a protected bed. Such considerations should be part of any barrier strategy.
BBC1 aired a television program entitled "The One Show" about the growth of bedbug infestations in London. In the program a pest control officer claimed that the use of insecticides alone was no longer an effective method to control bed bugs as they had developed a resistance to most if not all insecticides that might be used legally in the UK. He stated that insecticide use in conjunction to freezing bedbugs was the only effective control. All items of clothing and upholstery (including curtains) in the affected household had to be deep-frozen for at least 3 days in giant freezers to ensure complete eradication. The exact temperature at which bedbugs must be frozen was not mentioned.
An exterminator may use permethrin insecticide. Permethrin is a neurotoxin and is not known to be harmful to most mammals and humans. However it is highly toxic to house cats and lethal to cold blooded animals (snake, turtle, lizard. etc.).
Another method that might be useful in controlling bedbugs is the use of neem oil. It can be sprayed on carpets, curtains and mattresses.[verification needed] [expansion needed] Neem oil is made from the leaves and bark of the neem tree native to India. It has been used safely for thousands of years in India both as a natural, effective insect repellent and it is antibacterial. It has recently received US Food and Drug Administration approval for external use. It is also possible to incorporate neem oil into certain types of mattress. Such mattresses are currently being manufactured by a German company. Some may find the aroma of neem oil objectionable.
Practical tips for travellers and residents
Since most bedbugs are carried by travellers through contact with beds and hotel rooms in infected locations, following are some tips for those travelling to hotels that might be at risk.[verification needed]
- First, examine the room for potential hiding places of bedbugs, such as carpet edges, mattress seams, pillow case linings, bedboards, wall trim or other tiny crevaces in which bedbugs might hide.
- Next, look specifically at the mattress seams for signs of bedbug activity: droppings, eggs, bloodstains or even bedbugs themselves, hiding in tiny folds and seam lines.
- Keep a flashlight nearby when sleeping, to immediately observe suspected activity during the night without having to get up out of bed, thereby giving bedbugs time to hide in safety.
- Never leave your clothing lying on the bed, or any location of possible infestation (as mentioned above). Instead, use hangers or hooks capable of keeping all cloth distant from the floor or bed. Suspend new shopping in bags the same way.
- Close all luggage (suitcase, travel bag etc.) when you're not using it. This way, during the night the bugs may move over top of your bags with greater difficulty to get inside.
- Elevate your luggage off the floor to luggage stand, tables or chairs. These can also be hiding places, but less likely.
- Keep any bedbug you find (intact if possible) to show the hotel owner.
Practical tips for hotel and hostel managers
- Sun the bedding and bed clothes regularly.
- Place barriers to restrict movement of bedbugs. Do not put beds touching each other.
- Place barriers (double-sided tape) around the legs of beds.
- Do not allow bedclothes to drape on the floor.
- Watch for signs such as bloodstains on the bed and bed clothes.
- Listen to reports of bites. These may be fleas or bedbugs, but both must be taken seriously, for the comfort and health of guests, and the reputation of your business.
- See the #Control section above for specific ideas. Make the most of hot sunny weather to treat bedding with boiling water, if you suspect it is infected.
When you have minimized the presence of bedbugs through your own control measures then take strong steps to prevent new bedbugs being brought in:
- Put up signs saying that you have strict rules in order to keep your premises bed bug free. This is for the benefit of guests, and they will appreciate your efforts (especially if they have been affected by them in the past).
- Do not allow people to use their own sleeping bags or bed clothes, as these can carry bed bugs and other pests such as fleas.
- If a resident stays more than a few days, wash or sun their bedding every few days at least.
Question: If guests are asked to shower before sleeping, will this reduce new infestations?[expansion needed]
- ↑ Susan C. Jones, PhD http://ohioline.osu.edu/hyg-fact/2000/pdf/2105.pdf Extension Fact Sheet "Bed Bugs, Injury" January, 2004
- ↑ Mark D. Scarupa and Athena Economides, MD Journal of Allergy and Clinical Immunology "Bedbug bites masquerading as urticaria" Vol. 117, Issue 6, June 2006, p.1508-1509
- ↑ Sulzberger, M. B., et al. Dermatology: Diagnosis and Treatment. Chicago: Yearbook, 1961; p. 94
- 'Bed bugs – least toxic control' - alternatives to pesticides fact sheet from PAN UK.
-  The New York City Department of Health and Mental Hygiene "Vector surveillance and control: Bed bug fact sheet" 12 January 2008
- My Observations on Bedbugs, by Dr. Charles A.R. Campbell (historical interest only)
- Bed Bugs Pest Control Information - National Pesticide Information Center
- KidsHealth.Org: "Hey! A Bedbug Bit Me!"
- eMedicine, July 2006: Bedbug bites, Robert A. Schwartz, MD, MPH, et al.
- Bed Bugs Information: A look at the history of bed bugs and their effects on society. Includes recent bed bugs lawsuits.
- bed bug on the UF / IFAS Featured Creatures Web site
- Bed Bugs chapter in EPA and UF / IFAS National Public Health Pesticide Applicator Training Manual
- Information portal about Bed Bugs and how to avoid them hosted by David Cain
Audio and video
-  Goodnight, Don't Let the Bedbugs Bite. Philadelphia's KYW station speaks to John Russell, general manager of Action Termite and Pest Control about how you get bedbugs and what it takes to get rid of them.
- Bed Bug Central TV A Bed Bug Video Blog hosted by Entomologist Jeff White.
Duplicate content from Bedbugs: Bedbugs thrive in places with high occupancy, such as hotels. People can often acquire bedbugs at hotels, motels, or bed-and-breakfasts, and bring them back to their homes in their luggage. They also can pick them up by inadvertently bringing infested furniture or used clothing to their household. If someone is in a place that is severely infested, bedbugs may actually crawl onto and be carried by people's clothing, although this is atypical behaviour — except in the case of severe infestations, bedbugs are not usually carried from place to place by people on clothing they are currently wearing. Bedbugs may travel between units in multi-unit dwellings, such as condominiums and apartment buildings, after being originally brought into the building by one of the above routes.