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The Problem of Bed Bugs for Health Departments, Health Care and Social Service Provider ---PAGE BREAK--- Bed bugs are tiny parasites that seek out sleeping people or animals for a blood meal. 2 ---PAGE BREAK--- What is the Reason for the Resurgence of Bed Bugs? a) Rapid rate of reproduction b) Mass transportation (bus, train, taxi, plane) c) Hard to detect in small numbers d) Increased pesticide resistance e) Readily detect and avoid many chemicals f) Survive for long periods without a meal g) International Immigration ---PAGE BREAK--- 4 1. Cincinnati 2. Chicago 3. Columbus 4. Denver 5. Detroit 6. Washington, D.C. 7. New York City 8. Dayton, Ohio 9. Philadelphia 10. Baltimore 11. Lexington, KY 12. Cleveland 13. Las Vegas 14. Richmond, VA 15. Hartford, CT * = Orkin Survey of Service Accounts volume 2011; Map Source: www.bedbugregistry.com; Public reports (n=20,000) of hotel infestations as of March 2011 ---PAGE BREAK--- a) theatres b) office buildings c) hotels d) dormitories e) apartments f) private homes g) restaurants h) busses/trains/ taxis/ planes i) shelters ---PAGE BREAK--- They can catch rides on: Clothes, Backpacks, Luggage, Bags, Furniture, Bedding, Family, Friends, Co-workers. 6 They are excellent hitchhikers! ---PAGE BREAK--- Active Bed bugs also migrate by Walking from an infested area to new territory. From one apartment to another via pipes, telephone, cable or electrical wires. Down a hallway after dropping of an item being discarded. 7 ---PAGE BREAK--- 1 2 3 4 5 6 7 Tick Tick Bed bug Carpet Beetle Cockroach Adult Bed bug Cockroach ---PAGE BREAK--- Oval Bodied, < ¼ inch. Adults: brown to red in color Wingless – they do not jump Six legs are nearly colorless ›Size of a poppy seed Eggs are white, 1-2mm Eggs glued to rough surfaces ---PAGE BREAK--- Can you see bed bugs with the naked eye? You should be able to see adult bed bugs. Adults are a little smaller than an apple seed. 1st instar is about the size of a period at end of sentence. . ---PAGE BREAK--- Aggregate. Usually active at night. Attracted to exhaled CO2. Attracted to body temperature. Most travel 15-20 ft to feed. Adults can survive >6 months without feeding. ---PAGE BREAK--- Are bed bugs only active at night? While bed bugs prefer darkness, keeping the light on at night won’t deter them from biting. They are most active between 2 and 5am. ---PAGE BREAK--- ---PAGE BREAK--- Bed bugs have piercing-sucking mouth parts. Penetrate skin with beak and inject an anesthetic. 14 ---PAGE BREAK--- 1. hungry 2. Feeding 3. Full In 10 Minutes! Flattened from top to bottom Their bodies expand like an accordion. ---PAGE BREAK--- Bed Bug Bites Don’t burrow under skin like ticks. Professionals cannot identify bed bug infestations by the bites alone. Can bed bug bites be identified by professionals because they often show up in sets of three in a row:“breakfast, lunch, and dinner”? 16 ---PAGE BREAK--- Do bed bugs transmit diseases? There are no cases that indicate bed bugs pass diseases from one host to another. However, Itchy bites and Inflammation Secondary skin infections Anemia Stress Sleeplessness Agitation Anxiety Are common of bed bug infestations. ---PAGE BREAK--- Varying “sensitivity” to bites. (Itching, welts, rashes, secondary infection) 5 Reaction types: › no reaction; › delayed reaction; › both immediate & delayed; › immediate reaction only; › True hypersensitivity. ---PAGE BREAK--- Scabies is a condition where mites burrow into the skin resulting in lesions and open sores. 19 ---PAGE BREAK--- Fleas Chiggers Bird mites Rodent mites 20 Chiggers above Fleas right ---PAGE BREAK--- Signs of Bed Bugs Confirm bed bug Identification Dark and rusty colored droppings. Shed skins. Blood stains from crushed bugs. Eggs and casings. Voided material - leaving tell-tale blood spots. Live bed bugs. An offensive, sweet, musty odor. 21 ---PAGE BREAK--- Inspect and Assess The best way to get rid of bed bugs is to clean, disinfect and eliminate their hiding spaces. Inspect and assess the extent of the infestation to determine preparation needs and steps. ---PAGE BREAK--- Magnifying glass Strong flashlight Plastic zip-bags or scotch tape A probe Tweezers Screwdrivers Small tool kit Cleaning wipes Alcohol and Cotton swabs Mirror ---PAGE BREAK--- 24 ---PAGE BREAK--- Mattress Inspection Top and bottom seams Along the piping, Under mattress handles, Along air holes, Under buttons, handles, Around and under label, Between mattress and box spring platform or frame. ---PAGE BREAK--- 26 Remove the thin cloth layer under box springs. Use a flashlight, a hand Check the spaces between box spring frame parts. Look around staples and tacks. ---PAGE BREAK--- 27 Turn the frame over and inspect from the underside. Check screw and nail holes for bed bugs. Take the bed apart to check between parts. ---PAGE BREAK--- Empty drawers and shelves. Inspect drawer corners, Inspect the underside. Inspect all screw and nail holes. ---PAGE BREAK--- 29 Turn over the furniture and remove the thin cloth backing. Examine where material is stapled to the frame. Check all wood parts. Inspect all pillows and cushions. If the piece is highly infested, disposing of it properly. ---PAGE BREAK--- Television and other remote controls. Telephones, cell and cordless phones. Lamps and alarm clock. Computers and other electronics. ---PAGE BREAK--- Children’s toys and stuffed animals Brick walls and “popcorn” or other textured ceilings Books, magazines, newspapers and files Ceiling light fixtures, smoke detectors Heating units, air conditioners and ducts ---PAGE BREAK--- 20 bed bugs were found here ! Unusual Harborages 32 ---PAGE BREAK--- ---PAGE BREAK--- 34 ---PAGE BREAK--- The easiest bed bug control method. Bag items. Keep the ‘infested’ items separate from the clean items. Wash on the highest heat that the fabric can stand for 60 minutes. Either use dissolvable bags or seal and throw away the used plastic bags. 35 Source: M. Anderson, EPA R2 ---PAGE BREAK--- DRYERS The heat in a clothes dryer is extremely effective at killing bed bugs and eggs. Clothes dryers are accessible to almost everyone. Clothing, linens and other items that cannot be washed - dry on high heat for 20-30 minutes. 36 Source: M. Anderson, EPA R2 ---PAGE BREAK--- Vacuum daily Steam clean floors regularly. A HEPA-type vacuum is preferred. Vacuum curtains, walls, closets, and upholstered furniture. Vacuum talcum powder to inhibit bugs from crawling out of vacuum bag. Properly dispose of filter / bags. (seal in plastic bag) Vacuuming is an effective control method. ---PAGE BREAK--- Use silicon caulk to seal. Create a perimeter barrier. Target walls that are shared with other homes. Plates covering wall openings should be sealed. ---PAGE BREAK--- Use encasements on both mattress and box springs! Encasements trap bed bugs and eggs. They are escape proof. Encasements make inspection easier. Must be kept on for at least one year. They eliminate the need to apply pesticides on bedding. Encasements also limit exposure to dust mites. ---PAGE BREAK--- Designed to trap bed bugs when placed under furniture legs. Furniture must be away from the wall. Used as a complement to other methods. Most effective with a little talcum powder on the bottom of tray. ---PAGE BREAK--- M Isolated the bed by pulling it away from walls and other furniture. Put mattress and box spring into encasements. Keep bedding from touching the floor. Put each bed leg in an interceptor. ---PAGE BREAK--- 44 ---PAGE BREAK--- Steam kills bed bugs and eggs. A short period of heat exposure can kill all stages of bed bugs instantly. Time consuming. A rate of 20 seconds per linear foot. *The steamer should not “blow” air forcefully or it may cause bed bugs to scatter. Steam temperature must be 160o F or greater. *Do not apply steam to electrical outlets (not a DIY!). Steam Kills Bed Bugs! ---PAGE BREAK--- Use fans and a heat source to heat a space to 135°F to 140°F Hold temperature for 3 hours to heat all areas over 120°F. These treatments are best for cases where the resident is unable to prepare the unit. Ambient Heat can provide complete control. Contact your pest professional. 46 an entire structure, part of a structure, a single room, a box truck, a storage area. ---PAGE BREAK--- Increasing heat in the infested area by boosting thermostat… › Cannot achieve high heat through all items and behind walls. Putting Items in black plastic bags and leaving them in the sun or in a hot car… › May work on small items, such as shoes, or a few books, however bed bugs need to be exposed to temperatures above 120°F for an extended period of time to be killed. Using home propane space heaters or fireplace… › May cause fires. 47 ---PAGE BREAK--- Liquid CO2 is an effective method of killing bed bugs and eggs. Cryonite systems shoot dry ice flakes into bed bug harborages. Extreme low temperatures (-98oF) will kill bed bugs and eggs on contact. CO2 can be applied to most surfaces, including toys and books. Usually costly. Freezing Kills Bed Bugs! ---PAGE BREAK--- mattresses box springs furniture clothes shoes curtains and drapes books stuffed animals only severely infested items 49 ---PAGE BREAK--- Don’t Panic! Have a bed bug action plan. Educate your staff and clients. Assess the situation. Think through your treatment options. The best way to get rid of bed bugs is to clean, disinfect and eliminate their hiding places. Do not immediately reach for the spray can. Turn to professionals if needed. 50 ---PAGE BREAK--- Provide verbal and physical informational on bed bugs to clients. Inform clients they need to report any bed bug sightings to a facility employee immediately. Increase bed bug awareness in the facility with posters. Instruct about the importance of using a dryer to treat the client’s belonging. 52 ---PAGE BREAK--- a) SCREAM! b) call custodial staff and management c) inspect the surrounding area d) close the facility for the rest of the day e) call a Pest Control Company f) capture it for proper identification g) kill it and forget it, because it is only one What are the first things you should do if you think you see a bed bug? ---PAGE BREAK--- Do you visit places that you know or suspect have bed bugs: Have dedicated set of clothes (or pants) for working in the field. Have a change of clothes in a zip bag. Wear simple clothing when visiting a client’s. ---PAGE BREAK--- Jackets › Keep your jacket in your vehicle . › Never place it on the back of a chair. › Have a dedicated large plastic bag for your jacket when you leave the location. Shoes › Have a dedicated pair of work shoes. › Wear shoes that can be treated in a hot dryer. › Have minimal tread on shoes. 56 ---PAGE BREAK--- If you suspect Bed Bugs in a location you are working in: Ask whether a room or space has bed bugs. Do not bring personal items into the facility. Keep personal items in your vehicle. Try using a fanny pack. Inspect your work space. Use insect repellant. If you find a bed bug capture it for proper ID. 57 ---PAGE BREAK--- At the end of the day: Place all outer clothes in a plastic bag. Seal tight. Inspect clothing and bottom of shoes before entering your vehicle. Place work shoes in a sealable bag. Do not re- open until ready to treat. When at home: Wash and/or dry clothes on highest setting for 30 minutes. Discard all plastic bags used for bed bug prevention. Vacuum/ wipe down any equipment from an infested site. ---PAGE BREAK--- Transporting or removing a person from a bed bug infested location: Use drum liners to bag clothes and personal items. Wrap the infested wheel chair, in drum liners. Use drum liners as seat covers during transport. Or use Tyvec ® coveralls and booties. 59 ---PAGE BREAK--- Common Bed Bug Myth Proper use of pesticides may be one component of a bed bug control strategy, but may not eliminate bed bugs alone. Bed bugs have developed resistance to many kinds of pesticides. Pesticide applications alone will easily eliminate bed bug infestations. Bed bug control can only be maintained through a comprehensive Integrated Pest Management (IPM) treatment strategy that incorporates a variety of techniques and vigilant monitoring. ---PAGE BREAK--- A multifaceted control approach that combines: Knowledge Education Sanitation Maintenance Creating barriers Monitoring Careful inspection Non-chemical treatments Pesticides, if needed 61 ---PAGE BREAK--- a) Controlling pests with pesticides first. b) Controlling pests with only pesticides. c) Controlling pests with no pesticides. d) Using a combination of non-chemical strategies such as maintenance, sanitation, barriers, monitoring, non-chemical controls, followed by pesticides, if other methods are not as effective as desired. 62 Source: M. Anderson, EPA R2 ---PAGE BREAK--- The majority of available spray pesticide products (including pyrethroid based sprays) may not prove as effective as customers would like. EACH INFESTATION IS DIFFERENT! Assess each case separately and determine which method would be best in a particular location. Treatment decisions should be based on: › the degree of infestation, › vulnerability of population, and › ability of residents to complete pre-treatment procedures. ---PAGE BREAK--- Common Bed Bug Pesticides What chemical pesticides are most effective in treating bed bugs? a) boric acid b) bug bombs c) insect repellants d) pyrethroid sprays e) pesticide impregnated items f) diatomaceous earth g) pyrethroid and other dust mixtures ---PAGE BREAK--- When tested at Virginia Tech, bed bugs were not repelled by most insecticides, including the pyrethroids. These test results also indicated that bed bugs would not be repelled by pesticide treated mattress fabric. Field use of DEET by Rutgers Univ., when sprayed on pants legs and shoes, has shown notable effectiveness against bed bugs. 65 COMMON BED BUG ---PAGE BREAK--- Bug Bombs Bug bombs or foggers may act as dispersants, initiating bed bugs to scatter into adjacent rooms or units. Bug bombs may also be hazardous to your health and the health of others if directions are not followed precisely. Setting off multiple bombs or foggers does not equal added efficacy. They are highly volatile and have caused fires. ---PAGE BREAK--- DE is a natural, white, powdery substance that kills insects. When used properly, bed bugs crawl through DE. It can take up to 2 weeks to kill bed bugs; (useless if wet). Only use DE labeled for insects, and follow label instructions carefully. Apply DE to cracks & crevices in walls & behind wall plates. DE does kill chemical-resistant bed bugs, but it can’t be applied as widely as other products. 67 ---PAGE BREAK--- Many insecticides are ineffective in killing bed bugs because they have no means of being ingested. Always check the product label. ---PAGE BREAK--- Call several companies. Insist on references for bed bug treatment. Check the references. Do they offer an Integrated Pest Management solution to the problem? Do they perform a pre-treatment inspection and give a pre-treatment check-list? Do they offer both chemical and non-chemical treatment options? Do they recommend encasements and interceptors. Do they use only pesticides recommended for bed bugs? Are they licensed and insured? 69 ---PAGE BREAK--- 72 By M. Anderson, [EMAIL REDACTED] EPA R2 PTSB - Pesticides For more information go to: www.epa.gov/bedbugs