A resurgence in bedbugs is a result of increased travel and insecticide resistance
Many bedbug populations are resistant to pyrethroid, a chemical contained in most currently used insecticides.1 Bedbugs multiply exponentially, with thousands of bugs per infestation after 2–3 months.2
Bites can be difficult to identify
Bedbugs feed at night, primarily on areas not covered by clothing. Itchy, erythematous maculopapular lesions, 2–5 mm in diameter, usually appear within 24–48 hours.1,2 Less common presentations are wheals, linear lesions, bullae and vesicles.1,2 Bedbugs live in crevices of furniture and mattresses and are difficult to spot (Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.221454/tab-related-content).2 Many people do not know their home is infested. Some people, particularly older adults, may not develop any skin reaction to bites.1
Symptom management is important until the infestation is eradicated1,2
Antihistamines and topical steroids may help pruritus. Psychological effects, including anxiety, insomnia, social isolation and stigma, are common.1–3 Lesions resolve within 1–2 weeks after eradication.1,2
Eradication requires a combination of chemical and mechanical methods1–3
Patients should be given information on physical control of bedbugs, including vacuuming, steaming, freezing, washing and drying of clothing and bedding, as well as bagging belongings.4 Despite resistance, insecticides can reduce bedbug biomass.2 Desiccant dusts dehydrate bugs and can be part of a bedbug control strategy.1,2,4 Older adults and people with disabilities often require practical support for successful eradication.3
Simple precautions and use of personal protective equipment can reduce the risk of picking up bedbugs5
Bedbugs do not fly or jump and have to hitch a ride to travel. Tips for visiting infested dwellings include wearing disposable shoe covers and clothing that can be put in a hot dryer, carrying minimal belongings, hanging bags and coats up high or in sealable plastic containers or bags, and bringing a stool or sitting only on hard chairs without cushions.5
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Supplementary Material
See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.230526
Footnotes
Competing interests: None declared.
This article has been peer reviewed.
References
- 1.Doggett SL, Dwyer DE, Peñas PF, et al. Bed bugs: clinical relevance and control options. Clin Microbiol Rev 2012;25:164–92. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Parola P, Izri A. Bedbugs. N Engl J Med 2020;382:2230–7. [DOI] [PubMed] [Google Scholar]
- 3.Sheppard CL, Roche B, Austen A, et al. “When the bedbugs come, that’s another problem”: exploring the lived experiences of bedbug infestations among low-income older adults and service providers who support them. Perspect Public Health 2022. Sep 20;17579139221118777. doi: 10.1177/17579139221118777. [Epub ahead of print]. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Bedbugs: How do I get rid of them? Ottawa: Government of Canada; 2015. Available: https://www.canada.ca/en/health-canada/services/pest-control-tips/bedbugs-how-do-i-get-rid-them.html (accessed 2022 Nov. 12). [Google Scholar]
- 5.Bed bugs: have bite, will travel. Ottawa: Government of Canada — Canadian Centre for Occupational Health and Safety. Health and Safety Report; [updated 2022 Nov. 4]. Available: https://www.ccohs.ca/newsletters/hsreport/issues/2011/11/ezine.html#hsreport-inthenews (accessed 2022 Nov. 12). [Google Scholar]
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