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Bedbugs

Authors
Dirk M Elston, MD
Stephen Kells, PhD
Section Editors
Robert P Dellavalle, MD, PhD, MSPH
Ted Rosen, MD
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

Bedbugs are obligate blood-feeding insects that may infest human dwellings and may induce local skin reactions in humans (picture 1A-E). The management of bedbug infestations consists of measures to eradicate bedbugs to prevent future bites.

A bedbug bite most often appears as a small punctum without a surrounding inflammatory reaction; however, some individuals develop pruritic, inflammatory local skin reactions. Asymptomatic bedbug bites do not require treatment. Topical corticosteroids or oral antihistamines can improve pruritus when needed.

The clinical features, diagnosis, and management of bedbug infestations will be reviewed here.

TAXONOMY

Bedbugs (also written "bed bugs") are true bugs of the order Hemiptera. All insects within this order have wings that are half membranous and half sclerotic. In bedbugs, the membranous portion of the wing is vestigial, and only the non-functional sclerotic portion of the wing is visible.

Bedbugs belong to the family Cimicidae. Cimicids commonly infest human, bird, and bat habitats. As parasites, Cimicids are unique because they are obligate blood feeders but do not remain on the host to complete their life cycle. Rather, they move to adjacent areas and hide in the surrounding habitat. Cimex lectularius and C. hemipterus are the two bedbug species that most commonly affect humans.

                    

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Literature review current through: Nov 2016. | This topic last updated: Wed Aug 05 00:00:00 GMT+00:00 2015.
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References
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  1. Liebold K, Schliemann-Willers S, Wollina U. Disseminated bullous eruption with systemic reaction caused by Cimex lectularius. J Eur Acad Dermatol Venereol 2003; 17:461.
  2. Walpole DE, Newberry K. A field study of mating between two species of bedbug in northern KwaZulu, South Africa. Med Vet Entomol 1988; 2:293.
  3. Newberry K. Production of a hybrid between the bedbugs Cimex hemipterus and Cimex lectularius. Med Vet Entomol 1988; 2:297.
  4. http://www.cdc.gov/parasites/bedbugs/biology.html (Accessed on November 05, 2014).
  5. Goddard J, deShazo R. Bed bugs (Cimex lectularius) and clinical consequences of their bites. JAMA 2009; 301:1358.
  6. Saenz VL, Santangelo RG, Vargo EL, Schal C. Group living accelerates bed bug (Hemiptera: Cimicidae) development. J Med Entomol 2014; 51:293.
  7. Kells SA. Bed bugs: a systemic pest within society. Am Entomol 2006; 52:107.
  8. Gbakima AA, Terry BC, Kanja F, et al. High prevalence of bedbugs Cimex hemipterus and Cimex lectularis in camps for internally displaced persons in Freetown, Sierra Leone: a pilot humanitarian investigation. West Afr J Med 2002; 21:268.
  9. Thomas I, Kihiczak GG, Schwartz RA. Bedbug bites: a review. Int J Dermatol 2004; 43:430.
  10. Olson JF, Eaton M, Kells SA, et al. Cold tolerance of bed bugs and practical recommendations for control. J Econ Entomol 2013; 106:2433.
  11. Jupp PG, McElligott SE, Lecatsas G. The mechanical transmission of hepatitis B virus by the common bedbug (Cimex lectularius L.) in South Africa. S Afr Med J 1983; 63:77.
  12. Jupp PG, McElligott SE. Transmission experiments with hepatitis B surface antigen and the common bedbug (Cimex lectularius L). S Afr Med J 1979; 56:54.
  13. Ogston CW, Wittenstein FS, London WT, Millman I. Persistence of hepatitis B surface antigen in the bedbug Cimex hemipterus (Fabr.). J Infect Dis 1979; 140:411.
  14. Silverman AL, Qu LH, Blow J, et al. Assessment of hepatitis B virus DNA and hepatitis C virus RNA in the common bedbug (Cimex lectularius L.) and kissing bug (Rodnius prolixus). Am J Gastroenterol 2001; 96:2194.
  15. Vall Mayans M, Hall AJ, Inskip HM, et al. Do bedbugs transmit hepatitis B? Lancet 1994; 343:761.
  16. Jörg ME. [Cimex lectularius L. (the common bedbug), the vector of Trypanosoma cruzi]. Rev Soc Bras Med Trop 1992; 25:277.
  17. Salazar R, Castillo-Neyra R, Tustin AW, et al. Bed bugs (Cimex lectularius) as vectors of Trypanosoma cruzi. Am J Trop Med Hyg 2015; 92:331.
  18. Webb PA, Happ CM, Maupin GO, et al. Potential for insect transmission of HIV: experimental exposure of Cimex hemipterus and Toxorhynchites amboinensis to human immunodeficiency virus. J Infect Dis 1989; 160:970.
  19. Jupp PG, Lyons SF. Experimental assessment of bedbugs (Cimex lectularius and Cimex hemipterus) and mosquitoes (Aedes aegypti formosus) as vectors of human immunodeficiency virus. AIDS 1987; 1:171.
  20. Lowe CF, Romney MG. Bedbugs as vectors for drug-resistant bacteria. Emerg Infect Dis 2011; 17:1132.
  21. Barbarin AM, Hu B, Nachamkin I, Levy MZ. Colonization of Cimex lectularius with methicillin-resistant Staphylococcus aureus. Environ Microbiol 2014; 16:1222.
  22. Brouqui P, Raoult D. Arthropod-borne diseases in homeless. Ann N Y Acad Sci 2006; 1078:223.
  23. Potter MF, Haynes KF, Connelly K, et al. The sensitivity spectrum: Human reactions to bed bug bites. Pest Control Technology 2010; 38:71.
  24. Sansom JE, Reynolds NJ, Peachey RD. Delayed reaction to bed bug bites. Arch Dermatol 1992; 128:272.
  25. Cleary CJ, Buchanan D. Diagnosis and management of bedbugs: an emerging U.S. Infestation. Nurse Pract 2004; 29:46.
  26. Fletcher CL, Ardern-Jones MR, Hay RJ. Widespread bullous eruption due to multiple bed bug bites. Clin Exp Dermatol 2002; 27:74.
  27. deShazo RD, Feldlaufer MF, Mihm MC Jr, Goddard J. Bullous reactions to bedbug bites reflect cutaneous vasculitis. Am J Med 2012; 125:688.
  28. Scarupa MD, Economides A. Bedbug bites masquerading as urticaria. J Allergy Clin Immunol 2006; 117:1508.
  29. Abdel-Naser MB, Lotfy RA, Al-Sherbiny MM, Sayed Ali NM. Patients with papular urticaria have IgG antibodies to bedbug (Cimex lectularius) antigens. Parasitol Res 2006; 98:550.
  30. Abou Gamra EM, el Shayed FA, Morsy TA, et al. The relation between Cimex lectularius antigen and bronchial asthma in Egypt. J Egypt Soc Parasitol 1991; 21:735.
  31. Paulke-Korinek M, Széll M, Laferl H, et al. Bed bugs can cause severe anaemia in adults. Parasitol Res 2012; 110:2577.
  32. PARSONS DJ. Bedbug bite anaphylaxis misinterpreted as coronary occlusion. Ohio State Med J 1955; 51:669.
  33. Weedon D. Arthropod-induced diseases. In: Weedon's Skin Pathology, 3rd ed, Elsevier Limited, 2010. p.651.
  34. Tharakaram S. Bullous eruption due to Cimex lecticularis. Clin Exp Dermatol 1999; 24:241.
  35. Vaidyanathan R, Feldlaufer MF. Bed bug detection: current technologies and future directions. Am J Trop Med Hyg 2013; 88:619.
  36. Hinkle NC. Ekbom syndrome: a delusional condition of "bugs in the skin". Curr Psychiatry Rep 2011; 13:178.
  37. www.nytimes.com/2005/11/27/nyregion/27bugs.html (Accessed on February 05, 2008).
  38. Centers for Disease Control and Prevention (CDC). Acute illnesses associated with insecticides used to control bed bugs--seven states, 2003--2010. MMWR Morb Mortal Wkly Rep 2011; 60:1269.
  39. Kells SA, Goblirsch MJ. Temperature and Time Requirements for Controlling Bed Bugs (Cimex lectularius) under Commercial Heat Treatment Conditions. Insects 2011; 2:412.
  40. Fletcher MG, Axtell RC. Susceptibility of the bedbug, Cimex lectularius, to selected insecticides and various treated surfaces. Med Vet Entomol 1993; 7:69.
  41. Le Sueur D, Sharp BL, Fraser C, Ngxongo SM. Assessment of the residual efficacy of lambda-cyhalothrin. 1. A laboratory study using Anopheles arabiensis and Cimex lectularius (Hemiptera: Cimicidae) on treated daub wall substrates from Natal, South Africa. J Am Mosq Control Assoc 1993; 9:408.
  42. Gao YT, Shen PY, Wang BH, et al. Controlled release effect of insecticide microcapsules and their results in common household insect pest control. J Microencapsul 1984; 1:307.
  43. Kumar S, Prakash S, Rao KM. Comparative activity of three repellents against bedbugs Cimex hemipterus (Fabr.). Indian J Med Res 1995; 102:20.