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BEDBUGS

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BEDBUGS. NOT JUST IN NURSERY RHYMES. ANYMORE!!!! Nancy Boggs, RN, BSN, MA, LNHA ... Came to North America in the 1700's from Europe ... – PowerPoint PPT presentation

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Title: BEDBUGS


1
  • BEDBUGS
  • NOT JUST IN NURSERY RHYMES
  • ANYMORE!!!!

Nancy Boggs, RN, BSN, MA, LNHA Off-Site
Supervisor TriHealth SeniorLink
2
A FEW BEDBUG FACTS
  • Official name is Cimex Lextularius
  • Small, wingless insect AKA Red Coats,
    Chinches, or Mahogany Flats
  • Came to North America in the 1700s from Europe
  • Feed solely on the blood of warm-blooded animals
    preferably humans.
  • Were very common in the United States before
    WWII.
  • Largely eradicated in the 1940s and 1950s
    through the use of DDT
  • Resurgence worldwide--especially in North
    America, Europe and Australia
  • According to the CDC are not known to cause
    serious illness
  • Very difficult and expensive to eradicate!!!!!

3
Cimex Lectularius
4
Side View
5
How Can I Identify a Bed Bug
  • Hatchlings are size of poppy seeds
  • Adults are about ¼ inch long, oval, flat
  • Light tan to deep brown or burnt orange
  • Cast skins of bed bugs are often present
  • Do not fly but actively seek shelter when
    disturbed

6
Bedbug Nymph
7
Relative Size of a Bed Bug
8
Burnt Orange Specimen
9
Mattress Binding with Cast Skins
10
Bedbug Colony
11
Are Bed Bugs Harmful?
  • Seek out people and animals at night
  • Painlessly sip blood and inject tiny amount of
    saliva
  • Sensitivity to the saliva over time causes
    allergic reactions (bites)
  • Itching and irritation can lead to secondary
    infections which can be serious
  • Hard to distinguish from other insect bites
    without knowledge of persons home environment
  • Often treated with antihistamines and
    corticosteroids
  • Do not transmit any infectious agents

12
Bed Bug Bites
13
Typical Presentation
14
Raised Bumps and Welts
15
Inflamed Foot
16
Subtle Allergic Reactions
17
Lower Leg, Ankle and Foot
18
More Severe Reaction
19
Infected Lesions in Trunk Area
20
Raised Welts
21
Scalp Lesions
22
Severe Reaction and Infection
23
Bed Bug Life Cycle
  • Females lay 1-12 eggs per day
  • Eggs coated with sticky glue that helps them
    lodge on rough surfaces or cracks and crevices
  • Eggs hatch in 6-17 days as nymphs
  • Nymphs have different stages each requiring a
    blood meal
  • Reach adulthood in 5 weeks to 4 months
  • Can live from 12-18 months with over 3
    generations per year

24
Bedbug Eggs
25
Bed Bug Life Cycle
26
Eggs Shells and Fecal Matter
27
Bed Bug Nymph
There are five instars or molts
28
Exuvium or Cast Skin
29
Females mate up to five times after a blood
meal.
Adult female
Adult male
30
Modes of Travel
  • Usually brought in to the home on luggage,
    clothing or used furniture
  • Hotels, motels and apartments are high risk
    places to encounter bed bugs
  • Once introduced spread from room to
    roomapartment to apartment
  • Often hide in upholstered furniture in public
    places
  • Can ride in the crevices of pant cuffs, seams and
    hems

31
Can Travel in Luggage
32
Used Bedding is a BargainNOT!!!!!
33
Fecal Material on Used Mattress
34
Signs of Bed Bug Activity
  • Dark spotting and staining on mattresses and box
    springs
  • May see eggs and eggshells, molted skins of aging
    nymphs and the bugs themselves
  • May notice a sweetish smell in heavily infested
    areas
  • Hide during the day but can be found in
    mattresses, box spring frames, behind head boards
    and picture frames
  • Can crawl in and out of cracks in the wall and
    electrical outlets
  • May crawl up drapery and can be seen at crawling
    on walls in heavy infested areas.
  • Like to hide in cluttered rooms and closets

35
During feeding, the adult expands with engorged
blood and leaves behind a small fecal droplet.
Feeding
Fecal Droplet
36
Bed Bug Treatment
  • Use the services of a reputable professional
    exterminator and follow his or her
    recommendations explicitly
  • Follow all instructions given by the exterminator
    about preparation before and cleanup after
  • Vacuum thoroughly before and after each
    professional treatment with a bag-vacuum cleaner
    and discard bag outside of home
  • Remove clutter from the environment before
    treatment and discard any non-essential items
  • Discard heavily infested bedding and upholstered
    furniture wrap in plastic before removal
  • Treat items to be returned to the home using
    Sterifab or by laundering in hot water

37
Bed Bug Treatment Continued
  • Steam treat items with a high pressure steamer if
    not appropriate to launder or spray with
    Sterifab.
  • Wash and dry all clothing and linens in hot water
  • Keep all laundered linen and clothing in sealed
    plastic until infestation is completely cleared
    this could take up to six months
  • Be vigilant in checking home at least weekly,
    even after no further bed bug activity is noted.
  • Cover bedding in zippered mattress covers
    plastic or finely woven fabric rated for bed bugs
    and dust mites.
  • Put dry clean only clothing in dryer on high
    for 10 to 20 minutes.
  • Seal cracks and crevices in home.

38
Bed Bug Prevention
  • Reduce clutter around the house
  • Seal cracks and crevices
  • Check all secondhand beds, bedding, furniture and
    clothing
  • Examine the bed and headboard area when traveling
    (Pull back the sheets and mattress cover!!!)
  • Keep your luggage off of the floor
  • Wash, dry or freeze second hand clothing right
    awayeven if it comes from someone you think you
    know!!
  • Educate your teen-age and college-age children on
    what to look for.
  • Consider using air mattresses if residing in a
    high risk environment

39
Recommendations for Workers
  • Wear light colored, washable clothing if you work
    in healthcare or in frequent direct contact with
    the public.
  • Wash your clothing after one wearing or spray
    with Sterifab
  • Spray your shoes and lower legs with Off or
    other insect repellant with a high DEET content
    whenever you are working in a high risk
    environment.
  • Carry a portable stool if your work involves
    visiting people at home.
  • Avoid put your purse, brief case or tool bag on
    the floor
  • Consider removing your clothes in the garage (or
    inside the front door) and bagging them before
    entering your home if you work in a high risk
    environment.

40
Recommendations for Supervisors
  • Require staff to wear protective disposable
    clothing when working in an environment that is
    known to be actively infested
  • Consider installing automatic insecticide
    dispensers in your workplaceespecially in coat
    rooms, high traffic areaseven commercial
    vehicles
  • Consider using the services of a professional
    exterminator on a monthly or even weekly basis in
    your work place if you serve high risk
    populations.

41
What do we do nowwe got em at work!!!!!!
  • Do not panic!!!!!
  • Involve everyone in developing a plan
  • Educate! Educate! Educate!
  • Be up front with your patients, customers or
    clients
  • Work with management to provide information and
    support to employees
  • Train staff in preventive practices and demand
    complianceprovide updates
  • Educate patients, families, caregivers and
    providers

42
Engage Community Resources
  • Work with landlordseducate
  • Stay abreast of resources available through local
    government
  • Contact the Health Department with complaints and
    concerns
  • Contact HUD oversight agencies when dealing with
    public housing issues
  • Understand applicable housing regulations

43
HUD LOCAL OFFICE
  • Cincinnati
  • 15 East 7th StreetCincinnati, OH 45202-3188
  • Phone (513) 684-3451Fax (513) 684-6224TTY
    (513) 684-6180 Jurisdiction Thirteen counties
    in Southwestern Ohio  James A. Cunningham,
    Field Office DirectorContact the Director's
    Office  Office Hours 800 a.m. to 430
    p.m.Monday through Friday

44
ADDRESSING THE PROBLEM
  • Acknowledge the reality as first cases appear
  • Recognize stages of staff emotion disbelief,
    denial, panic, fear, anger, fragmentation of team
    members
  • Rally the troops let them know Weve got to get
    our act together because these little critters
    are not going away.
  • Develop a bed bug policy
  • Organize a swat team
  • Form a bedbug committee to manage the problem
    and refine strategies

45
Strategies That Really Work
  • Educating and reeducating every single employee
  • Finding effective products
  • Sterifab
  • Protective Clothing
  • Automatic aerosol dispensers
  • Portable stools
  • GoodNight Spray
  • Zippered Mattress Covers
  • Developing a relationship with a quality
    exterminatorlearning how to work with other
    exterminators

46
STERIFAB
47
MPE Protective Apparel1-888-688-2046
48
More Products From Millers Precision Enterprises
Boots
Hood
49
Good Night Spray
50
Microfiber and Plastic Mattress and Box Spring
Covers
51
More Strategies That Really Work
  • Keeping corporate leadership informed and
    enlisting their support
  • Partnering with landlords and Public Housing
    Agencies
  • Using oversight agencies when landlords are slow
    to respond
  • Finding alternative short-term and permanent
    housing for our participants
  • Educating our contracted providers
  • Developing and refining additional tools
  • Comprehensive bedbug policy
  • Standard service plan
  • Participant and family contracts
  • In-service materials

52
Helping Participants
  • Understanding the stigma historically connected
    with bedbugs
  • Remembering that patient care still comes first
  • Treating everyone with dignity and sensitivity
  • Tolerating the idea that not everyone considers
    bedbugs a big deal
  • Knowing that no one-size treatment fits all
  • Accepting that these critters are here to
    staydeal with it and move on!!!!

53
Acknowledgements
  • Harvard School of Public Health Website
    WWW.hsph.harvard.edu/bedbugs
  • County of San Diego Department of Environmental
    Health Website www.co.san-diego.ca.us/deh/chd/vect
    or/vbedbugs
  • Tammy Berkel, Owner, Valley Pest Control
  • Mary Rohs, OTR/L, M.Ed., LNHA, SeniorLink Service
    Operations Manager
  • Dora Winters, Lead Health Care Tech
  • Stephen L. Doggett, Department of Medical
    Entomology, University of Sydney

54
Good Night, Sleep Tight
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