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!!!!!
3Cimex Lectularius
4Side View
5How 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
6Bedbug Nymph
7Relative Size of a Bed Bug
8Burnt Orange Specimen
9Mattress Binding with Cast Skins
10Bedbug Colony
11Are 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
12Bed Bug Bites
13Typical Presentation
14Raised Bumps and Welts
15Inflamed Foot
16Subtle Allergic Reactions
17Lower Leg, Ankle and Foot
18More Severe Reaction
19Infected Lesions in Trunk Area
20Raised Welts
21Scalp Lesions
22Severe Reaction and Infection
23Bed 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
24Bedbug Eggs
25Bed Bug Life Cycle
26Eggs Shells and Fecal Matter
27Bed Bug Nymph
There are five instars or molts
28Exuvium or Cast Skin
29 Females mate up to five times after a blood
meal.
Adult female
Adult male
30Modes 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
31Can Travel in Luggage
32Used Bedding is a BargainNOT!!!!!
33Fecal Material on Used Mattress
34Signs 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
35During feeding, the adult expands with engorged
blood and leaves behind a small fecal droplet.
Feeding
Fecal Droplet
36Bed 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
37Bed 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.
38Bed 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
39Recommendations 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.
40Recommendations 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.
41What 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
42Engage 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
43HUD 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
44ADDRESSING 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
45Strategies 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
46STERIFAB
47MPE Protective Apparel1-888-688-2046
48More Products From Millers Precision Enterprises
Boots
Hood
49Good Night Spray
50Microfiber and Plastic Mattress and Box Spring
Covers
51More 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
52Helping 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!!!!
53Acknowledgements
- 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
54Good Night, Sleep Tight