Bed bug bites

1. The common bed bug is now a major problem related to international travel.
2. It travels in baggage and is widely distributed in hotels, motels and backpacker accommodation. 
3. Bed bugs are most commonly
   • found on mattresses, particularly along the stitched edges where there are folds that help to conceal them.
   • They are also found:
     • on bed frames
     • in bed side furniture
     • in picture frames
     • behind wall paper
     • in cracks and crevices or other areas of a room that will provide them with protection, such as carpet edges, behind skirting boards or between wooden floor boards.

presentation

1. linear group of three or more bites (along the line of superficial blood vessels)
2. extremely itchy
3. maculopapular red lesions with possible wheals.
   • red wheals may range from 2 cm to 5 cm in width with inflammation common.
4. Anaphylactic shock could possibly occur in individuals that are highly allergic, although this is very rare.
5. commonly found on the neck, shoulders, arms, torso and legs. 
6. A bed bug infestation can be diagnosed by identification of rust-coloured specimens collected from the infested residence. 

MANAGEMENT

• Treatment is not generally required. 
• However, various treatments may relieve the symptoms of bed bug bites:
  • Itchy lesions can be treated with topical steroids and/or oral antihistamines.
  • Secondary infection should be treated with antibiotics.
  • Systemic reactions to bed bug bites are treated with 
    • antihistamines
    • corticosteroids,
    • intramuscular adrenaline.

Eradication of bed bugs

1. Call in a licensed pest controller.
   • Control treatment is basically directed towards applying insecticides to the crevices in walls and furniture
2. Heat
   • The rapid increase of temperature is an excellent way of killing bed bugs in bedding and sheets.
   • Bed bugs will die within one hour when exposed to temperatures over 45°C, or immediately at temperatures of 60°C or higher.
   • Washing in water above 60ºC (to ensure every bug stage will be killed) and drying infested linen in a dryer is an effective method of killing bed bugs.
   • It is recommended that clothes be placed on the hot setting and dried for at least 30 minutes.
3. Cold
   • Rapid freezing can be fatal to bed bugs. Placing smaller items in the freezer overnight is an effective control method. It is suggested to leave items in freezer for 10 hours per 2.5 kg of dry linen weight.

Prevention

1. Check second-hand furniture before purchase. Avoid buying a second-hand mattress.
2. Wash second-hand bedding and clothing in hot water before use.
3. If travelling, check every hotel room for bed bugs. Keep your bags off the floor. When you get home, hotwash your clothes, and thoroughly vacuum your bags. Seal the vacuum bag before destruction.