Bedbugs

Bed Bug Infestation: An Updated Review

In the past decade, there has been a global resurgence of bed bug infestations, especially in developed countries. Proper awareness and identification of bed bug infestations are essential to guide treatment and eradication. The purpose of this article is to familiarize physicians with bed bug bites so that they can effectively diagnose, treat, and address questions about bed bug bites and infestations. Bed bug bites are often painless. Typical reactions include pruritic, erythematous maculopapules occurring in clusters or in a linear or curvilinear distribution in exposed areas of the body. A small red punctum may be visualized at the center of the bite mark. Lesions that appear three in a row and papules on the upper eyelid associated with erythema and edema are highly suggestive of bites from bed bugs. Exaggerated local reactions such as vesicles, urticarial wheals, urticarial perilesional plaques, diffuse urticaria, bullae, and nodules may occur in previously sensitized individuals. Reactions to bed bug bites are self-limited. As such, treatment is mainly symptomatic. Topical pramoxine and oral antihistamines can be used to alleviate pruritus. Topical corticosteroids can be used for significant eruptions to control inflammation and pruritus, and to hasten resolution of the lesions. Integrated pest management, an approach for the eradication of bed bugs, includes monitoring devices (active monitors include the use of heat or carbon dioxide attractants and passive monitors include the use of sticky pads for trapping), and judicious use of nonchemical and chemical treatments known to be effective. Nonchemical interventions include keeping affected areas clean and free of clutter, vacuuming, washing linens with hot water, caulking wall holes and cracks where bugs can hide, proper disposal of highly infested items, and placement of bed bug traps/interceptors at the base of beds and furniture. Chemical interventions involve the use of insecticides such as synthetic pyrethroids, silicates, insect growth disruptors, carbamates, organophosphates, neonicotinoids, diethyl-meta-toluamide, chlorfenapyr, fipronil and plant essential oils. Insecticides should be used with caution to prevent over-exposure and toxicity (in particular, cardiovascular and neurologic toxicity), especially if there are young children around. It is important to note that multiple mechanisms of insecticide resistance exist and as such, chemical treatment should only be undertaken by trained professionals who understand the current literature on resistance. Both nonchemical and chemical technologies should be combined for optimal results. Bed bug infestations may cause diverse dermal reactions, stigmatization, poor self-esteem, emotional stress, anxiety, significant adverse effect on quality of life, and substantial socioeconomic burden to society. As such, their rapid detection and eradication are of paramount importance. Consultation with a professional exterminator is recommended to fully eradicate an infestation.

Contribution to the Cimicidae (Hemiptera: Heteroptera) fauna from Argentina: biology and geographical distribution

The bed bug family Cimicidae (Hemiptera: Heteroptera) constitutes a group of specialized haematophagous ectoparasitic insects with about 110 species worldwide and 13 species in the Neotropics. Here we provide biological and faunistic observations for 4 out of the 8 species recorded in Argentina. Propicimex tucmatiani (Wygodzinsky, 1951) was recorded for the first time in the Province of Santa Fe and we provide the first barcode sequence for this species. Acanthocrios furnarii (Cordero & Vogelsang, 1928), a mainly ornithophilic species, has been found in a human apartment in Buenos Aires and was probably attacking humans. Bertilia valdiviana (Philippi, 1865) had been reported in 1950 in the Province of Ro Negro, we discuss its potential habitat and host association after visiting the only location where this species had been recorded so far in Argentina. Moreover, we provide some natural history data, i.e. developmental stages, sex ratio and feeding habit of the parrot parasite Cyanolicimex patagonicus Carpintero, Di Iorio, Masello & Turienzo, 2010 from a colony in El Condor (Province of Ro Negro).

Efficacy of a topical product combining esafoxolaner, eprinomectin and praziquantel against bedbug (Cimex lectularius) experimental infestations in cats

Bedbugs (Cimex lectularius) are a persistent nuisance pest for humans and their home environment, and may also opportunistically feed on other mammals, including household pets like dogs and cats. NexGard® Combo is a topical endectoparasiticide product for cats combining esafoxolaner, an isoxazoline compound with insecticidal and acaricidal properties, the nematocide eprinomectin and the cestocide praziquantel. The insecticidal efficacy of this product was evaluated in cats experimentally infested with C. lectularius in a blinded, negative controlled and randomized study. Two groups of 7 cats were formed: an untreated control group, and a NexGard® Combo group treated once on Day 0 at the label dose. Cats were then challenged weekly, each with twenty unfed adult C. lectularius, on Days 1, 7, 14, 21 and 28. After close contact with the cat's skin for 15 min, live fed C. lectularius were collected and incubated for 96 h. The weekly efficacy evaluations were based on a comparison of the number of surviving bedbugs in the control and the treated group after 48, 72 and 96 h of incubation. The model was demonstrated to be robust as in the control group the average feeding rate after the 15-minute challenge was 94%, and as 96% of incubated bed bugs were alive after 96 hours of incubation. Significant live bedbug reductions were demonstrated in the Nexgard® Combo treated group: after 96 h of incubation, the reductions ranged from 80.6 to 88.0% during the Day 1 to Day 21 period, and dropped to 58% at Day 28.

Staphylococcus aureus native mitral valve endocarditis associated with bed bug bites - A case report and review of the literature

Staphylococcus aureus is a leading cause of community acquired bacteremia and infective endocarditis. S. aureus is a part of the normal skin flora in approximately one third of the human population. Infective endocarditis due to S. aureus can cause several complications and is associated with increased mortality. A 48-year-old female with no significant medical history presented with S. aureus bacteremia and native mitral valve endocarditis. Multiple cutaneous skin lesions were identified, which she reported were due to recent bed bug bites. No source of infection was found except for the skin lesions. Her hospital course was complicated by pulmonary and cerebral septic emboli, left pleural empyema, and acute renal injury. We suspected the bed bug skin bites were the most likely source of bacteremia. Bed bugs carry many human pathogens but have not been shown to be a competent vector. We did not find any literature on endocarditis associated with bed bug bites; thus, our case will be a novel finding.

Detection of target-site and metabolic resistance to pyrethroids in the bed bug Cimex lectularius in Berlin, Germany

Knockdown-resistance (kdr) against pyrethroids in bed bugs (Cimex lectularis) is associated with the presence of several point mutations in the voltage-sensitive sodium channel α-subunit gene and/or an increased metabolic detoxification by cytochrome P450 monooxygenases (CYPs). In the present study, pyrosequencing assays were developed to quantify the presence of the kdr substitutions (V419L or L925I substitution) in bed bugs in Berlin, Germany. In 14 of 17 bed bug field strains, pyrosequencing revealed the presence of the substitution L925I with allele frequencies between 30% and 100%. One field strain additionally carried the substitution V419L with allele frequencies of 40% in males and 96% in females. In seven of the 17 field strains, mRNA levels of four CYP genes were examined using RT-qPCR. Relative to a susceptible laboratory reference strain, five field strains showed significantly higher mRNA levels of cyp397a1 with 7.1 to 56-fold increases. One of these strains additionally showed a 4.9-fold higher mRNA level of cyp398a1 compared to the reference strain, while cyp4cm1 and cyp6dn1 showed no significant differences. Our findings indicate that multiple resistance mechanisms are present in German C. lectularius populations simultaneously.

Parasite-bacteria interrelationship

Parasites and bacteria have co-evolved with humankind, and they interact all the time in a myriad of ways. For example, some bacterial infections result from parasite-dwelling bacteria as in the case of Salmonella infection during schistosomiasis. Other bacteria synergize with parasites in the evolution of human disease as in the case of the interplay between Wolbachia endosymbiont bacteria and filarial nematodes as well as the interaction between Gram-negative bacteria and Schistosoma haematobium in the pathogenesis of urinary bladder cancer. Moreover, secondary bacterial infections may complicate several parasitic diseases such as visceral leishmaniasis and malaria, due to immunosuppression of the host during parasitic infections. Also, bacteria may colonize the parasitic lesions; for example, hydatid cysts and skin lesions of ectoparasites. Remarkably, some parasitic helminths and arthropods exhibit antibacterial activity usually by the release of specific antimicrobial products. Lastly, some parasite-bacteria interactions are induced as when using probiotic bacteria to modulate the outcome of a variety of parasitic infections. In sum, parasite-bacteria interactions involve intricate processes that never cease to intrigue the researchers. However, understanding and exploiting these interactions could have prophylactic and curative potential for infections by both types of pathogens.

Influence of physical factors of apartments, educational attainment, nationality and unemployment on the number of Cimex lectularius inquiries

OBJECTIVE

The aim of the study was to determine the effect of physical factors of apartments, educational attainment, nationality and unemployment on the number and distribution of bed bug call inquiries in Budapest, Hungary.

METHODS

Educational attainment, apartment conditions, the level of unemployment, the ratio of dependent people in the households, nationality and proportion of dependent people were selected as regressors. Monthly ambient temperature values were correlated with monthly call inquiry numbers.

RESULTS

Downtown units showed the highest call inquiry rates. Significant positive correlations were found between the call inquiry rates and the ratio of low educational attainment inhabitants (people with ≤ 8 school classes), the rate of small floor area apartments (apartment area < 29 m²), proportions of the comfortless apartments in the district housing stock and proportion of unemployed people on district level as well as proportion of gypsy inhabitants in the districts. Significant negative correlation was found between the call inquiry rates and the average area (m²) of apartments. The number of call inquiries showed expressed, temperature-depending seasonality between March and December 2015. In multiple regression analyses, the level of unemployment and proportion of gypsy inhabitants showed significant correlations with the rate of bed bug call inquiries.

CONCLUSIONS

Apartment conditions, educational attainment, nationality, unemployment, and the city structure have notable influence on the occurrence of bed bug call inquiries on urban level, although the level of unemployment and nationality seem to be the strongest factors. The annual changes of the ambient temperature have effect on the call inquiry rate.

Status of Urban Bed Bug Infestations in Southern China: An Analysis of Pest Control Service Records in Shenzhen in 2012 and Dongguan in 2013

The recent resurgence of bed bugs (Cimex spp.) in many developed countries has drawn increasing attention worldwide. The status of urban bed bug infestations were investigated in Shenzhen and Dongguan, two major cities in southern Guangdong Province of southern China, based on pest control service records from two different companies (one during 2012 and another during 2013). The results showed that Shenzhen and Dongguan have a severe problem with bed bug infestations: the control of bed bugs is a constant concern, except during the winter. In Shenzhen, a similar number of premises were treated for bed bugs in central business districts and suburban districts. However, in Dongguan, more premises were treated for bed bugs in suburban districts than in central business districts. The treatment rate for worker sleeping quarters, apartments, hotel, and private houses in Shenzhen was 53.8, 43.0, 1.9, and 1.3%, respectively. The percentage of treated rooms was 56.1% for worker sleeping quarters and 91.1% for apartments. In Dongguan, the treatment rate for worker sleeping quarters, apartments, hotel, and private houses was 90.0, 10.0, 0.0, and 0.0%, respectively.

Viral metagenomics on animals as a tool for the detection of zoonoses prior to human infection?

Many human viral infections have a zoonotic, i.e., wild or domestic animal, origin. Several zoonotic viruses are transmitted to humans directly via contact with an animal or indirectly via exposure to the urine or feces of infected animals or the bite of a bloodsucking arthropod. If a virus is able to adapt and replicate in its new human host, human-to-human transmissions may occur, possibly resulting in an epidemic, such as the A/H1N1 flu pandemic in 2009. Thus, predicting emerging zoonotic infections is an important challenge for public health officials in the coming decades. The recent development of viral metagenomics, i.e., the characterization of the complete viral diversity isolated from an organism or an environment using high-throughput sequencing technologies, is promising for the surveillance of such diseases and can be accomplished by analyzing the viromes of selected animals and arthropods that are closely in contact with humans. In this review, we summarize our current knowledge of viral diversity within such animals (in particular blood-feeding arthropods, wildlife and domestic animals) using metagenomics and present its possible future application for the surveillance of zoonotic and arboviral diseases.

Bed bugs reproductive life cycle in the clothes of a patient suffering from Alzheimer's disease results in iron deficiency anemia

We report the case of an 82-year-old patient, hospitalized for malaise. Her clothes were infested by numerous insects and the entomological analysis identified them as being Cimex lectularius (bed bugs). The history of the patient highlighted severe cognitive impairment. The biological assessment initially showed a profound microcytic, aregenerative, iron deficiency anemia. A vitamin B12 deficiency due to pernicious anemia (positive intrinsic factor antibodies) was also highlighted, but this was not enough to explain the anemia without macrocytosis. Laboratory tests, endoscopy and a CT scan eliminated a tumor etiology responsible for occult bleeding. The patient had a mild itchy rash which was linked to the massive colonization by the bed bugs. The C. lectularius bite is most often considered benign because it is not a vector of infectious agents. Far from trivial, a massive human colonization by bed bugs may cause such a hematic depletion that severe microcytic anemia may result.

Novel and viable acetylcholinesterase target site for developing effective and environmentally safe insecticides

Insect pests are responsible for human suffering and financial losses worldwide. New and environmentally safe insecticides are urgently needed to cope with these serious problems. Resistance to current insecticides has resulted in a resurgence of insect pests, and growing concerns about insecticide toxicity to humans discourage the use of insecticides for pest control. The small market for insecticides has hampered insecticide development; however, advances in genomics and structural genomics offer new opportunities to develop insecticides that are less dependent on the insecticide market. This review summarizes the literature data that support the hypothesis that an insect-specific cysteine residue located at the opening of the acetylcholinesterase active site is a promising target site for developing new insecticides with reduced off-target toxicity and low propensity for insect resistance. These data are used to discuss the differences between targeting the insect-specific cysteine residue and targeting the ubiquitous catalytic serine residue of acetylcholinesterase from the perspective of reducing off-target toxicity and insect resistance. Also discussed is the prospect of developing cysteine-targeting anticholinesterases as effective and environmentally safe insecticides for control of disease vectors, crop damage, and residential insect pests within the financial confines of the present insecticide market.

Bed bugs: clinical relevance and control options

Since the late 1990s, bed bugs of the species Cimex lectularius and Cimex hemipterus have undergone a worldwide resurgence. These bed bugs are blood-sucking insects that readily bite humans. Cutaneous reactions may occur and can start out as small macular lesions that can develop into distinctive wheals of around 5 cm in diameter, which are accompanied by intense itching. Occasionally, bullous eruptions may result. If bed bugs are numerous, the patient can present with widespread urticaria or eythematous rashes. Often, bites occur in lines along the limbs. Over 40 pathogens have been detected in bed bugs, but there is no definitive evidence that they transmit any disease-causing organisms to humans. Anemia may result when bed bugs are numerous, and their allergens can trigger asthmatic reactions. The misuse of chemicals and other technologies for controlling bed bugs has the potential to have a deleterious impact on human health, while the insect itself can be the cause of significant psychological trauma. The control of bed bugs is challenging and should encompass a multidisciplinary approach utilizing nonchemical means of control and the judicious use of insecticides. For accommodation providers, risk management procedures should be implemented to reduce the potential of bed bug infestations.

Bedbugs (Cimicidae infestation): the worldwide renaissance of an old partner of human kind

Bedbugs have been known as a human parasite for thousands of years, but scientific studies about this insect are recent and limited. Cimex lectularius, the common bedbug, was a well-known parasite in human dwellings until the end of the Second World War. Nowadays, bedbugs are considered uncommon in the industrialized world. Anecdotal reports suggest that bedbugs are getting more common in the United States, Canada, and United Kingdom. In Brazil, there are few reports about bedbug infestations in the literature. The aim of this article was to alert physicians, especially in Brazil, about this ectoparasitosis, including aspects of the bedbug biology, their parasitism in human host, treatment and prophylaxis.

Bedbugs and infectious diseases

Bedbugs are brown and flat hematophagous insects. The 2 cosmopolite species, Cimex lectularius and Cimex hemipterus, feed on humans and/or domestic animals, and recent outbreaks have been reported in occidental countries. Site assessment for bedbug eradication is complex but can be assured, despite emerging insecticide resistance, by hiring a pest-control manager. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial reactions and anaphylaxis can also occur. Bedbugs are suspected of transmitting infectious agents, but no report has yet demonstrated that they are infectious disease vectors. We describe 45 candidate pathogens potentially transmitted by bedbugs, according to their vectorial capacity, in the wild, and vectorial competence, in the laboratory. Because of increasing demands for information about effective control tactics and public health risks of bedbugs, continued research is needed to identify new pathogens in wild Cimex species (spp) and insecticide resistance.

Insect seminal fluid proteins: identification and function

Seminal fluid proteins (SFPs) produced in reproductive tract tissues of male insects and transferred to females during mating induce numerous physiological and behavioral postmating changes in females. These changes include decreasing receptivity to remating; affecting sperm storage parameters; increasing egg production; and modulating sperm competition, feeding behaviors, and mating plug formation. In addition, SFPs also have antimicrobial functions and induce expression of antimicrobial peptides in at least some insects. Here, we review recent identification of insect SFPs and discuss the multiple roles these proteins play in the postmating processes of female insects.

Insect-specific irreversible inhibitors of acetylcholinesterase in pests including the bed bug, the eastern yellowjacket, German and American cockroaches, and the confused flour beetle

Insecticides directed against acetylcholinesterase (AChE) are facing increased resistance among target species as well as increasing concerns for human toxicity. The result has been a resurgence of disease vectors, insects destructive to agriculture, and residential pests. We previously reported a free cysteine (Cys) residue at the entrance to the AChE active site in some insects but not higher vertebrates. We also reported Cys-targeting methanethiosulfonate molecules (AMTSn), which, under conditions that spared human AChE, caused total irreversible inhibition of aphid AChE, 95% inhibition of AChE from the malaria vector mosquito (Anopheles gambia), and >80% inhibition of activity from the yellow fever mosquito (Aedes aegypti) and northern house mosquito (Culex pipiens). We now find the same compounds inhibit AChE from cockroaches (Blattella germanica and Periplaneta americana), the flour beetle (Tribolium confusum), the multi-colored Asian ladybird beetle (Harmonia axyridis), the bed bug (Cimex lectularius), and a wasp (Vespula maculifrons), with IC(50) values of approximately 1-11muM. Our results support further study of Cys-targeting inhibitors as conceptually novel insecticides that may be free of resistance in a range of insect pests and disease vectors and, compared with current compounds, should demonstrate much lower toxicity to mammals, birds, and fish.