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Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL. Bed Bug Infestation: An Updated Review. Curr Pediatr Rev 2024; 20:137-149. [PMID: 37038684 DOI: 10.2174/1573396320666230406084801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 04/12/2023]
Abstract
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.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
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Akhoundi M, Zumelzu C, Sereno D, Marteau A, Brun S, Jan J, Izri A. Bed Bugs (Hemiptera, Cimicidae): A Global Challenge for Public Health and Control Management. Diagnostics (Basel) 2023; 13:2281. [PMID: 37443675 DOI: 10.3390/diagnostics13132281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Bed bugs, Cimex lectularius, and C. hemipterus are among the most common ectoparasites in human life worldwide. They feed on humans of all ages and sexes across all socioeconomic levels. Bed bugs' blood feeding is responsible for a wide range of clinical manifestations varying from minor reactions to bullous eruptions or severe allergies. In addition, they are responsible for considerable psychological distress. Therefore, diagnosis of bed bug bites and their consequence manifestations is beneficial in adapting remedies and treatment protocols advised by clinicians. So far, there is regrettably no definitive way to control these ectoparasites despite extensive efforts of public health authorities to manage them. An overview of the literature and medical documents gathered from bed bug-infested patients referred to the Parasitology and Dermatology departments of Avicenne Hospital (Bobigny, France) allowed us to document and illustrate a range of clinical disorders and psychological concerns caused by bed bugs' bites and their clinical diagnosis. We also review the available tools currently used to control the bed bugs and present potential candidate methods for their successful eradication.
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Affiliation(s)
- Mohammad Akhoundi
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
| | - Coralie Zumelzu
- Dermatology Department, AP-HP, Avicenne Hospital, 93000 Bobigny, France
| | - Denis Sereno
- Parasite Infectiology and Public Health Research Group, Institute de Recherche Pour le Développement, InterTryp, Montpellier University, 34032 Montpellier, France
| | - Anthony Marteau
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
| | - Sophie Brun
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
| | - Julie Jan
- Agence Régionale de Santé (ARS), Île-de-France, 75935 Paris, France
| | - Arezki Izri
- Parasitology-Mycology Department, Avicenne Hospital, AP-HP, Sorbonne Paris Nord University, 93000 Bobigny, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), 13005 Marseille, France
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Hamlili FZ, Bérenger JM, Parola P. Cimicids of Medical and Veterinary Importance. INSECTS 2023; 14:392. [PMID: 37103207 PMCID: PMC10146278 DOI: 10.3390/insects14040392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 06/19/2023]
Abstract
Members of the Cimicidae family are significant pests for mammals and birds, and they have attracted medical and veterinary interest. A number of recent studies have investigated bed bugs, due to their dramatic resurgence all over the world. Indeed, bed bugs are of significant public health and socioeconomic importance since they lead to financial burdens and dermatological complications and may have mental and psychological consequences. It is important to note that certain cimicids with a preference for specific hosts (birds and bats) use humans as an alternative host, and some cimicids have been reported to willingly feed on human blood. In addition, members of the Cimicidae family can lead to economic burdens and certain species are the vectors for pathogens responsible for diseases. Therefore, in this review, we aim to provide an update on the species within the Cimicidae family that have varying medical and veterinary impacts, including their distribution and their associated microorganisms. Various microbes have been documented in bed bugs and certain important pathogens have been experimentally documented to be passively transmitted by bed bugs, although no conclusive evidence has yet associated them with epidemiological outbreaks. Additionally, among the studied cimicids (bat bugs, chicken bugs, and swallow bugs), only the American swallow bug has been considered to be a vector of several arboviruses, although there is no proven evidence of transmission to humans or animals. Further studies are needed to elucidate the reason that certain species in the Cimicidae family cannot be biologically involved in transmission to humans or animals. Additional investigations are also required to better understand the roles of Cimicidae family members in the transmission of human pathogens in the field.
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Affiliation(s)
- Fatima Zohra Hamlili
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France
- Department of VITROME, Aix Marseille Univ, IRD, AP-HM Assistance Publique-Hôpitaux de Marseille, SSA, 13005 Marseille, France
| | - Jean Michel Bérenger
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France
- Department of VITROME, Aix Marseille Univ, IRD, AP-HM Assistance Publique-Hôpitaux de Marseille, SSA, 13005 Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, 19–21 Boulevard Jean Moulin, 13005 Marseille, France
- Department of VITROME, Aix Marseille Univ, IRD, AP-HM Assistance Publique-Hôpitaux de Marseille, SSA, 13005 Marseille, France
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Affiliation(s)
- Philippe Parola
- From the VITROME (Vecteurs-Infections Tropicales et Méditerranéennes) Research Unit, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille (P.P.), and the Parasitology-Mycology Department, Avicenne Hospital, Bobigny (A.I.) - both in France
| | - Arezki Izri
- From the VITROME (Vecteurs-Infections Tropicales et Méditerranéennes) Research Unit, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille (P.P.), and the Parasitology-Mycology Department, Avicenne Hospital, Bobigny (A.I.) - both in France
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Man With Zosteriform Burning Rash and Respiratory Distress. J Emerg Med 2019; 56:e129-e131. [PMID: 30879858 DOI: 10.1016/j.jemermed.2019.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/23/2019] [Accepted: 02/02/2019] [Indexed: 11/20/2022]
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Blakely BN, Hanson SF, Romero A. Survival and Transstadial Persistence of Trypanosoma cruzi in the bed bug (Hemiptera: Cimicidae). JOURNAL OF MEDICAL ENTOMOLOGY 2018; 55:742-746. [PMID: 29381783 DOI: 10.1093/jme/tjx252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Indexed: 06/07/2023]
Abstract
Bed bug populations are increasing around the world at an alarming rate and have become a major public health concern. The appearance of bed bug populations in areas where Chagas disease is endemic raises questions about the role of these insects in the transmission of Trypanosoma cruzi, the etiological agent of the disease. In a series of laboratory evaluations, bed bug adults and nymphs were experimentally fed with T. cruzi-infected blood to assess the ability of T. cruzi to survive inside the bed bug and throughout the insect's molting process. Live T. cruzi were observed in gut contents of experimentally infected bed bug adults via light microscopy and the identity of the parasite was confirmed via polymerase chain reaction analysis. T. cruzi persisted at least 97-d postinfection in adult bed bugs. Nymphal stage bed bugs that were infected with T. cruzi maintained the parasite after molting, indicating that transstadial passage of T. cruzi in bed bugs took place. This report provides further evidence of acquisition, maintenance, and for the first time, transstadial persistence of T. cruzi in bed bugs.
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Affiliation(s)
- Brittny N Blakely
- Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM
| | - Stephen F Hanson
- Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM
| | - Alvaro Romero
- Department of Entomology, Plant Pathology and Weed Science, New Mexico State University, Las Cruces, NM
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Halpert E, Borrero E, Ibañez-Pinilla M, Chaparro P, Molina J, Torres M, García E. Prevalence of papular urticaria caused by flea bites and associated factors in children 1-6 years of age in Bogotá, D.C. World Allergy Organ J 2017; 10:36. [PMID: 29158868 PMCID: PMC5674867 DOI: 10.1186/s40413-017-0167-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 09/13/2017] [Indexed: 12/04/2022] Open
Abstract
Background Papular urticaria is a chronic inflammatory disease caused by exposure to arthropod bites. The disease has been reported in children attending medical centers, but the causes as the risk factors associated with the disease have not been established. The objective of this study was to determine the prevalence of papular urticaria caused by flea bite and identify the risk factors in children between 1 to 6 years of age in Bogotá D.C, between March 2009 and June 2011. Methods A cross-sectional, two-stage, clustered study using random probability sampling and stratified with proportional allocation was carried out in children (1–6 years of age) in educational institutions in Bogotá D.C. to determine the prevalence of the disease. Children underwent a dermatological examination by general practitioners with a previous training. Furthermore, digital photographs of skin lesions were taken for further confirmation of the diagnosis by dermatologists. A structured survey was completed by the parents or caregivers, and it was evaluated using an unconditional logistic regression to identify factors associated with the disease. Results A total of 2437 children were included in the study. The prevalence of papular urticaria caused by flea bite in this population was 20.3% (CI 95%: 18.2 to 22.5%). The major risk factors associated with the disease were the presence of fleas in households (OR 1.74, CI 95%: 1.35 to 2.25), using mattresses without springs (OR 1.73, CI 95%: 1.20 to 2.50), the use of daily public transportation to carry the children to the educational institutions (OR 1.76, CI 95%: 1.07 to 2.89), having a soil/earth floor in the main bedroom (OR 6.81, CI 95%:1.16–39.96), and having siblings with a history of atopic dermatitis (OR 1.76 CI 95%: 1.07–2.89). Conclusions A high prevalence of papular urticaria caused by flea bite was found in Bogotá D.C. The main factors associated with the disease might be modified with the implementation of prevention, control strategies in housing, educational institutions, and public transportation.
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Affiliation(s)
- Evelyne Halpert
- Dermatology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Elizabeth Borrero
- Eje de Salud Pública, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Pablo Chaparro
- Escuela de Salud Pública, Maestría en Epidemiología, Universidad del Valle, Bogotá, Colombia
| | - Jorge Molina
- Centro de Investigaciones en Microbiología y Parasitología Tropical, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - Maritza Torres
- Centro de Investigaciones en Microbiología y Parasitología Tropical, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia.,Universidad Manuela Beltrán, Bogotá, Colombia
| | - Elizabeth García
- Allergy Section, Hospital Universitario Fundación Santa Fe de Bogotá, Faculty of Medicine, Universidad de los Andes, Bogotá, Colombia.,Sección de Alergia Pediátrica, Fundación Santa Fe de Bogotá, Av 9 N° 116-20, oficina 213, Bogotá, D.C Colombia
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Dang K, Doggett SL, Veera Singham G, Lee CY. Insecticide resistance and resistance mechanisms in bed bugs, Cimex spp. (Hemiptera: Cimicidae). Parasit Vectors 2017; 10:318. [PMID: 28662724 PMCID: PMC5492349 DOI: 10.1186/s13071-017-2232-3] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 06/06/2017] [Indexed: 11/16/2022] Open
Abstract
The worldwide resurgence of bed bugs [both Cimex lectularius L. and Cimex hemipterus (F.)] over the past two decades is believed in large part to be due to the development of insecticide resistance. The transcriptomic and genomic studies since 2010, as well as morphological, biochemical and behavioral studies, have helped insecticide resistance research on bed bugs. Multiple resistance mechanisms, including penetration resistance through thickening or remodelling of the cuticle, metabolic resistance by increased activities of detoxification enzymes (e.g. cytochrome P450 monooxygenases and esterases), and knockdown resistance by kdr mutations, have been experimentally identified as conferring insecticide resistance in bed bugs. Other candidate resistance mechanisms, including behavioral resistance, some types of physiological resistance (e.g. increasing activities of esterases by point mutations, glutathione S-transferase, target site insensitivity including altered AChEs, GABA receptor insensitivity and altered nAChRs), symbiont-mediated resistance and other potential, yet undiscovered mechanisms may exist. This article reviews recent studies of resistance mechanisms and the genes governing insecticide resistance, potential candidate resistance mechanisms, and methods of monitoring insecticide resistance in bed bugs. This article provides an insight into the knowledge essential for the development of both insecticide resistance management (IRM) and integrated pest management (IPM) strategies for successful bed bug management.
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Affiliation(s)
- Kai Dang
- Urban Entomology Laboratory, Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Stephen L. Doggett
- Department of Medical Entomology, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145 Australia
| | - G. Veera Singham
- Centre for Chemical Biology, Universiti Sains Malaysia, 10 Persiaran Bukit Jambul, 11900 Penang, Malaysia
| | - Chow-Yang Lee
- Urban Entomology Laboratory, Vector Control Research Unit, School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
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