Bed Bugs: Coming to a Town Near You? How Did they Get Here? Why here, why now? 3/8/2016

Transcription

1 Bed Bugs: Coming to a Town Near You? Presented by: Kathleen Biddlestone RN, BSN, CDDN Infection Control/Quality Assurance Nurse Cuyahoga County Board of Developmental Disabilities Active member of Cuyahoga County Bed Bug Task Force DDNA, San Diego April 2, 2016 How Did they Get Here? Have been in existence for thousands of years Cavemen; Pharaoh; Aristotle WW2 Era 1/3 homes had bedbugs Fairly well eradicated by the 1950 s Use of DDT, Chlordane, Lindane DDT eliminated in 1972 Bedbugs returned in late 1990 s Why here, why now? Resurgence due to increase in international travel FDA bans on pesticides High tenant turnover Insecticide resistance 1

2 Orkin Statistics 1. Chicago 2. Detroit 3. Columbus, Ohio 4. Los Angeles 5. Cleveland Akron Canton, Ohio 6. Dallas Ft. Worth 7. Cincinnati 8. Denver 9. Richmond Petersburg, Va. 10. Dayton, Ohio 11. Indianapolis 12. Houston 13. Seattle Tacoma 14. Washington, District of Columbia Hagerstown, Md. 15. Milwaukee Terminix Statistics 1. Detroit, Michigan (4) 2. Philadelphia, Pennsylvania (1) 3. Cleveland-Akron, Ohio (15) 4. Los Angeles, California (14) 5. Dayton (-) 6. Chicago, Illinois (5) 7. Columbus (8) 8. Cincinnati, Ohio (2) 9. Dallas-Forth Worth, Texas (7) 10. San Francisco-Oakland-San Jose, CA (-) What are they? External parasites (Cimex lectularius) Approximately the size of an apple seed Nocturnal, active at night, hide by day Do not fly or jump Climb on surfaces such as wood, paper, cloth Don t climb well on smooth surfaces such as glass, porcelain, stainless steel Bed bugs can travel over 100 feet in one night, but they tend to live within 8 feet of where their hosts are 2

3 Exoskeleton, 6 Legs, 0 Wings, 2 Antennae, 1mouthpiece Bedbug Feeding Habits Feed on blood, preferably human, but will feed on warm blooded mammals Sharp beak pierces the skin of a host, they inject a salivary fluid containing an anticoagulant that helps them obtain blood Also secrete an anesthetic which numbs the site Nymphs may become engorged with blood within three minutes Mature bed bug usually feeds for ten to fifteen minutes. After feeding, return to hiding When hungry, bed bugs again search for a host Bed Bug Trivia Bed bugs can ingest seven times their own weight in blood, which would be the equivalent of an average-sized male drinking 120 gallons of liquid. 3

4 How Bedbugs are Attracted to Us Attracted by heat/co2/keramones Results in bugs mistakenly attracted to heat emitted by electronic devices Travel Habits Walking from room to room via pipes, cables, wires, duct work down a hallway after dropping off an item Hitchhiking Life Cycle Adult female lays 1-12 eggs/day, up to 150/lifetime Glued" to surfaces, along seams, books, piping of mattresses, dresser drawers Hatch in 1-2 months, depending on temperature, humidity 4

5 Stages of Bed Bug Development Adult can live for months Without a blood meal!!!! How Do I Know if I Have Them? Equal Opportunity Annoyers Non discriminatory Do NOT equal poor sanitation, hygiene, housekeeping Do NOT equal low income Can t afford treatment More likely to use second hand items More likely to live in congregate settings 5

6 Evidence of fecal spots on mattresses, bedding, baseboards, outlet covers Appear reddish brown, but may redden if exposed to alcohol Bites Bite marks on exposed body parts that appear after sleeping May resemble mosquito or spider bites May or may not itch May be in a line or clusters Not all people will show evidence of bites Do not have a red spot in the center, often characteristic of a spider or flea bite Joint Statement on Bed Bug Control in the United States from the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Environmental Protection Agency (EPA) Although bed bugs are not known to transmit disease, they are a pest of significant public health importance. 6

7 Not an Identified Health Risk Despite the ICK factor, based on research to date Bed bugs are not known to transmit disease Diseases have not been known to replicate in bed bugs Viruses and other agents die in their body South African researchers fed bed bugs with AIDS infected blood, but the virus died. When fed Hepatitis B infected blood, they retained the virus for several weeks, but when they fed on chimpanzees, virus did not transmit. Kissing bugs and Chagas disease Associated Health Concerns No significant blood loss Anemia in long standing, excessive infestations, especially in under nourished populations such as Infants and the elderly Anxiety, insomnia, emotional distress Irritant - asthma Do not vector diseases 7

8 The War on Bedbugs Education Prevention Tips for travelers Isolation/Proper identification Notification Monitoring Integrated Pest Management Workplace Prevention Strategies Employee education Have a PLAN! Make a protocol! Be prepared Residential/Vocational Facilities Consider using a dryer or hot box for high risk items Monitor individuals who dumpster dive Monitor staff sleeping areas (OSOC) Hot wash/hot dry all purchased incoming clothing/soft goods Monitor after visitations/loas 8

9 Inspection/isolation of individual s clothing & personal belongings, daily upon arrival Hot wash/hot dry clothing Inspect, then isolate personal belongings (sealed plastic bag, plastic tote) Lunch bags Back packs Purses Avoid shared spaces, i.e. lockers, closets Consider rights and consents Encasements Must be sealed tightly Left in place 18 months Free of rips/tears Interceptors Keep bed away from wall Avoid dust ruffles Keep blankets/sheets off of the floor Home Visitation Dress for the Occasion 9

10 Home Visitation Pre-interview: pets in home, illnesses, chemical treatments in last 2-3 months Wear simple clothes, avoid accessorizing Avoid shirts with buttons and pockets Wear light colored clothes (easier to see) Avoid cargo pants and cuffed pants Wear shoes that can be heated in a clothes dryer Pay special attention to shoes Use shoe protectors Home Visitation Don t sit on beds or upholstered surfaces Bring in minimal belongings-just the necessities Hang coats up high, don t let them drag on floors, or lay on couches/beds Self inspection prior to entering vehicle Use a lint roller Heat treat clothing upon return home Carry a supply of sealable plastic bags Keep items off of the floor Office Buildings/Office areas Consider changing to plastic or metal chairs Easier to treat, less hiding places for bed bugs If there is a bed bug sighting, spray with alcohol based spray, such as Steri-Fab, or steam 10

11 Know Your Enemy-Proper ID Developed by Dr. Susan Jones The Ohio State University Department of Entomology Monitoring Placement of monitoring sticky traps Carbon dioxide/lure based traps Buses Classrooms Work lines Things to consider Transportation Vocational services Residential provider Parent/guardians NOTIFICATIONS 11

12 School Letterhead Date Dear Parent or Guardian: This letter has been sent to you in response to a bed bug being found in your child s classroom. Although it is often very difficult to identify the source of the bed bug and pinpoint how it was brought into the school, our staff is in the process of conducting a thorough inspection of the school and treating appropriately where necessary. We will continue to monitor the situation and consult with public health and pest control professionals to eliminate any bed bugs in the building and to minimize the potential for future bed bug activity in the school. Although beg bugs are a nuisance, they have not been known to spread disease. Anyone who comes in direct contact with bed bugs or their eggs can unknowingly carry them into their home or workplace. They are easily spread by moving beds, furniture, luggage, or clothing from one location to another. For this reason, it is important that you inspect your child s backpack, lunch bag and other items regularly for the presence of bedbugs. Bed bug experts recommend that you routinely check your residence for signs of bed bug activity. Eliminating an extensive bed bug infestation can be a very challenging and costly process, so it is very important to begin treatments and prevention practices as soon as a problem is identified. Bed bugs require blood to survive and reproduce, so they will typically look to bite any areas of exposed skin while you are asleep. The bites may not hurt at first, but may become swollen and itch a few days later, much like a mosquito bite. Most bed bug bites do not usually necessitate medical treatment. Wash the affected area with soap and water and then apply Calamine lotion to help dry out the bumps and stop the itching. If allergic reactions persist, an antibiotic cream or topical steroid, such as Hydrocortisone, will help take care of the infection. Please contact your physician with specific medical questions. If you have any questions regarding bed bugs or our response efforts, please feel free to contact the Principal or School Nurse. Detailed information on bed bugs and appropriate control measures can be obtained on the or. Thank you for your assistance in this matter. Sincerely, Principal or School Nurse Barriers to Bed Bug Control Denial of a bed bug problem/stigma Incorrect identification Ignorance of bed bugs and Management strategies Do-it-yourself mentality Money Clutter Mental health problems Physical incapacity IPM- Integrated Pest Management Environmental Heat Cold Chemicals PREVENT REINTRODUCTION 12

13 Environmental Controls Vacuum Double bag and discard contents immediately May add cornstarch or talc to contents of bag to block breathing holes of bedbugs Steam Must penetrate all layers Why Are They So Hard to Eliminate???? CLUTTER=HARBORAGE Here s One Reason Why! They are masters at hiding! 13

14 Increased clutter leads to increased costs Unusual Bed Bug Hiding Places A prosthetic leg A casket Dance club 911 call center Washing machine factory Tow boat on the Ohio River Wheel chairs/walkers Gel overlay pads Hair extensions Treatment Costs Pest control companies may charge $250-$900 per room treated, with an average of $400- $600, depending on local rates, the level of infestation and the types of treatments used. 14

15 The homeowner or tenant is usually required to do extensive work (cleaning, vacuuming, washing fabric items, etc.) before and after the treatment. Many infestations need two or three treatments; companies with lower prices may not include these follow-up visits in their quotes. Very few guarantees. Total costs for getting rid of bed bugs can range from $1,000-$10,000 Not a Do-it-Yourself Solution OTC sprays (hardware stores/big box stores) Must be sprayed directly on the bed bugs Only kills on contact Little to no residual activity Avoid use of bug Bombs Most bugs are hiding and WILL NOT be killed Treatment Basics Chemical Treatment No single magic bullet. Usually takes multiple treatments, days apart. Use multiple formulations, and often, different insecticides. Residual insecticide is necessary. Rotate insecticide use. Can t be used on clothing or bedding. Residents often have to relocate 15

16 Heat Treatment Heat entire unit to hour process Probes to monitor temperatures Higher cost No residual, so often accompanied by chemical treatment Heat Treatment Requirements Monitors in the 4 corners of treated rooms Clock starts when all 4 reach 120 degrees Minimum of 3 hours in critical rooms Minimum of 1 hour in adjacent rooms Discarding Not necessarily the solution, as bedbugs can be present in remaining items 16

17 Fumigation Boxes (hard goods) Read and follow manufacturer s directions Off label use (research in progress) Avoid use in food prep areas Avoid use around pets or children Make or purchase a box or tote Add Nuvan strip Seal tightly Keep outdoors Allow contents to fumigate HEAT -122 º YOUR BEST WEAPON! Dryer heat minutes highest heat Steam Dry clean COLD Much less effective 0º F for at least 4 days Freezer Garage Cold must penetrate all areas of item Where Do I Begin???? Guidelines for Prevention and Management of Bed Bugs in Shelters and Group Living Facilities bb_guidelines/ 17

18 Not a War to Fight on Your Own 2 Men Start Fire Trying to Get Rid of Bedbugs References (2013). Retrieved January 17, 2014, from (2012). Retrieved January 14, 2014, from (2016). Retrieved February 18, 2016, from (2015, December 18). Retrieved February 17, 2016, from (2008). Retrieved February 1, 2016, from Guidelines for Prevention and Management of Bed Bugs in Shelters and Group Living Facilities (n.d.). Retrieved February 12, 2016, from Preventing and Getting Rid of Bed Bugs Safely [Video file]. (2011, April 17). Retrieved January 15, 2014, from How Bed Bugs Find Us. [Video file]. (2012, November 28). Retrieved January 14, 2014, from Update on Bed Bug 'Bug Bombs' from Dr. Susan Jones 18

19 Thank you and.. Good Night Sleep Tight Don t Let the Bed Bugs Bite! 19