Sleep Tight As Buggers Don't Transmit Disease

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Do not let the bed bugs bite. So goes the nursery rhyme. It seems that the old dread of disease from the bed bug is not to be feared.

A report in the April 1 issue of the Journal of the American Medical Association found that the little buggers don’t transmit disease as previously thought. The report reviewed more than 50 previously published articles and found no reliable evidence of disease transmission.

The authors of the study do point out that even though there is no transmission of disease, the bed bugs (Cimex lectularius) still remain a nuisance.

Bed bugs are a human parasite (organism living in, with, or on another organism) and feed only on blood. They are small but visible to the naked eye, wingless, yellow to reddish brown in color, oval shaped, and have prominent eyes. They can hide in the cracks and crevices of mattresses, in box springs, on the backboards of beds, and behind loose wallpaper baseboards, and they can travel in furniture, luggage, clothing, and other personal belongings. Bed bugs are predominantly night feeders, attracted to warm-blooded animals which includes humans.

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The authors found multiple reports describing various cutaneous reactions associated with bed bug bites. Systemic reactions, such as anaphylaxis, were less common.

In many cases there is no reaction to the bite. Often there will barely be any visible evidence of a puncture from a bite. The most common reaction is the development of small inflamed pruritic (itchy) bumps where each bite occurred. These usually resolve in one to two weeks. Over-the-counter topical antihistamines or topical corticosteroids will help with the itching.

Much less often, an allergic reaction to the bed bug bite can cause a complex skin reaction that results in urticaria (inflammation and swelling of the skin) at the site of the bite. When this happens, care should be taken so that the resulting rash doesn’t become secondarily infected. Use the OTC topical creams as above for the itching. If the rash becomes infected, then antibiotics may be required.

Rarely, asthma occurs as a systemic type of an allergic reaction caused by bed bug bites. This may be accompanied by more extensive urticaria and anaphylaxis (severe and sometimes fatal reaction to an allergen resulting in breathing difficulties, low blood pressure, and eventually shock if untreated). Anaphylaxis reactions need to be treated as an emergency. If you have these types of symptoms, go to the emergency room.

The authors noted that eradication of the creatures is challenging because of insecticide resistance, a lack of effective products, and health concerns about spraying mattresses with pesticides.

Source reference:
Goddard J, DeShazo R "Bed bugs (Cimex lectularius) and clinical consequences of their bites" JAMA 2009; 301: 1358-1366.

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