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Options Bed Bugs: Clinical Relevance and Control Bed Bugs: Clinical Relevance and Control Options Stephen L. Doggett, Dominic E. Dwyer, Pablo F. Peñas and Richard C. Russell Clin. Microbiol. Rev. 2012, 25(1):164. DOI: 10.1128/CMR.05015-11. Downloaded from Updated information and services can be found at: http://cmr.asm.org/content/25/1/164 These include: http://cmr.asm.org/ REFERENCES This article cites 227 articles, 16 of which can be accessed free at: http://cmr.asm.org/content/25/1/164#ref-list-1 CONTENT ALERTS Receive: RSS Feeds, eTOCs, free email alerts (when new articles cite this article), more» on January 10, 2012 by UNIV OF SYDNEY Information about commercial reprint orders: http://cmr.asm.org/site/misc/reprints.xhtml To subscribe to to another ASM Journal go to: http://journals.asm.org/site/subscriptions/ Bed Bugs: Clinical Relevance and Control Options Stephen L. Doggett,a Dominic E. Dwyer,b Pablo F. Peñas,c and Richard C. Russelld Department of Medical Entomology, ICPMR, Westmead Hospital, Westmead, New South Wales, Australiaa; Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, Westmead Hospital, and Sydney Institute for Emerging Infectious Diseases and Biosecurity, University of Sydney, Westmead, New South Wales, Australiab; Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australiac; and Department of Medical Entomology, University of Sydney at Westmead Hospital, Westmead, New South Wales, Australiad INTRODUCTION ............................................................................................................................................164 Downloaded from BED BUG IDENTIFICATION AND BIOLOGY .................................................................................................................165 CLINICAL RELEVANCE ......................................................................................................................................167 Clinical Overview .........................................................................................................................................167 Bed Bug Bite Reactions ...................................................................................................................................167 Diagnosis and Misdiagnosis ..............................................................................................................................170 Bite Treatment............................................................................................................................................171 The Bite: Clinical Complications ..........................................................................................................................171 Infectious Diseases .......................................................................................................................................171 Miscellaneous Health Impacts............................................................................................................................175 Mental Health Impacts ...................................................................................................................................176 http://cmr.asm.org/ Health Benefits? ..........................................................................................................................................178 Clinical Relevance Summary..............................................................................................................................178 BED BUG CONTROL ........................................................................................................................................179 Control Overview.........................................................................................................................................179 Bed Bug Prevention (Risk Management) .................................................................................................................179 Nonchemical Control.....................................................................................................................................180 Insecticidal Control .......................................................................................................................................181 The Future of Insecticides ................................................................................................................................183 BED BUGS: THE FUTURE....................................................................................................................................184 ACKNOWLEDGMENTS......................................................................................................................................185 on January 10, 2012 by UNIV OF SYDNEY REFERENCES ................................................................................................................................................185 INTRODUCTION site (http://www.bedbug.org.au). Despite limitations and poten- tial biases in these data (Table 1), the information probably rep- n recent years, bed bugs have undergone a major resurgence in resents a moderately accurate indication of the current situation, the number of infestations, leading to clinical and control prob- I with the most problematic cities being Chicago, New York, De- lems. This rise in activity is truly a global event, with increases in troit, Cincinnati, and Philadelphia (Table 1 and Fig. 1). Data from numbers of infestations reported for the Americas (153, 238, 246), New York City showed that the number of bed bug complaints to Australia (99, 102, 104), Europe (37, 44, 170, 196, 232, 254), Asia the city council rose from 537 in 2004 to 10,985 in 2009 (43). Thus, (145, 149, 177, 282, 284), and Africa (227). bed bugs have rapidly become a widespread societal pest, and the Although bed bugs have a long association with humans, for a risk of exposure through normal daily life appears to be increas- period from the 1950s to almost the start of the 21st century, this ing. In addition to homes and hotels, infestations are appearing in pest had become relatively uncommon, particularly in the more the office and retail environment, in the health and transport sec- economically advantaged nations. Not only was the reappearance tors, and in cinemas; in fact, they can be found in almost any of this pest unexpected, but the degree of the resurgence has al- location where people sleep or sit (103). most been met with awe by many in the pest management indus- What is particularly confounding about the resurgence is that try. A survey of Australian professional pest managers in 2006 it involves two species: the common bed bug, Cimex lectularius L., indicated that numbers of infestations rose by over 4,500% in the and the tropical bed bug, Cimex hemipterus F. The involvement of early years of the 21st century (102), comparable to what has been these two species makes the ascertainment of the reasons for this seen in other parts of the world (189, 246, 254). Bed bugs have global resurgence more challenging. become especially problematic in the United States, being re- Various factors have been postulated to be responsible for the ported in all 50 states; now, an estimated 1 out of 5 Americans resurgence. Resistance to carbamate and pyrethroid insecticides either has had a bed bug infestation in their home or knows some- (45, 167, 171, 185, 209, 261, 284), and, more recently, to the or- one who has encountered them (220). Currently, there is no peer- reviewed published data on the actual prevalence of bed bug in- festations across the United States. However, two of the largest Address correspondence to Stephen L. Doggett, pest control firms in the United States have released information [email protected]. on the most affected cities, based on the numbers of bed bug Copyright © 2012, American Society for Microbiology. All Rights Reserved. treatments undertaken by their respective companies, and this doi:10.1128/CMR.05015-11 information corresponds well to hits on a dedicated bed bug web- 164 cmr.asm.org 0893-8512/12/$12.00 Clinical Microbiology Reviews p. 164–192 Bed Bugs: Clinical Relevance and Control Options TABLE 1 The top 15 bed bug cities in the United States according to reasons behind the resurgence are multifactorial, and many other two large U.S.-based pest control companies and hits to a possible contributors were reviewed previously (239). dedicated bed bug website The implication of the huge upturn in the number of bed bug Most affected city, determined by: infestations is that people are increasingly being exposed to the Ranking Terminixa Orkinb bedbug.org.auc insect and, as a consequence, the various associated health risks. This has prompted a number of recent clinical reviews (67, 72, 78, 1 New York Cincinnati New York 106, 126, 130, 143, 144, 175, 287, 289), while contemporary clin- 2 Cincinnati Columbus, OH Chicago 3 Detroit Chicago Los Angeles ical investigations have only just begun to emerge (241, 250). De- 4 Chicago Denver Washington, DC spite numerous reviews, articles continue to present unsubstanti- 5 Philadelphia Detroit Philadelphia ated scientific “facts” on bed bugs. This paper reviews the health 6 Denver Washington, DC San Francisco impacts of bed bugs and both the direct clinical effects (notably 7 Washington, DC New York Houston the cutaneous reactions produced from the bite) and the indirect Downloaded from 8 Los Angeles Philadelphia Columbus but far-reaching impacts while attempting
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