Of all possible allergic reactions, the wheals that come from bed bug bites may be the most horrifying. “One aspect of the medical effects of bed bug bites that is almost never addressed is the significant psychological distress caused by the bites,” noted Stephen L. Doggett, Senior Hospital Scientist at Westmead Hospital, New South Wales, Australia. “This is a very real health problem and should not be ignored.”
Bed bug infestation is on the rise, Doggett reported. The adults are about the size of an apple seed, and are most commonly found along mattress beading (the rope-like trim around the top of typical mattresses). They live on human blood. Most bites occur at night while the victim is asleep. Bed bugs inject saliva into their bite sites to prevent coagulation of the blood. This saliva contains protein fractions that produce allergic reactions. It may take several days for skin lesions to develop. Some people develop bullous eruptions with fever and malaise. Anaphylaxis has been reported in rare cases.
Bed bug bites have been misdiagnosed as many other conditions, including:
1. Bites from other insects, including mosquitoes and spiders
2. Scabies, a contagious skin disease caused by tiny mites
3. Food allergies
4. Hives
5. Antibiotic reactions
6. Staphylococcus infections
7. Chicken pox
Since bed bugs suck blood, there is concern in the medical community that these insects may be able to transmit infectious disease. Pascal Delaunay and colleagues in France provided a review of 45 candidate pathogens that have at least some potential to be transmitted by bed bugs. Hepatitis B virus is the leading suspect, but so far there is no proof that bed bugs are effective disease vectors.
The possibility of HIV transmission raises special concerns. In lab experiments, HIV survived for 8 days in bed bugs. However, the virus did not replicate and was not transmitted to lab animals. “Therefore, to date, HIV is no longer a valid candidate pathogen for bedbug-borne transmission,” Delaunay concluded.
Both Delaunay and Doggett recommended professional pest control measures for bed bug infestations. The insects can hide in many areas, so it's not enough to clean or even replace the bed. Delaunay added that fumigants are frequently used by nonprofessionals, but are not effective.
For treatment, Doggett recommended that doctors consult the review by Dr. Jerome Goddard and Dr. Richard deShazo of Mississippi State University. Options include antihistamines, corticosteroids, antibiotics, and epinephrine.
References:
1. Delaunay P et al, “Bedbugs and infectious diseases”, Clin Infec Dis. 2011 January 5; 52(2): 200-10.
http://www.ncbi.nlm.nih.gov/pubmed/21288844
2. Doggett SL et al, “Bed bugs: What the GP needs to know”, Aust Fam Physician 2009 Nov; 38(11): 880-4.
http://www.ncbi.nlm.nih.gov/pubmed/19893834
3. Goddard J et al, “Bed bugs (Cimex lectularius) and clinical consequences of their bites”, JAMA 2009 Apr 1; 301(13): 1358-66.
http://www.ncbi.nlm.nih.gov/pubmed/19336711
Reviewed July 12, 2011
by Michele Blacksberg R.N.
Edited by Alison Stanton
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.