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General Information and Complaint Investigation Procedures

Although bed bugs are not a known vector of any human disease, their presence and their bites can be annoying, leading to a loss of sleep, and allergic reactions.  Local pest control personnel and environmental health specialists are reporting an increase in the number of calls, concerns and questions relating to bed bugs.  In an effort to provide consistent, reliable information about bed bugs, the North Carolina Mosquito & Vector Control Association (NCMVCA), in collaboration with the Sleep Products Section, NCDA&CS, (http://www.ncagr.gov/SPCAP) provides the following information:

1.  Life Cycle

Common or human bed bugs (Cimex lectularius) are small, wingless insects that feed on blood. Adults can be up to a quarter of an inch long (about the size of an apple seed), typically dark brown with a flattened body.  Bed bugs usually come out at night to feed and stay well hidden during daylight hours. 

After hatching, the immature bed bugs, called nymphs, will go through a series of five molts until they reach their full adult stage. The first-instar nymphs are the size of a pin head.  A bed bug’s life span can range from 10 months to a year and they can live up to 3 - 6 months without feeding on blood.  Each adult female can lay approximately 200 to 500 eggs during her lifespan. 

2.    Bed bug complaints

Bed bug complaints are on the rise world-wide.  Bed bugs are found in all types of residential and commercial facilities such as motels, apartments, beach rentals, park cabins, private homes, homeless shelters, schools, theatres and other public venues.  Increased travel, insecticide resistance, short residual activity of chemicals and targeted pest control are cited by the professionals as major reasons for their resurgence.

Bed bugs are accidental ‘hitchikers’ and spread very easily by hitching a ride on luggage, linens, clothing or any other item transported from one place to another. Because they are such prolific breeders, a few bugs can easily become an infestation in a relatively short period of time.  Although they may initially stay close to their food source, such as a bed, as their numbers increase they can be found throughout the dwelling.

3.    Investigating a complaint

a.  Personal protection from bed bugs

 When investigating a complaint, you can speed your investigation and reduce the risk of spreading the infestation if you come prepared.  Bring only the items you need (see below), preferably in a waist- or shoulder-pack and carry it at all times.  Leave any additional gear or equipment outside until needed.  The use of personal protective equipment (PPE), such as protective suits or shoe coverings is highly recommended, especially in the case of a heavy infestation.  Try not to come in direct contact with infested areas.

b.  Equipment for bed bug inspection

  • flash light (LED lights are preferred because of the light color and intensity)
  • camera
  • forceps
  • gloves
  • vials with alcohol to preserve kill and preserve specimens along with additional empty vials to collect dead specimens, cast off skins, etc.
  • small plastic bags to hold the vials of samples
  • labels and a pencil for recording
  • tools for dismantling furniture (Please ask the owner to dismantle bed frame and/or headboard)
  • sticky tape to catch live bed bugs
  • large plastic bag for your equipment bag.  Should you find the area to be heavily infested, you may want to enclose your equipment bag to reduce the risk of contaminating other areas, such as your vehicle.

c.  Initial Steps:

Before conducting a full investigation, there are several tell-tale signs that indicate you may be dealing with bed bugs.  Initially, we suggest you look for the following:

  • Bite marks on the resident:  Different individuals react differently to bed bug bites.  Most of the population will have welts or bumps that itch, caused by an allergic reaction to bed bug saliva. Sometimes these will occur in a row or clustered.  Arms, shoulders, back and neck are the most common body areas where bites occur. These can be easily misdiagnosed for other skin conditions or other insect bites such as poison ivy, scabies, chicken pox, general skin allergies, chigger and tick bites.  In order to confirm a bed bug infestation, it will be necessary to collect bugs and submit them for identification.
  • Excrement:  Bed bugs leave behind fecal blood spots or specks that stain mattresses, framing or walls.  You can ask the owner if they remember seeing this type of stain or advise them to look for spots found on the bed sheets, comforters and blankets.  In particular, ask them about the corners of mattresses, under seams, ticking, labels or tags where bed bugs might congregate in larger numbers.
  • Smell:  In the case of a particularly heavy infestation, the room may have a distinctive sickly sweet, musty odor.

4.  Bed Bug Inspection

a.  Thorough Inspection Procedure:

 As you enter the infested premises, scan the walls, ceiling and any other light colored surfaces for signs of bed bugs. These may be obvious if it is a heavy infestation.  Your investigation can start at the bed but should not be limited to that area.  Pay close attention to the mattress, bed frame, box spring and the wall-facing sides of headboards.  Live bugs may be difficult to find because they prefer to remain hidden during the day and will crawl quickly into cracks and crevices when disturbed.  More frequently, you may find signs of their presence, such as cast skins (from molting), dead bugs, fecal spots or eggs.

 As you conduct your investigation you should collect specimens and have them submitted for positive identification by trained experts.  Collect specimens in vials of alcohol or tape skins/dead bugs to a piece of paper. 

b.  Preventing the spread of bed bugs

If a bed bug infestation is confirmed, advise the owners to seek professional help, especially in the case of a severe infestation and to strictly follow treatment guidelines to eliminate the infestation and the spread of bed bugs to other areas.  Advise the owner that after treatment, the area should be cleaned of all signs of infestation, so as not to cause confusion at subsequent inspections.  Special care should be taken to seal cracks, crevices and other areas where bed bugs were found.

Conduct a follow up inspection in a week to 10 days, since eggs take 7-10 days to hatch.  In the case of a heavy infestation, more than one follow up visit is recommended.

Following are some additional recommendations that may be help your clients to reduce the risk of re-infestation.
Used mattresses or rental furniture:  Advise your clients to check used or rental furniture before bringing onto the premises.  Before purchasing a used mattress, they should make sure that the item has been sanitized by a licensed sanitizer and that each item has a yellow tag.  They should never pick up used mattresses or furniture from the side of the road or by a dumpster.  These items could have been exposed to bed bugs.
New mattresses or furniture: Your client should be aware that all new mattresses or furniture should arrive sealed in plastic from the manufacturer.  New mattresses must have a bedding tag certifying that they are made by a licensed manufacturer.
Encasements or enclosures:  Recommend the purchase of mattress and box spring encasements, available at department stores or online.  These should completely enclose the mattress and/or box spring, leaving no gaps or holes. The zipper should have small teeth and seal completely.  This practice will contain any bed bug eggs not completely removed from the mattress and well as ensure that a new infestation does not find suitable shelter.
Clutter:  In all circumstances, apartments, hotels, etc, clutter should be eliminated to deny bed bugs hiding places.
Communicate:  Make sure that all parties involved are aware of what to look for and who to notify should the initial signs of bed bug activity be noticed.  In a private residence, all family members should be aware and vigilant for possible bed bug activity.  For hotels and rental property, housekeeping and maintenance staff should be trained on what to look for to detect bed bugs in the early stages.

5.  Further information:

For more information regarding bed bugs in NC, please contact Jung Kim, NCDACS (phone 919-733-3556, ext. 403, email: jung.kim@ncagr.gov). If you have a bed bug sample for identification, please submit the sample to 1631 MSC, Raleigh NC 27699-1631.

6.  Additional Online Resources:

Readers need to pay close attention to the source of information. Unfortunately, much of the bed bug information online may not be accurate and can be misleading.

Here are some reliable and useful sites on bed bugs. 

North Carolina Department of Agriculture and Consumer Services - Bed bugs  (http://www.ncagr.gov/SPCAP/sleep/Bedbugs.htm)

NCBedBugs.com  (http://www.ncbedbugs.com/)

NCSU - bed bug biology and control (http://www.ces.ncsu.edu/depts/ent/notes/Urban/bedbugs.htm)

 Wake County Human Services - Bed bugs  (http://www.wakegov.com/humanservices/publichealth/information/diseases/pages/bedbugs.aspx)

 NYC - Bed bugs, information, resources, & management for New York City residents  (http://www.nyc.gov/html/doh/bedbugs/html/home/home.shtml)

EPA - bed bug information  (http://www.epa.gov/bedbugs/)

Virginia Department of Agriculture and Consumer Services - Bed bug outreach and education program  (http://www.vdacs.virginia.gov/pesticides/bedbugs.shtml)
University of Kentucky - Bed bugs (http://www.ca.uky.edu/entomology/entfacts/ef636.asp)

 University of Florida - Bed bugs  (http://ipm.ifas.ufl.edu/community/structural/bed_bug_IPM.shtml)

University of Nebraska - Managing bed bugs  (http://lancaster.unl.edu/pest/resources/bedbug263.shtml)

NPMA - bed bug information  (http://www.pestworld.org/all-things-bed-bugs/)