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Department: Health

How to recognize a bed bug?
From its appearance
Bed bugs are small insects that feed mainly on human blood. A newly hatched bed bug is semi-transparent, light tan in color, and the size of a poppy seed. Adult bed bugs are flat, have rusty-red-colored oval bodies, and are about the size of an apple seed. Bed bugs can be easily confused with other small household insects, including carpet beetles, spider beetles and newly hatched cockroaches (nymphs).

From its markings, droppings and eggs
Blood stains, droppings and eggs can be found in several locations including:
• Mattress seams and tufts, sheets, pillow cases and upholstered furniture.
• Crevices and cracks in furniture.
• Baseboards of walls.

From its bite
Some people do not react to bed bug bites. But for those who do, bite marks may appear within minutes or days, usually where skin is exposed during sleep. They can be small bumps or large itchy welts. The welts usually go away after a few days. Because the bites may resemble mosquito and other insect bites, a bump or welt alone does not mean there are bed bugs.

How Bed Bugs Grow and Reproduce?
Bed bugs are most active when we sleep. They crawl onto exposed skin, inject a mild anesthetic and suck up a small amount of blood. Most people never feel the actual bite. Bed bugs need a blood meal to grow and lay eggs. A female lays 5-7 eggs per week and if fed, will lay 200-500 eggs in her life. Eggs take about 10 days to hatch. Bed bugs are fully grown in 2 to 4 months and can live as long as a year.

The Health Effects of Bed Bugs
Although bed bugs and their bites are a nuisance, they are not known to spread disease.
• Bed bug bites can be very itchy and irritating. Most welts heal in a few days but in unusual cases, the welt may persist for several weeks. Usually an anti-itching ointment will help, but if bites become infected, people should see their doctor.

• The anxiety about being bitten can lead to sleeplessness, which can affect one’s well being. Properly and effectively responding to bed bugs helps to keep anxiety in check. Some people become so desperate that that they use illegal or excessive amounts of pesticides that can lead to poisonings.

Signs and Prevention of Infestations
Bed bugs can enter homes by latching onto used furniture, luggage and clothing, and by traveling along connecting pipes and wiring.
Signs
• Insect bites that after sleeping are usually the first sign of an infestation.
• Live or dead bed bugs are found.
• Dark stains on fabric (from the excrement and blood).
• Fresh blood will be found on bedding (person rolls over and crushes the bed bug(s).
• Heavy infestations may leave a sweet musty odor.
• Bed bugs are often found along bed mattress, seams, crevices, box spring, bed frame, and headboard).
Other areas include upholstered furniture, edges of carpeting, wood molding along the walls, inside electrical devices and in stored items and clutter.

Prevention
• Free and donated items should be carefully examined before bringing them home.
• Never bring bed frames, mattresses, box springs or upholstered furniture found on the street into your home.
• Check all used or rented furniture for bed bugs.
• If you suspect you have been around bed bugs, immediately wash and dry your clothing on hot settings or store it in a sealed plastic bag until you can.

Travel tips-
• Travel with clothes that can be laundered in hot water and dried on hot heat for at least 30 minutes.
• Use hard smooth luggage.
• Keep luggage off the floor and beds. Use luggage racks.
• Do not unpack clothing and leave on beds.
• Seal cracks and crevices with caulk, even if you don't have bed bugs. This will help prevent bed bugs and other pests from coming in.

Inspecting Bed Bug
Look for bed bugs, blood stains, droppings and eggs (a flashlight and a magnifying glass will help). Start by looking in an area 10-20 feet around where you sleep or sit. That's the distance a bed bug will usually travel.

Keep a written record of every room and location where you find signs of bed bugs. Share this record with a pest control professional.

Inspection Tips
• Check the top and bottom seams, tufts and any rips in the covers of mattresses and box springs.
• Look underneath the bed and along the bed frame and headboards.
• Use a flash light to inspect cracks and crevices of furniture, windows and door frames.
• Swipe a putty knife or playing card into cracks and crevices to force bed bugs out. A hot blow dryer on a low setting will also work. If live bugs do come out, crush them with a paper towel and throw them away outside your building.
• Remove drawers from furniture and check the inside, top and bottom, joints and even screw holes.
• Remove and check zippers, seams and tufts in cushions of upholstered furniture, and their frames.
• Using crevice tools, check paintings, posters, pictures and mirrors.
• Check cracks in plaster and peeling wallpaper.
• Inspect the face plates of electrical outlets and light switches (by eye only – do not insert anything into areas with wires).
• Look in phones, clocks, smoke detectors and toys.

Getting Rid of Bed Bugs
If you have bed bugs, you shouldn't feel ashamed. Anyone can get bed bugs. Notify your landlord and neighbors. The sooner everyone responds, the more successful everyone will be.

Choosing and working with a pest control company:
Bed bug infestations usually require the services of well-trained, licensed pest management professionals. There are many pest control companies and licensed pest professionals in the area. Not all are well trained in managing bed bugs. To get rid of bed bugs, you must choose the right company, be clear about what you want done and monitor performance.
• Find a company through dependable referrals, directories,
professional associations and check to make sure they are licensed.
• Agree on a service plan and its cost. Expect at least two treatment visits and a third follow-up visit to confirm that bed bugs have been eliminated. Severe infestations or cluttered apartments may take more visits to eliminate bed bugs.

A good company will…
• Inspect your property before giving you a price quote or begin any pesticide application.
• Give you a written inspection report, and an action plan of how to prepare for treatment and prevent further infestation.
• Base quotes on inspection findings, not flat fees. The cheapest services are rarely the best.
• Visit often until the job is done.
• Educate you on how to prevent bed bugs.
• Work with you until the bed bugs are gone.

Bed bug infestations usually require the use of pesticides. Only professionals should apply pesticides for bed bugs. Foggers and bug bombs are not effective against them.

Ask the professional to:
• Use the least-toxic pesticide labeled for bed bugs that will be effective.
• Follow all instructions and warnings on product labels.
• Tell you when it's safe to re-enter a treated room.
• Never spray the top of mattresses or sofas, and if needed, to use only small amounts of pesticides on their
seams only.

Steps to Take When Inspecting:
• Furniture must be inspected carefully, even to the point of dismantling the bed for easier inspection and possible treatment. Look especially behind the headboard. Check the mattress and boxspring carefully, particularly the seams and dust cover on the underside of the boxspring.
• Check under and behind other pieces of furniture, such as chairs, couches, dressers, etc. It may be necessary to remove the dust covers on the undersides of chairs and couches. Pull drawers out of dressers, inspect them carefully and examine the interior of the dresser. Check under lamps on nightstands.
• Remove and inspect objects, such as pictures, mirrors, curtains, etc., that are hung or mounted on walls.
• Check obvious cracks and crevices along the baseboards, particularly the back framing pieces.
• Inspect torn or loose wallpaper and decorative borders.
• Check clothing and other items stored in areas where bed bugs have been found.
• Check attics, eaves and roof overhangs for signs of bat or bird activity. Request old nesting material be removed. If there are bats roosting in the attic, have management contact a pest control company or wildlife removal company in the area for assistance.

Cleaning and Disinfecting to Reduce the Spread:
• Examine all items in infested rooms for bed bugs. Look for black or brown fecal spots to pinpoint hiding places. Kill bed bugs by dropping them in hot, soapy water and flushing. Remember that immature bed bugs are very tiny.

• Wash all items showing bed bug stains in hot water (140oF) and place in hot dryer on the highest setting for at least 20 minutes. After drying store items in sealed plastic bags until you are sure you have gotten rid of bed bugs

• Thoroughly vacuum infested areas. This includes carpets, floors, cracks and crevices, mattress, box springs furniture, beds, headboards, and sofas. Do not forget the void area underneath box springs--tear away the cambric fabric and look for bed bugs there. After you are finished, bag the vacuum cleaner bag and take it to the outside trash dumpster. Bed bugs are very resistant to being killed and you do not want them crawling out of the vacuum cleaner to re-infest the building. Vacuum every couple days until the infestation is gone.

• Use a steamer on mattresses to kill eggs that might have been overlooked. Steaming is effective and safer than spraying mattresses with insecticides. Steam cleaning carpets is also a good idea, but work with the pest control company to make sure you are not interfering with the effectiveness of treatments. Be sure that mattresses dry completely to avoid mold and mildew.

• Enclose infested mattresses and box springs in a cover that is labeled “allergen rated,” “for dust mites,” or “for bed bugs” for at least a full year. Periodically check for rips or openings and tape these up.

• Eliminate clutter in infested areas to reduce bed bug hiding places and make treatments more effective. Stacks of clothing, paper items, and corrugated cardboard are likely hiding places because bed bugs like to hide in small cracks. Get rid of clutter to reduce places bed bugs can hide. After checking them for bed bugs, consider putting non-essential belongings into storage until the bed bugs are gone from your home. Check all items again before returning.

• Repair cracks and crevices. Repair cracks in plaster, repair or remove any loose wallpaper and tighten light switch covers. Apply caulk to seal crevices and joints in baseboards and gaps on shelving or cabinets. Force bed bugs out of cracks and crevices with a putty knife or playing card, or with hot air from a blow-dryer on low setting. Catch them with sticky packing tape or crush them in paper towels. The heat from blow-dryers will kill bed bugs after 30 seconds of continuous contact.

• Usually, it is not necessary to get rid of furniture or bedding at the first signs of bed bugs. Cleaning and enclosing is often adequate.

• Box springs should only be discarded if they cannot be covered and are heavily infested.

• Use plastic sheeting (shrink /pallet wrap) or place securely in plastic bags any items to be thrown away. Label with a sign that says “infested with bed bugs.”

Source: Georgia Division of Public Health
New York City Public Health and Mental Hygiene
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