Bed bugs are small parasitic insects that feed on human blood.

While they are a public health concern, bed bugs are not known to transmit disease through their bites.

Bed bugs use a small tube-like structure called a proboscis to pierce the skin and drink a person's blood. The pests are most active when humans are asleep, during the night and early morning.

The bed bug bites may form a line or be in a zigzag pattern.

Bed bugs can bite anywhere on the body where there is skin. Typically, bites tend to occur on areas exposed during sleeping, such as: neck, face, hands, shoulders, arms and legs.

Many people do not feel the bite itself or develop clear symptoms other than the dots where the bug bit and some minor, surrounding inflammation and irritation. Others are considered hypersensitive to bites and develop more severe symptoms.

In most cases symptoms occur more or less immediately after the bite, but they can develop or progress over the following days as well. Without further irritation, symptoms typically resolve after a week or so.

Almost all bed bug bites will produce some degree of discomfort, typically itchiness and inflammation. Other signs and symptoms of bed bug bites include: a burning painful sensation, a raised itchy bump with a clear center, a red itchy bump with a dark center and lighter swollen surrounding area, small spots of blood from bites often dried or stained onto sheets or bed clothing, reddish or reddish-brown dried stains on fabrics due to bed bug droppings and white or clear skins, shed by the nymphs as they mature.

While fairly rare, some people have or developed severe reactions and symptoms from bed bug bites. Serious symptoms that require medical attention include: difficulty breathing, blisters, fever, feeling nauseous or flu-like, swollen tongue and irregular heartbeat.

 

Living with bed bugs can cause additional health complications:

Increased likelihood of infection: Due to the skin's surface being compromised. 

Sleep deprivation: The idea of being fed on can be extremely stressful. Given that the bugs only feed at night, some people will avoid sleep or will only get fitful or restless sleep. 

 

Treatment

Bed bug bites should heal on their own, but may be itchy and swollen in the meantime. There are relatively few treatments options when it comes to uncomplicated bed bug bites.

The first recommended line of treatment involves cleaning the wound, ideally with soap and water.

For itchy bites, the following may relieve minor symptoms: Over-the-counter hydrocortisone, anti-itch creams and antihistamines.

Most wounds heal on their own within a week, sometimes two.

If severe swelling, inflammation, or itchiness occurs or persists, a person should seek medical attention.

A dramatic immune response may be a sign of an allergic reaction. If this is the case, one of the following may need to be administered: An injectable corticosteroid, antihistamine and epinephrine medication.

If infection occurs, antibiotics may be prescribed.

 

Identification

Older bed bugs are about the size of an apple seed and are brown in color.

One way to help prevent exposure and potential infestations by bed bugs is to be able to recognize bed bugs and distinguish them from other pests.

Common characteristics of nymphs (young bed bugs) include: Being less than 5 mm in length, whitish-yellow and or clear-colored and invisible without a microscope or magnifying glass. The nymphs are easier to see if they have just fed when the blood fills their abdomen, giving it a reddish brown color.

Adult bed bugs are typically far easier to spot than nymphs. Identifiable characteristics of most adult bed bugs include: An oval-shaped body, apple seed in size, a body that is fairly flat unless recently fed and inflated and reddish-brown to light-brown or tan color of shell, depending on how recently it fed.

Controlling bed bugs needs the identification and complete removal or destruction of the pest's eggs.

On average, one female can produce at least 345 eggs over her lifetime. Egg-laying females often increase the volume and frequency of feeding to support their brood.

 

Prevention

The key to preventing bed bug bites is to stop the insects entering, feeding, and breeding in human environments.

In the daytime, bed bugs often seek refuge in the cracks and crevices of furniture, flooring, walls, and mattresses.

The seams and folds of upholstered furniture can also offer an ideal hiding place. Bed bugs have been known to persist in vacuum canisters or units.

The insects tend to pick hiding spots near human sleeping quarters, including bedrooms. Bed bugs found in other rooms are usually a sign of a severe infestation.

Areas where bed bug infestations commonly occur include: Apartment or condominium buildings, large office spaces, hotels, daycares, nursing homes, hospitals, college dormitories or housing units, public transportation, including airplanes, shopping malls and rented homes.

Items commonly responsible for spreading bed bugs include: Used or secondhand furniture, new furniture or textiles exposed to bed bugs during transit, chairs or loungers where people fall asleep and bedding or bed clothes.

 

Control of bed bugs

Home tips for preventing, controlling, and clearing bed bug infestations include:

1. Avoid furniture or items from infested areas or environments commonly impacted by bed bugs, such as apartment buildings.

2. Pick furniture or items made out of materials that do not typically contain cracks, crevices or seams, including plastic, stone, metal, plaster, and high-weave textiles.

3. Washing bedding at high temperatures and checking for signs of bed bugs in hotel rooms can help prevent bed bug bites.

4. Fill or seal cracks, crevices, and seams with products, such as glue or calking.

5. Clean bedding and bed clothing regularly.

6. Wash and dry bedding at high heat.

7. Vacuum upholstered items regularly and thoroughly, including mattresses, pillows, etc.

8. Clean heavier bedding items, including mattresses, pillows, comforters, and duvet covers, using high heat, ideally the "dry steam" setting available on modern washing machines.

9. Check for signs of bed bugs upon entering hotel rooms or other pest hot spots.

Remember, where there is one bed bug there are usually many, often in the areas surrounding or adjacent to the infected room or item.

Cover as much of the skin as possible while sleeping.

In severe or persistent cases, furniture or infected items may need to be destroyed, ideally by burning.