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Review

Bed Bugs: Clinical Relevance and Control Options

Stephen L. Doggett, Dominic E. Dwyer, Pablo F. Peñas, Richard C. Russell
Stephen L. Doggett
aDepartment of Medical Entomology, ICPMR, Westmead Hospital, Westmead, New South Wales, Australia
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  • For correspondence: Stephen.Doggett@swahs.health.nsw.gov.au
Dominic E. Dwyer
bCentre 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, Australia
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Pablo F. Peñas
cDepartment of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia
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Richard C. Russell
dDepartment of Medical Entomology, University of Sydney at Westmead Hospital, Westmead, New South Wales, Australia
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DOI: 10.1128/CMR.05015-11
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    Fig 1

    Relative hits from the United States by state to the website http://www.bedbug.org.au as determined by Google Analytics, 6 June 2011 to 2 November 2011, based on 18,672 hits (134).

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    Fig 2

    The various life stages of the common bed bug, Cimex lectularius. Bar, 5 mm. Depicted are the egg stage, the five instars, and both adults. All stages were identified according to the key of Usinger (297). (Reprinted from references 95 and 105.)

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    Fig 3

    Bed bug infestation on a mattress. People most commonly encounter bed bugs in infested beds. The insects typically harbor along the mattress piping. Various stages can be observed, along with dark fecal spotting.

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    Fig 4

    Bite reactions the morning after being bitten by bed bugs. The bites are faint erythematous macules and papules 2 to 3 mm in diameter. The bed bug species was not identified; the bites occurred in a region where both C. lectularius and C. hemipterus occur. (Reprinted from reference 105.)

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    Fig 5

    Same patient shown in Fig. 4 but 4 days later. Lines of bites that run along the body can be observed, along with the classic bed bug wheal, measuring 2 to 3 cm in diameter. (Reprinted from reference 105 [courtesy of Nigel Hill].)

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    Fig 6

    Lines of bites along the arm. The bed bug species was not identified.

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    Fig 7

    A 4-year-old girl bitten by hundreds of C. lectularius bed bugs (identified by the authors). Multiple discrete bed bug wheals, some with purpuric centers, cover much of the body. (Reprinted from reference 105.)

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    Fig 8

    Same patient shown in Fig. 7. A diffused erythema has developed in the more severely bitten areas. This could be the result of trauma (e.g., scratching) to the affected areas.

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    Fig 9

    Bullae with hemorrhagic serum on the hands and ankles from the bite of C. lectularius (identified by the authors). These appeared between 24 and 36 h following the bites. The purpuric/necrotic lesions on the ankle indicate the severity of the reaction. (Reprinted from reference 105.)

Tables

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  • Table 1

    The top 15 bed bug cities in the United States according to two large U.S.-based pest control companies and hits to a dedicated bed bug website

    RankingMost affected city, determined by:
    TerminixaOrkinbbedbug.org.auc
    1New YorkCincinnatiNew York
    2CincinnatiColumbus, OHChicago
    3DetroitChicagoLos Angeles
    4ChicagoDenverWashington, DC
    5PhiladelphiaDetroitPhiladelphia
    6DenverWashington, DCSan Francisco
    7Washington, DCNew YorkHouston
    8Los AngelesPhiladelphiaColumbus
    9BostonDayton, OHDenver
    10San FranciscoBaltimoreSeattle
    11Columbus, OHLexington, KYCincinnati
    12Dayton, OHMinneapolis-St. Paul, MNMinneapolis
    13BaltimoreHartford-New Haven, CTIndianapolis
    14Louisville, KYBoston-Manchester, MAPhoenix
    15DallasLos AngelesRaleigh
    • ↵a In order of the numbers of bed bug treatments by Terminix pest control during 2011; the period of recording was not stated (286).

    • ↵b In order of the numbers of bed bug treatments by Orkin pest control between January 2008 and July 2010 (29). Note that both rankings 1 and 2 will be biased based on the respective companies' client bases.

    • ↵c In order of the number of hits to http://www.bedbug.org.au as determined by Google Analytics from 6 June 2011 to 2 November 2011, based on 18,672 hits (134). These data may be biased against the socially disadvantaged, who may not have Internet access.

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Bed Bugs: Clinical Relevance and Control Options
Stephen L. Doggett, Dominic E. Dwyer, Pablo F. Peñas, Richard C. Russell
Clinical Microbiology Reviews Jan 2012, 25 (1) 164-192; DOI: 10.1128/CMR.05015-11

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Bed Bugs: Clinical Relevance and Control Options
Stephen L. Doggett, Dominic E. Dwyer, Pablo F. Peñas, Richard C. Russell
Clinical Microbiology Reviews Jan 2012, 25 (1) 164-192; DOI: 10.1128/CMR.05015-11
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  • Top
  • Article
    • SUMMARY
    • INTRODUCTION
    • BED BUG IDENTIFICATION AND BIOLOGY
    • CLINICAL RELEVANCE
    • BED BUG CONTROL
    • BED BUGS: THE FUTURE
    • ACKNOWLEDGMENTS
    • REFERENCES
    • Author Bios
  • Figures & Data
  • Info & Metrics
  • PDF

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