Prevention, identification, and treatment options for the management of bed bug infestations
In the past decade, bed bug infestations have been increasing worldwide. Historically, studies have failed to provide evidence for the transmission of human diseases through bed bugs, but recent evidence is lacking. Although physical reactions to bed bug bites continue to be documented, evidence regarding the mental health effects arising from bed bug infestations is limited to anecdotes and case reports. This report provides an update and summary of the bed bug management strategies discussed during a workshop at the 2010 Canadian Public Health Association Conference. ‘‘Best practices’’ regarding prevention, identification, and treatment options are presented, using evidence from existing evaluative studies. Awareness of bed bug behaviour and proper building maintenance can prevent transfer of bed bugs from belongings, including second-hand items, and reduce entry points and harbourage sites. In addition to inspection by trained professionals, early recognition of clinical symptoms and environmental signs of an infestation are important to avoid further spread of bed bugs and to allow implementation of safe and effective treatment options. Early findings may indicate a need for special support for vulnerable individuals with mental health issues potentially exacerbated by bed bug infestations. Preparing units for treatment, including the removal of clutter, is essential. However, physical and financial limitations are challenges for managing bed bug infestations, especially for vulnerable populations. Current treatment options such as application of heat or pesticides can be effective when properly implemented,but there are concerns with pesticide resistance. An Integrated Pest Management approach is recommended and should include ongoing monitoring and prevention that are essential for positive treatment outcomes. Regulatory officials, building management, and pest management professionals are encouraged to collaborate using a systematic approach to address bed bug infestations.