Bed Bugs: Yucky, But Will The Pesticide Kill You? Alternatives?

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Bed bugs are back in the news, but now there are concerns that the pesticides might cause worse health problems than the critters themselves.  Although the reports from the CDC are that 111 people got sickened and one died in the last seven years, I suspect the reports underestimate the possibilities.  To be reported, a case would have to be linked directly to pesticide exposure, and that is likely to only happen if the exposure happened very recently or was industrial in nature (pesticide sprayers).

In a report from Japan, an agricultural worker spraying chlorfenapyr (the insecticide favored for bed bugs but which kills a broad spectrum of bugs) got sick.  He complained of fatigue and was treated for dehydration.  By the time the insecticide had done its work, he spiraled into death despite all attempts to save his life.  It took seven days for him to show full poisoning effects.  In the U.S., a 55-year-old male showing similar symptoms seven days after exposure would not be likely to be linked to a home application of insecticide done seven days previously.  (Report is below at the very end of this post).

So rather than expose ourselves to slow death, what else can be done?  The other standby is heat.  A standard steam cleaner can be handy.  They also don’t like a thing called Diatomaceous earth dust, which works as well as the insecticide.  And, because they cannot fly, a range of traps are effective.  I’m including a number of studies below that I included for a patient who had an infestation (not in Maine.)

J Econ Entomol. 2009 Jun;102(3):1182-8.Links

Lethal effects of heat and use of localized heat treatment for control of bed bug infestations.Pereira RM, Koehler PG, Pfiester M, Walker W.

Department of Entomology, University of Florida, Building 970 Natural Area Drive, Gainesville, FL 32611-0620, USA.

Bed bugs, Cimex lectularius L., hide in cracks and crevices in furniture and are difficult to control. The bed bug thermal death kinetics were examined to develop a heat treatment method to eliminate bed bug infestations in room contents. High temperatures caused temporary immobilization (knockdown) of bed bugs even with exposures that did not have lethal effects. Exposure of bed bug adults to 39 degrees C for 240 min caused no mortality; however, as temperatures increased from 41 to 49 degrees C (105-120F) exposure times that caused 100% mortality decreased. The temperature difference to provide a 10-fold change in the mortality was estimated at 4 degrees C, and the estimated activation energy (EA) was between 484 and 488.3 kJ/mol. This demonstrates that bed bugs are not more resistant or susceptible to changes in temperature than other tested insects and that the temperatures needed to kill bed bugs are relatively low. In room treatment tests, heat treatment times varied from 2 to 7 h with complete mortality of exposed bed bugs within the treatment envelope created by surrounding the treated furniture with polystyrene sheathing boards. Containment and circulation of heat around the treated material were crucial factors in an efficient heat treatment for bed bug control. The room floor material greatly affected containment of the heat. The tested method for limited heat treatment of furniture and other room contents required equipment costing less than US$400 and provided opportunity for residual pesticide application around the room with minimal disruption in use of treated room.

PMID: 19610436

JAMA. 2009 Apr 1;301(13):1358-66. Links

Bed bugs (Cimex lectularius) and clinical consequences of their bites.Goddard J, deShazo R.

Department of Entomology and Plant Pathology, Mississippi State University, Box 9775, Mississippi State, MS 39762, USA.

CONTEXT: Bed bug (Cimex lectularius) infestations are rapidly increasing worldwide. Health consequences include nuisance biting and cutaneous and systemic reactions. The potential for bed bugs to serve as disease vectors and optimal methods for bed bug pest control and eradication are unclear. OBJECTIVES: To present current knowledge of the health and medical effects of bed bugs and to explore key issues in pest control and eradication efforts. DATA SOURCES: A search of MEDLINE and EMBASE databases (1960-October 2008) for articles using the keywords bed bugs, Cimex lectularius, humans, parasitology, pathogenicity, and drug effects. For pest control, PubMed and Toxline searches (1960-October 2008) were performed using the keywords bed bugs, Cimex, control, prevention, and eradication. Manual searches of older journals, textbooks, pest control trade journals, and newspapers (1892-October 2008) were also performed. STUDY SELECTION: Original accounts or investigations of bed bugs, clinical responses with sufficient detail of cause and effect between the bed bug bite and clinical response, and convincing evidence of substantiated presence of bed bug exposure. For pest control, documentation that an eradication measure quantitatively decreased bed bugs. DATA EXTRACTION: A trained medical reference librarian assisted with the literature search. Two authors with expertise in the diagnosis, treatment, and eradication of bed bugs reviewed the clinical articles. One author evaluated the pest control articles. DATA SYNTHESIS: Fifty-three articles met inclusion criteria and were summarized. Only 2 clinical trials concerning bed bugs were identified and tested the ability of pest control interventions to eradicate bed bugs. Although transmission of more than 40 human diseases has been attributed to bed bugs, there is little evidence that they are vectors of communicable disease. A variety of clinical reactions to bed bugs have been reported, including cutaneous and rarely systemic reactions. A wide range of empirical treatments, including antibiotics, antihistamines, topical and oral corticosteroids, and epinephrine, have been used for bite reactions with varying results. No evidence-based interventions to eradicate bed bugs or prevent bites were identified. CONCLUSIONS: Treatment options for cutaneous and systemic reactions from bed bug bites have not been evaluated in clinical trials and there is no evidence that outcomes differ significantly from those receiving no treatment. Evidence for disease transmission by bed bugs is lacking. Pest control and eradication is challenging due to insecticide resistance, lack of effective products, and health concerns about spraying mattresses with pesticides.

PMID: 19336711

J Med Entomol. 2009 May;46(3):566-71.Links

Evaluation of two least toxic integrated pest management programs for managing bed bugs (Heteroptera: Cimicidae) with discussion of a bed bug intercepting device.Wang C, Gibb T, Bennett GW.

Center for Urban and Industrial Pest Management, Department of Entomology, Purdue University, West Lafayette, IN 47907, USA.

The cost and effectiveness of two bed bug (Cimex lectularius L.) integrated pest management (IPM) programs were evaluated for 10 wk. Sixteen bed bug-infested apartments were chosen from a high-rise low-income apartment building. The apartments were randomly divided into two treatment groups: diatomaceous earth dust-based IPM (D-IPM) and chlorfenapyr spray-based IPM (S-IPM). The initial median (minimum, maximum) bed bug counts (by visual inspection) of the two treatment groups were 73.5 (10, 352) and 77 (18, 3025), respectively. A seminar and an educational brochure were delivered to residents and staff. It was followed by installing encasements on mattresses and box springs and applying hot steam to bed bug-infested areas in all 16 apartments. Diatomaceous earth dust (Mother Earth-D) was applied in the D-IPM group 2 d after steaming. In addition, bed bug-intercepting devices were installed under legs of infested beds or sofas or chairs to intercept bed bugs. The S-IPM group only received 0.5% chlorfenapyr spray (Phantom) after the nonchemical treatments. All apartments were monitored bi-weekly and retreated when necessary. After 10 wk, bed bugs were eradicated from 50% of the apartments in each group. Bed bug count reduction (mean +/- SEM) was 97.6 +/- 1.6 and 89.7 +/- 7.3% in the D-IPM and S-IPM groups, respectively. Mean treatment costs in the 10-wk period were $463 and $482 per apartment in the D-IPM and S-IPM groups, respectively. Bed bug interceptors trapped an average of 219 +/- 135 bed bugs per apartment in 10 wk. The interceptors contributed to the IPM program efficacy and were much more effective than visual inspections in estimating bed bug numbers and determining the existence of bed bug infestations.

PMID: 19496428

MotherEarth D – Diatomaceous Earth 1 866  581 7378

A Fabric Steam Cleaner will kill eggs and bugs.  Since steam can penetrate mattresses and furniture, the heat will kill them in a couple of seconds.  Repeat steaming once a week until no sign of them remains.

Spray Rubbing Alcohol on them.  It kills them instantly.

Bed bugs can’t cross Vasoline or petroleum jelly. Crossing Glass and metal is also difficult.  One old prevention was to place bed legs in tin cans coated with petroleum jelly.  They can’t climb up onto the bed.

Sticky tape around bed legs also works.

Call a professional exterminator for bombing and spraying.

Chudoku Kenkyu. 2007 Apr;20(2):131-6.

[Case report of acute death on the 7th day due to exposure
to the vapor of the insecticide chlorfenapyr].

[Article in Japanese]

Hoshiko M, Naito S, Koga M, Mori M, Hara K, Ishitake T.


National Hospital Organization Ureshino Medical Center.


We present the case of a 55-year-old male agricultural
worker who complained of severe general fatigue and hyperperspiration after
exposure to an insecticide vapor. He worked in a tea plantation and used
chlorfenapyr, a broad spectrum for harmful insects, without any protective mask
or clothes. After one day of insecticide spray work, he gradually began to
complain of general fatigue, hyperperspiration, nausea and vomiting. At first,
he was diagnosed as being dehydrated and was treated with fluid replacement
therapy. Although he received this conservative therapy, there was no effect on
the above mentioned symptoms. On the 7th day of the onset of his symptoms, his
consciousness level deteriorated rapidly and body temperature exceeded 40
degrees C. No cerebral vascular disease or meningitis was observed. Finally, he
died despite intensive care. The findings of the clinical course and laboratory
data suggest a clinical diagnosis of acute pesticide poisoning due to exposure
to chlorfenapyr vapor. We suggest that agricultural workers should use this
insecticide with caution and sufficient protective gear.

PMID: 17533964


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