Bedbugs: A Growing, but Manageable Concern

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Bedbugs A growing, but manageable concern

Abstract

Bedbugs are spreading at an alarming rate and are a pest of great public health importance. To date, bedbugs have not been known to transmit disease however it is evident that secondary infections may occur due to scratching bedbug bites. Effects of anxiety and insomnia are a few reported systematic reactions to living in a bedbug infested environment. Dealing with an infestation requires persistence, creativity and a great integrated pest management (IPM) program. This case study demonstrates how a specially designed chair helped reduce and control an infestation without the use of pesticides.

Main Article

Bedbugs are becoming a huge concern in North America, spreading throughout hotels, stores, offices, homes, apartment buildings, on transit (buses and subways) and even in healthcare facilities. Bedbugs (Cimex lectularius) are blood-feeding insects that have plagued humans for thousands of years (Goddard & deShazo, 2009). Victims of bedbug bites have been reported to suffer from loss of sleep, psychological distress, as well as develop clinical symptoms such as skin rashes and allergic reactions (Hwang, Svoboda, De Jong, Kabasele, & Gogosis, 2005; Paul & Bates, 2000).

Environmental Protection Agency (EPA), the Centers for Disease Control and Prevention (CDC), and the United States Department of Agriculture (USDA) all consider bedbugs a public health pest. However, unlike most public health pests, bedbugs are not known to transmit or spread disease. Secondary infections such as impetigo, ecthyma, and lymphanigitis may occur due to scratching and effects of anxiety and insomnia are a few systematic reactions due to living in a bedbug infested environment (Hwang et al., 2005).

Any break in the skin
causes increased risk for MRSA

Whether or not bedbugs can transmit human disease agents remain a point of contention. One serious potential health concerns with bedbugs is Methicillin Resistant Staphylococcus aureus (MRSA). Any break in the skin causes increased risk for MRSA. Repeated bedbug bites and scratching causes health risks that are potentially dangerous. reported the recovery of Methicillin Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus faecium (VRE) from bedbugs in Vancouver, British Columbia  (Lowe & Romney, 2011).

Bedbugs carrying MRSA and/or VRE may have the potential to act as vectors for transmission (Cockburn et al., 2013; Fong et al., 2012; Lowe & Romney, 2011). Further studies are needed to characterize the association between S. aureus and bedbugs. Bedbug carriage of MRSA, and the portal of entry provided through feeding, suggests a plausible potential mechanism for passive transmission of bacteria during a blood meal. Due to the insect’s ability to compromise the skin integrity of its host, and the propensity for S. aureus to invade damaged skin, bedbugs may serve to amplify MRSA infections in impoverished urban communities (Lowe & Romney, 2011).

As we have no firm evidence of the ultimate effects of bedbugs, infestations should be taken seriously in order to prevent potential health risk due to infections, anxiety, sleep apnea or other conditions. Bedbugs do not jump or fly and move slowly as they travel (Sutherland, Choe, & Lewis, 2013). Bedbugs are known to travel over 100 feet in one night, but tend to live within 5 to 20 feet of a blood meal. This may be why beds are ideal locations for bedbugs to harbour. The perimeter of the bed such as the night tables, baseboards, picture frames above and around the bed are also prime locations for them to harbour. Bedbugs reside in dark closed places as close to the bloodmeal as possible. They can squeeze into cracks, crevasses, seams, and tight places to hide and mate. They prefer to feed at night when it is dark and while hosts are inactive. Bedbugs sense the perception of body temperature and are stimulated as the host omit carbon dioxide during sleep. Perfect conditions for bedbugs to come out for a blood meal.  We should not be fooled by the term bedbug as these little creatures will reside anywhere as long as a blood meal is close by. Even though bedbugs are primarily active at night, they will seek hosts in daylight if hungry (Chen & Copes, 2010; Sutherland et al., 2013).

Workplace Infestation: A Case Study

Corey Strickland is a manager of Real Estate and Facilities for a global IT company. He is responsible for managing 26 separate facilities in Eastern Canada and the North East United States. Bedbugs have been a real challenge at one of the facilities he manages. The bedbug infested building is over 100,000 square feet with seven separate floors. The building is occupied with a Development Centre that operates 24 hours a day, seven days a week and has over 500 work stations. Over the past 6 years, there has been an increase in bedbug infestations within the vicinity of this building. This building is located in a city that has had a significant increase in bedbug infestations. In addition, many of the staff at the Development Centre reside in a building directly behind the Development Centre and this residence is infested with bedbugs.  One challenge is that the Development Centre management has no control over the infested residence. Employees of the Development Centre that live in this building bring bedbugs to work. The reverse may happen as employees are exposed to bedbugs at work and take them home. Within the Development Centre, bedbugs were found in desks, cupboards, cabinets and all the chairs that staff sit on. With over 500 workstations, there are the same number of chairs that are used potential hosts for up to 24 hours a day, resulting in a perfect location for bedbugs to reside.

The facilities management team spent countless amount of time, effort and cost combating the bedbug infestation. They contracted a reputable pest management firm who conducted bedbug audits using bedbug sniffing dogs (Figure 1). Once the dogs locate the bedbugs, appropriate spraying and treatment were applied. The facility management team developed an educational program for all employees which included identifying and immediate reporting of sightings. They offered special pest control service discounts for all employees to have their residence checked for bedbugs, in hopes of eradicating the problem on site as well as at the employee’s residence.

Figure 1: Bedbug sniffing dog

Figure 1: Bedbug sniffing dog

There have been no identified employee retention issue, but it is evident that the stigma associated with a building’s reputation of having bedbugs impacts recruitment. No one wants to work in a building with bedbugs. Although the staff of the Development Centre appreciated the efforts of the facility management team, staff morale was negatively impacted during the infestation. The Facility management team took the morale issue very seriously and continued every effort to eradicate bedbugs from this building. Following pest control treatment each floor was audited using bedbug sniffing dogs for effectiveness within three weeks of the treatment.

One floor had 150 sightings of bedbugs following treatment. It is interesting to note that this was over 50% of the total area that was previously treated with insecticide and over 70% of the sightings by the dogs were in chairs. This lead the Facilities Management team to reach out for a solution to deal with the bedbug infestations in their chairs. The ergoCentric Research and Development team took on the challenge to develop a chair that continued to meet the comfort and ergonomic requirements but had the capability to reduce bedbug harbourage in the chair. To create a bedbug resistant chair, ergoCentric used guiding principles of understanding how bedbugs breed, feed and live. As a result, they removed all seams and crevices where a bedbug might reside in a chair. With the exception of the chair’s castors or adjustable arms rests, there are no areas where a bedbug can reside. The casters and arms are removable, so in the event of a concern they can be chemically treated, steamed or placed in a freezer for up to 5 days to kill any bedbug or eggs that may reside in these two components of the chair.

The Development Centre trialed replacing existing chairs with ergoCentric’s bedbug resistant chair (ecoCentric Mesh) on one floor which initially reported the 150 sightings of bedbugs (Figure 2). All 200 chairs on the floor were discarded and replaced with bedbug resistant chairs and the same process of treatment and auditing followed. After a three-week period, the bedbug sniffing dogs only found 7 sightings on this floor and only 1 was found on the bedbug resistant chair. The Development Centre is in the process of replacing all chairs with the bedbug resistant chair and continues to work closely with its pest control service on an exceptional integrated pest management plan.

Figure 2: EcoCentric Mesh Chair trialed in the facilities

EcoCentric Mesh Chair trialed in the facilities

Conclusion

In this case study, an integrated pest management program targeting furniture yielded significant reductions in the number of bedbugs identified. The challenges of eliminating bedbugs cannot resolved by eliminating one sole factor, but by introducing the ergoCentric’s bedbug resistant seating, we have achieved a significant step forward. Previous studies have identified bedbugs as a potential source of multidrug-resistant pathogens like MRSA, and have the capacity to transfer the pathogens to human hosts. Given the prevalence of bedbugs in urban centers, the potential for an outbreak is quite high. Current studies are aimed towards tracking the bedbug population following furniture replacement on a much larger scale. Simple considerations like our choices in furniture could yield significant returns when the next outbreak occurs.

For more information, please see an informative video on the innovation here:

https://www.youtube.com/watch?1=&v=j3kSRCv5Mqk

References:

Chen, H., & Copes, R. (2010). A review on bed bugs: epidemiology, health effects, and surveillance activities. Retrieved from http://www.publichealthontario.ca/en/eRepository/OAHPP review on bed bugs – Chen and Copes – Nov 3 2010.pdf

Cockburn, C., Amoroso, M., Carpenter, M., Johnson, B., McNeive, R., Miller, A., … Vaidyanathan, R. (2013). Gram-Positive Bacteria Isolated from the Common Bed Bug, Cimex lectularius. Entomologica Americana, 119(1 & 2), 23–29.

Fong, D., Bos, C., Stuart, T., Perron, S., Kosatsky, T., & Shum, M. (2012). Prevention, identification, and treatment options for the management of bed bug infestations. Environmental Health Review, 55(4), 89–102.

Goddard, J., & deShazo, R. (2009). Bed Bugs (Cimex lectularius) and Clinical Consequences of Their Bites. JAMA, 301(13), 1358.

Hwang, S. W., Svoboda, T. J., De Jong, I. J., Kabasele, K. J., & Gogosis, E. (2005). Bed bug infestations in an urban environment. Emerging Infectious Diseases, 11(4), 533–8.

Lowe, C. F., & Romney, M. G. (2011). Bedbugs as vectors for drug-resistant bacteria. Emerging Infectious Diseases, 17(6), 1132–4.

Paul, J., & Bates, J. (2000). Is infestation with the common bedbug increasing? BMJ (Clinical Research Ed.), 320(7242), 1141.

Sutherland, A., Choe, D., & Lewis, V. (2013). Bed Bugs: Integrated Pest Management in and around the Home. University of California Pest Notes, May, 1–6.

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Keith Sopha
Advisory board member of InfectionControl.tips. President of the Canadian Association of Environmental Management – CAEM. Preceptor for Ontario Hospital Associations Environmental Services level 1 and level 2 correspondence courses. Environmental consultant for the Provincial Infectious Diseases Advisory Committee environmental best practices document released in 2009, second edition released in 2012 and is working with the team developing the 3rd edition. Keith was part of the leadership team which developed the Environmental best practice educational tool kit for the Province of Ontario. Member of the Program Advisory Committee for the development of Centennial College – Health Care Environmental Management Program. Co- leader of the Canadian Hospital Environmental Services Study through Queen’s University. Co- leader of the Hospital Environmental Cleaning Time Standards study, also conducted through Queen’s University and is the environmental consultant for Accreditation Canada/International developing standards for the State of Qatar.

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