While bed bugs are not known, at present, to carry any disease pathogens, they are still an important emerging public health issue. And, with ever-increasing news coverage of the bed bug resurgence, the general public — your clients and potential clients — easily can become alarmed and confused. As a result, the need to stay well informed about the health and medical impacts of bed bugs is more vital than ever in dealing with customers' concerns. Here's a look at the issues.
Conflicting Reports. Despite the availability of information, most Americans still have misconceptions about bed bugs, according to the recent Bed Bugs in America survey from the National Pest Management Association (NPMA). Nearly half of the respondents to the NPMA survey incorrectly believed that bed bugs carry disease.
The availability of information may be adding to the confusion. "In our information age, customers have more access to information than ever before. Some of it is good, some is just inaccurate," says Michael Merchant, professor and extension urban entomologist at Texas AgriLife Research & Extension Center, Dallas, Texas.
Case in point: According to Merchant's blog, Insects in the City, the mass media earlier this year widely reported on one study which suggested that bed bugs carry disease. The study, originally published in a letter to the editor of Emerging and Infectious Diseases, a journal of the Centers for Disease Control and Prevention (CDC), examined whether or not the bed bugs brought in on the persons of three hospitalized patients carried disease.
The researchers found that the bed bugs tested positive for two different strands of antibiotic-resistant pathogens — Enterococcus faecium (VRE) and Staphylococcus aureus (MRSA). The researchers then speculated that the bed bugs may have picked up the bacteria from the low-income community where patients were from (infections from the two bacteria were prevalent there). They also hypothesized that bed bugs in this community could be acting as a hidden environmental reservoir for MRSA, and could be contributing to the spread and amplification of MRSA infections in these impoverished and overcrowded communities.
The problem? According to Merchant, the study was an example of "quick and dirty" research. It provided only preliminary findings that may prove useful for future tests, but as they stand, are incomplete and potentially misleading.
"The standard of proof is pretty high for stating that a given insect or animal is capable of spreading infection," says Merchant. "This test does not meet that burden of proof by a mile. And the authors would be the first to admit it."
According to Merchant, the prevalence of so much conflicting information places new demands on the industry. "There's more demand than ever for pest management professionals to be well read and knowledgeable about their craft," he says.
As a result, Merchant suggests that pest management professionals rely on multiple trusted sources for the latest in bed bug research and data. "PMPs need to find sources they feel they can count on — NPMA and trade resources, industry bloggers, etc. — for the up-to-date news. These sources will often help digest and clarify what may be in the mass media."
Physical & Mental Health. So do bed bugs carry disease? In a word — No. The answer is really that straightforward, for now. Research on the public health effects of bed bugs has been limited over the past several decades. As the bed bug population declined, so did the research about them. With the current resurgence, the scientific community is working to catch up.
In a recent clinical review published in the Journal of the American Medical Association, medical entomologist Jerome Goddard and medical doctor Richard deShazo combed existing medical literature and could find no strong evidence showing bed bugs to have "vector competence" or the ability to acquire, maintain and transmit an infectious agent.
According to their exhaustive review of the available literature, the most likely candidate for disease transmission is the hepatitis B virus (HBV). The data they reviewed showed that after feeding on an infectious blood meal, bed bugs excrete HBV surface antigen in their feces and could be a possible source of HBV infection by contamination of skin lesions or mucosal surfaces, or by inhalation of dust. However, their transmission of a human disease is yet to be firmly established. In fact, the team concluded that although transmission of more than 40 human diseases has been attributed to bed bugs, there is little evidence that such transmission has ever occurred.
Beyond disease transmission, Americans have other fears about the physical health impacts of bed bugs. According to NPMA's Bed Bugs in America survey, the fear of getting bitten tops the list of the public's concerns. In reality, bed bug bites are a nuisance, but physical reactions to them vary greatly.
According to the CDC, many people have mild to severe allergic reactions to bites with effects ranging from no reaction to a small bite mark to, in rare cases, anaphylaxis (severe, whole-body reaction). Bites can also lead to secondary infections of the skin such as impetigo, ecthyma and lymphanigitis. Most bites do not require any treatment at all. The best bet is to avoid scratching and apply antiseptic creams or lotions and take an antihistamine.
Emerging health concerns also include the impact on mental health. The CDC suggests that bed bugs also may affect the mental health of people living in infested homes. Reported affects include anxiety, insomnia and systemic reactions.
As the bed bug problem continues to grow, researchers will continue to study the health and medical impacts. For now, PMPs are challenged to remain current on the solid science related to bed bugs to better understand and address their clients' concerns.
"We are asking today's PMPs to wear a lot of hats — that of research analyst, psychologist and proficient technician," Merchant says. "We need to give more credit to PMPs for the skill set now required of them. The services the industry provides is a valuable one — maybe more than we realize."
The author is a freelance writer based in Milwaukee, Wis. She can be reached at email@example.com.