Bed bug bites can look a lot like other insect bites. Some clues that can suggest the presence of bed bugs include finding red, itchy bites upon awakening - especially if the bites line up in a row on the skin. Bed bugs typically bite at night on exposed areas of skin, so the bites are most commonly found on the face, neck, hands and arms. Although some people develop a bite reaction immediately, others may take two to three days before a reaction becomes noticeable, and not all people have obvious bed bug bite symptoms. A bed bug bite can appear as a tiny puncture wound without a surrounding reaction, and can easily be missed. In fact, 30 percent of individuals living in bed bug-infested dwellings report a lack of bites or skin reactions. This appears to be more common amongst the elderly. On the other hand, other people have exuberant reactions, with large, red, raised and itchy welts. This is especially true if one becomes sensitized to bed bug bites, so that with repeated bites there is an increased risk of an exaggerated reaction to bed bug bites.
Bed bugs are a growing problem in schools and daycares. Typically they are introduced by students or staff living with an infestation at home. Pinpointing where the bugs exist can be challenging in such environments since there are no beds or sleeping areas for the insects to congregate. (Similar challenges occur when bed bugs are found in offices, libraries and retail stores.) Usually only small numbers of bed bugs are spotted, often on a student’s clothing, backpack, chair or desk. While this does not necessarily confirm that the child’s residence also has bed bugs, the parents should be notified that the home should be inspected, preferably by a professional. Teachers, nurses, and staff should be educated about the bugs and what they look like. Bed bugs should also be considered if a student frequently has reddened itchy welts --but keep in mind such reactions can be for reasons other than bed bugs. 
Bedbugs bite and suck blood from humans. Bedbugs are most active at night and bite any exposed areas of skin while an individual is sleeping. The face, neck, hands, and arms are common sites for bedbug bites. The bite itself is painless and is not noticed. Small, flat, or raised bumps on the skin are the most common sign; redness, swelling, and itching commonly occur. If scratched, the bite areas can become infected. A peculiarity of bedbug bites is the tendency to find several bites lined up in a row. Infectious-disease specialists refer to this series of bites as the "breakfast, lunch, and dinner" sign, signifying the sequential feeding that occurs from site to site. In some people, the bites can take several days to develop. The signs may become apparent up to 14 days after the bite has occurred.

Bed bug bites are caused primarily by two species of insects: Cimex lectularius (the common bed bug) and Cimex hemipterus.[3] They are about 1 to 7 mm in size.[7] Spread is by the bugs walking between nearby locations or being carried within personal items.[2] Infestation is rarely due to a lack of hygiene but is more common in high density areas.[8][2] Diagnosis involves both finding the bugs and the occurrence of compatible symptoms.[5] Bed bugs spend much of their time in dark locations like mattress seams or cracks in the wall.[2]

Bedbugs do, however, have a unique bite pattern. Although some bites may appear alone, most bites occur in a row of three to five bites (termed "breakfast, lunch, and dinner") or in a cluster of red bumps (a rash called bedbug dermatitis). The bites often appear in a zig-zag formation, but may appear in a straight line if the bugs bite you in the morning.
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In the case of beds, a more economical option is to encase both the mattress and box spring in a protective cover like those used for allergy relief. Encasements specifically designed to help protect against bed bugs are available through retail or pest control firms. Higher quality ones tend to be more durable and comfortable to sleep on. Once the encasement is installed and zipped shut, any bugs which happen to be inside are entombed and eventually will die. Encasements also help protect newly purchased beds, and make it easier to spot and destroy any bugs residing on the outer surface during subsequent examination. Encasements will not, however, keep bed bugs from crawling onto a bed and biting a sleeping person.
Unlike those of other insects, bed bug bites may sometimes appear in tight lines of multiple, small, red marks where multiple bed bugs have fed along an exposed area. Bed bug bites can cause itchiness. Initially, a victim may detect a slight burning sensation. The burning area then develops red bumps, known as papules or wheals (rash). In extreme cases, bites may swell dramatically or turn into blister-like skin inflammations.
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