Bed bugs (Cimex lectularius) are small, flat, parasitic insects that only feed on the blood of humans and animals while they sleep. They are reddish-brown in color, about 1mm to 7mm in size, and can live for several months without a blood meal. Bed bugs are not known to spread diseases, but their presence can cause itching and loss of sleep. Excessive scratching can increase the chance of secondary skin infections. Bed bugs are found all over the world and the cleanliness does not determine the presence of bed bugs.
To avoid light, bedbugs hide in the seams of mattresses and crevices of bed frames, walls, and furniture during the day.5,7 They are attracted to human hosts by warmth and carbon dioxide; these hosts generally sleep within 3 to 7 feet (1 to 2 meters) of the bedbugs’ hiding places.8,9 Feeding usually takes place just before dawn.10 Bedbug saliva contains several anesthetic, vasodilatory, anticoagulant, and proteolytic compounds that allow the insects to feed undetected for five to 10 minutes. Three of these compounds have been identified as instigators of the subsequent hypersensitivity reactions that may be noticed when the host awakens.11–14
The size of bed bug bites varies with a number of different factors. Bed bugs inject an anti-coagulant along with their saliva when they pierce the skin to take a blood meal. This anti-coagulant is mostly responsible for how a person reacts to the bite and determines the size of the bug’s bite. Since people will have various sensitivities to the bed bug’s bite, the size of the bite will vary, as well. Another factor that influences the size of a bed bug reaction is the number of times a person is bitten. Bite reactions of people bitten many times are also variable, and their response may be either more or less intense as the number of bites increases.
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