If all other options have been exhausted, you may need to seek a professional PMP (Pest Management Professional). There are pesticides that are approved for professionals to use during a infestation. These pesticides, however, are not always effective, and typically not as effective as steam cleaning, excessive heat, or excessive cold. The exterminator may opt to treat the area with carbon dioxide.
Symptoms may not appear until some days after the bites have occurred. Reactions often become more brisk after multiple bites due to possible sensitization to the salivary proteins of the bed bug. The skin reaction usually occurs in the area of the bite which is most commonly the arms, shoulders and legs as they are more frequently exposed at night. Numerous bites may lead to an erythematous rash or urticaria.
The best way to confirm that the bites are from bed bugs is to find other evidence of a bed bug infestation. Common telltale signs can be found on or near your mattress: pull up your sheets and check the seams and folds for thin black fecal streaks or small red blood spots. You might also find bed bugs, living or dead, and their discarded shells in various hiding places, such as the joints of your bed frame.
One bed bug will usually take more than one bite. Once a bed bug inserts its mouthparts and finds a suitable blood vessel, it will begin feeding. However, finding the right blood vessel may take more than one injection into the skin. In addition, bed bugs are very sensitive to movement by the host they are feeding on. Therefore, if a sleeping person moves, a feeding bed bug will probably withdraw its mouthparts and begin its search for a blood meal on another part of the body. It’s important to remember that the number of bites a person receives is not indicative of the number of bed bugs that feed on that person.