Bed bugs have five immature nymph life stages and a final sexually mature adult stage. They shed their skins through ecdysis at each stage, discarding their outer exoskeleton. Newly hatched nymphs are translucent, lighter in color, and become browner as they moult and reach maturity. Bed bugs may be mistaken for other insects, such as booklice, small cockroaches, or carpet beetles; however, when warm and active, their movements are more ant-like, and like most other true bugs, they emit a characteristic disagreeable odor when crushed.
With practice and a flashlight, nonprofessionals can become proficient in finding and destroying bed bugs. The process is made easier by reducing clutter, especially in bedrooms and sleeping areas. Bugs that are spotted can be removed with a vacuum (see previous discussion), or killed with over-the-counter insecticides labeled for such use. Most bed bug sprays intended for householders have little remaining effect after the spray has dried. Therefore it’s important to initially contact as many of the insects as possible with the spray droplets. Insecticide labels should be read carefully as some bed bug products should not be used on mattresses and seating areas. Some insecticides applied as powders or dusts (e.g., diatomaceous earth) will kill bed bugs although boric acid powder will not. However powders can be messy and difficult to apply, especially by nonprofessionals. Total release foggers (otherwise known as ‘bug bombs’) are ineffective against bed bugs and potentially dangerous when used incorrectly (see University of Kentucky entomology fact sheet Limitations of Home Insect Foggers).
Bring in only what is needed, and avoid sitting or placing coats and other items on beds, floors and sofas where the bugs commonly reside. Essential items can be placed on a tabletop or other hard surface, preferably away from bedrooms and sleeping areas. Better to sit on a hard (non-upholstered) chair than on sofas and recliners. Also try to avoid leaning or brushing against beds and upholstered furniture. If such items are carried out of infested dwellings (e.g., by sanitation workers or firefighters), it’s best to wrap them in plastic or at least not hold them against your body during transport. Emergency Medical (EMS) personnel may need to take additional precautions, such as removing a patient’s bed bug-infested shoes or clothing, or installing plastic sheeting before transporting them in the emergency vehicle.
It often seems that bed bugs arise from nowhere. The bugs are efficient hitchhikers and are usually transported into dwellings on luggage, clothing, beds, furniture, and other items. This is a particular risk for hotels and apartments, where turnover of occupants is constant. Bed bugs are small and agile, escaping detection after crawling into suitcases, backpacks and belongings. Acquiring secondhand beds, couches and furniture is another way that the bugs are transported into buildings. Bed bugs also can be carried in on one’s clothing, shoes or wheelchair. Once bed bugs are introduced, they can crawl from room to room or floor to floor. They can also be transported throughout buildings on people and their belongings.
General housecleaning measures, (e.g. vacuuming floors and surfaces), seldom reach where bed bugs hide. For this reason, repetitive vacuuming by occupants may not be worth the effort, especially compared to other important preparatory activities. Targeted vacuuming of bed bugs and infested harborages, however, can help remove some of the bugs before other treatment measures are undertaken. Bed bugs and especially the eggs can be difficult to dislodge. Optimum results will be achieved by moving and scraping the end of the suction wand along infested areas such as seams and fabric folds of beds and sofas, and the perimeter edge of wall-to-wall carpet. Bed bugs can survive the high speed trip down a vacuum, so it’s important to carefully dispose of the vacuum contents in a sealed trash bag afterwards.
Treatment is symptomatic. Eliminating bed bugs from the home is often difficult. Part of this is because bed bugs can live for a year between feeding. Repeated treatments of a home may be required. These treatments may include heating the room to 50 °C (122 °F) for more than 90 minutes, frequent vacuuming, washing clothing at high temperatures, and the use of various pesticides.
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.