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. 
Avoidance is the best means of preventing bedbug infestation.8 While traveling, sleeping quarters and bedding should be closely inspected for signs of bedbugs. Suitcases should be placed on metal racks away from walls and furniture. Frequent travelers might consider obtaining a portable heating unit for luggage and clothing (e.g., Packtite) as an additional precaution. Items at yard sales and secondhand stores should also be carefully examined before purchase.8  All potentially infested items should be sorted and sealed in plastic bags and removed only when ready to be disinfested (see Table 36 for instructions regarding effective care of infested items). Wearing long-sleeved nightclothes can minimize exposed skin, and although insect repellants have not been shown to be reliably effective, oil of lemon eucalyptus or diethyltoluamide (DEET) might help deter bites.44,45

Bed bug infestations are primarily the result of two species of insects from genus Cimex: Cimex lectularius (the common bed bug) and Cimex hemipterus.[3] These insects feed exclusively on blood and may survive a year without eating.[3] Adult Cimex are light brown to reddish-brown, flat, oval, and have no hind wings. The front wings are vestigial and reduced to pad-like structures. Adults grow to 4–5 mm (0.16–0.20 in) long and 1.5–3 mm (0.059–0.118 in) wide.

A definitive diagnosis of health effects due to bed bugs requires a search for and finding of the insect in the sleeping environment as symptoms are not sufficiently specific.[5] Bed bugs classically form a line of bites colloquially referred to as "breakfast, lunch, and dinner" and rarely feed in the armpit or behind the knee which may help differentiate it from other biting insects.[4] If the number in a house is large a pungent sweet odor may be described.[4] There are specially trained dogs that can detect this smell.[2]
Bedbug bites typically are stealthy and not felt by the host. This is because they inject a numbing substance into the skin along with an anticoagulant agent to prevent blood from clotting at the feeding site. Itchy, red bites on the skin may be the first sign you've been bitten. Bites are most common on the arms and shoulders, and the bites often occur in straight rows, as pictured here.
Your replies to these questions are great! I have a question for you. I’ve recently returned home after spending a week in a hotel and the day after I returned I noticed 4 red dots which could be bites on my waist line. They don’t itch or hurt but I’ve never had anything like this before. I can send you a picture if you tell me how. I’m worried that they may be bed bug bites.
The common bed bug (C. lectularius) is the species best adapted to human environments. It is found in temperate climates throughout the world. Other species include Cimex hemipterus, found in tropical regions, which also infests poultry and bats, and Leptocimex boueti, found in the tropics of West Africa and South America, which infests bats and humans. Cimex pilosellus and Cimex pipistrella primarily infest bats, while Haematosiphon inodora, a species of North America, primarily infests poultry.[42]

Bed bugs often hide in seams, folds and crevices of mattresses, box springs, bed frames and headboards. A thorough inspection requires dismantling the bed so that upper and lower seams and surfaces can be examined. Things to look for are the bugs themselves, shed skins of the nymphs (immature bed bugs), and the blackish fecal spots. The dark spots of dried bed bug excrement are often present along mattress seams or wherever the bugs have resided. Box springs afford many places for bed bugs to hide, especially along the upper seams and underneath, where the bottom edge of the box rests on the frame. If an underlying dust cover is present, it may have to be removed to gain access for inspection and possible treatment. Successful treatment of mattresses and box springs can be difficult, however, and infested ones may need to be discarded or encased in a protective cover. 
Bed bugs occur in all regions of the globe.[7] Rates of infestations are relatively common, following an increase since the 1990s.[3][4][6] The exact causes of this increase is unclear; with proposals including greater travel, more frequent exchange of second-hand furnishings, a greater focus on control of other pests, and increasing resistance to pesticides.[4] Bed bugs have been known human parasites for thousands of years.[2]
Hi, I am at a loss about what to do. I have been getting bitten day and night, but I don’t know if they are bedbugs. Whatever it is, seems to get under my clothes and bite me along the waist, bra line, posterior, and chest. They only itch when I first discover them, afterwards they don’t bother me…. But I am the only person in the house getting bitten! I washed and steamed everything and everyone! What else can I do?!
Bedbugs are most often found in hotels, hostels, shelters, and apartment complexes where lots of people come and go. Because bedbugs hide in small crevices, they can hitch a ride into your home on luggage, pets, furniture, clothing, boxes, and other objects. Bedbugs are found worldwide, but are most common in developing countries. Once rare in North America, they may be on the rise due, in part, to increases in international travel.
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