Avoiding repeated bites can be difficult, since it usually requires eradicating bed bugs from a home or workplace; eradication frequently requires a combination of pesticide and non-pesticide approaches. Pesticides that have historically been found to be effective include pyrethroids, dichlorvos and malathion. Resistance to pesticides has increased significantly over time and there are concerns of negative health effects from their usage. Mechanical approaches such as vacuuming up the insects and heat-treating or wrapping mattresses have been recommended.
The significant resurgence of bedbugs in the past decade has been attributed to pesticide resistance, more frequent travel, lack of public awareness, and inadequate pest control programs. Bedbugs are obligate blood parasites (insect family Cimicidae). They can withstand a large range of temperatures but are attracted to warmth and carbon dioxide. They typically feed just before dawn. Cutaneous reactions to bedbug bites can include macules, papules, wheals, vesicles, bullae, and nodules. Bites may be confused with other skin conditions. Bedbug bite reactions are typically self-limited and resolve within one to two weeks without treatment. Bedbug infestation may cause significant psychological distress. The diagnosis of a bedbug infestation is based on history, appearance of bites, and inspection of sleeping quarters. Although there is no evidence that bedbugs transmit disease, systemic reactions may include asthma, angioedema, generalized urticaria, iron deficiency anemia, and, rarely, anaphylaxis. An integrated pest management strategy should be employed to eliminate infestation. Tactics include vacuuming, heat or cold treatment, trapping devices, and pesticides.
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.