Bed Bugs in SchoolsDealing with Special Needs Situations Rosmarie Kelly, PhD MPH Public Health Entomologist GDPH
What are bed bugs?• Bed bugs are small, brownish, flattened insects that feed on the blood of people while they sleep.• Bed bugs do not transmit disease, but they can cause significant itchiness, anxiety, and sleeplessness.
What are bed bugs?• Usually, bed bugs will hide during the day and only come out to feed during the night.• Unlike head lice, they usually do not live on a person.• They can hitchhike from one place to another in backpacks, clothing, luggage, books, and other items.
Bed bugs were once acommon public health pest worldwide.•Bedbugs were originallybrought to the United States byearly colonists from Europe.•Bedbugs thrive in places withhigh occupancy, such as hotels.•Bedbugs were believed to bealtogether eradicated 50 yearsago in the United States andelsewhere with the widespreaduse of DDT.
They’re Back!Bed bugs are once again a The cause of this resurgence isproblem within residences of still uncertain, but most believe itall kinds, including homes, is related to increasedapartments, hotels, cruise international travel and the useships, dormitories and shelters. of new pest-control methods that do not affect bedbugs.
Of the 90 or so species in thefamily Cimicidae,approximately 7 will feed onhuman blood, but only 2 arecommonly found: Cimexlectularius (bed bug) andCimex hemipterus (tropicalbed bug). 7
Habits & HabitatsBed bugs are active mainly at night; they reach peak activity beforedawn.During the daytime, they prefer to hide close to where people sleep.Their flattened bodies enable them to fit into tiny crevices - especiallythose associated with mattresses, box springs, bed frames, andheadboards.Bed bugs do not have nests like ants or bees, but do tend to congregatein habitual hiding places.Bed bugs do not fly, but can move quickly over floors, walls, ceilings andother surfaces.Bed bugs will travel 5-20 ft. from an established harborage to feed on ahost. Egg-laying females also wander.
Bed Bug FactsBed bugs respond to warmth and carbon dioxide when searching for ablood meal.All nymphal stages and adults of both sexes require blood for nutritionand development.Bed bugs ordinarily feed within 24 hours of hatching, once between eachmolt and once before egg deposition; an average period of 8 days isrequired between molts.Adult females will continue to take blood meals every 3-4 days dependingon ambient temperature and humidity.Bed bugs take up to 10 minutes to complete a blood meal, and willconsume 2-5 times their own body weight in blood during that time.
More Bed Bug FactsIndividual bed bugs usually do not feed everynight but at intervals of a few days to aweek.Bed bugs do not remain on the hostbetween feedings.Once a bed bug is finished feeding, it quicklyretreats back to its hiding place.Bed bugs may also feed on small animals,such as pets.
Bed Bug BitesThe bite of a bed bug is painless.The amount of blood loss due to bed bug feeding typically doesnot adversely affect the host.Bed bugs feed on any bare skin exposed while sleeping (face,neck, shoulders, arms, hands, etc).Skin reactions are commonly associated with bed bug bites,which result from the saliva injected during feeding.Some individuals do not react to bed bug bites, while others notea great deal of discomfort often with loss of sleep from thepersistent biting.
Reactions to BitesCommon allergic reactions includethe development of large weltsthat are accompanied by itchingand inflammation.The welts usually subside to redspots but can last for several days.Blister-like eruptions have beenreported in association withmultiple bed bug bites andanaphylaxis may occur in patientswith severe allergies.
Disease Issues• Bed bugs require blood in order to reproduce and complete their life cycle.• There is no evidence that bed bugs are involved in the transmission (via bite or infected feces) of any disease agent, including hepatitis B virus and HIV, the virus that causes AIDS.• However, the CDC & EPA issued a joint statement saying that “Although bed bugs are not known to transmit disease, they are a pest of significant public health importance.” • Frequent feeding can disrupt peoples sleep and make them irritable. • Seeing bites may cause emotional distress in some people. • Heavy rates of feeding can result in significant blood loss and eventually lead to anemia, especially in malnourished children.http://www.cdc.gov/nceh/ehs/publications/bed_bugs_cdc-epa_statement.htm
Could my classroom be infested?• Actual bed bug infestations in non-residential schools are uncommon.• More commonly, a few bed bugs will hitchhike to school from an infested home by hiding in a student’s clothing or backpack.• Bed bugs that hitch a ride into the school in one student’s backpack could be carried home by another student, making the school a potential hub for bed bug spread.• This is not a minor concern – bed bugs are very expensive and difficult to eradicate.
Preparing for a Bed Bug ProblemSuggested Supplies: disposable gloves, trashbags, plastic tarps, plastic storage bins, andtape on hand to hold infested items and formoving infested items (clothing, backpacks,desks and other equipment)Designate areas where potentially infesteditems can be held temporarily (several days, ifnecessary).Initiate a policy of keeping all “Lost and Found”clothing, backpacks, etc. in closeable plasticstorage bins (rather than in cardboard boxes)preferably in a central location.Establish a list of primary school personnel whoneed to be aware of the situation immediatelyin order to address the problem and to dealwith questions from parents, staff, andpotentially the news media.
What if I find a bed bug on a student?• If a bed bug is found on a student, it may indicate that the student has bed bugs at home.• However, bed bugs can crawl onto or off of a person (or their belongings) at any time, so it is also possible that the bed bug was brought to school by someone else.
verify that the problem is due to bed bugs eggs 19
Not Bed Bugs Key to Common Pests of Man and Animals http://ipm.ncsu.edu/AG369/keys.html
Try to determine the source• How many bed bugs were found?• Were they found associated with one person or more than one person (e.g., on clothing, backpack/bag, desk)?• If more than more person is involved, are those individuals related or have something in common such as being classmates, use the same transportation, etc.• Where were the bed bugs found in the school (classroom, lockers, office, gym or other facility, or transportation, etc.)?
Conduct a thorough inspection – questions to ask• Does the student/teacher switch rooms over the course of the day? Identify and inspect those rooms as well.• Does the student participate in after-school activities (athletics, band, etc.) where they may have taken potentially-infested personal items with them?• Where does the person keep their personal belongings during the day?• Have any new items been brought into the room/school? (e.g., boxes, bags, “lost and found” items, etc.)• Has the individual (student, staff, etc.) experienced the same problem at home?• Have they done any traveling (particularly involving overnight stays at a hotel or other vacation rental property)?• Have they had any visitors stay at their home recently?
If you suspect a student has bed bug • The student should be discreetly removed from the classroom. • If a confirmed bed bug was found on a student, then the school principal or nurse should contact the student’s parents or guardian. • Educational materials should be provided to the family. • The school should consider notifying families of the affected class or classes.
If a bed bug infestation is suspected or anumber of students are getting bitten duringclass, the school should contact a licensed pestmanagement professional for assistance.
What can I do to eliminate bed bugs from my classroom?• Work with licensed pest control - DO NOT allow untrained staff to apply pesticides on school property.• Backpacks, lunch boxes, and other items that travel back and forth to school can also be inspected daily and sealed in plastic containers to prevent bed bugs from getting into them at home.• Hard surfaces can be cleaned with standard cleaning products.
Control of WashablesWashing clothes at 60°C (140°F) is effective against all lifestages.Tumble drying in a hot (>40°C; 104°F) dryer for 30 minutes orfreezing at –17°C (1.4°F) for 2 hours will also kill bed bugs.Adults and nymphs can be drowned by soaking laundry, but thiswill not kill the eggs.NOTE: It takes about 8 hours to disinfest 5 lbs of laundry byputting it in a freezer at –18°C (0.4°F).
Temperature Extremes - Steam HeatBed bugs are very sensitive to heat, and a combination of steamcleaning and insecticide use has been found to be more effectivefor long-term control than insecticides alone.The steam emission tip must usually be about 2.5-3.8 cm fromthe surface being steamed.If the tip is too far away, the steam may not be hot enough to killall the bed bugs and eggs that it contacts.If the tip is too close, excess moisture may be injected into thetreated material, which may lead to other problems
Temperature Extremes - “Dry” Heat For heat treatment to be effective, it is critical that high temperatureand low relative humidity be attained for a minimum length of time(49-52oC [120-125oF] and 20-30% relative humidity for 20-30minutes).Heat treatment provides no residual effect, and bed bugs can re-occupy any site so treated immediately after temperatures return tosuitable levels.Laundering infested linens or cloth items in hot water with detergent,followed by at least 20 minutes in a clothes dryer on high heat,should kill all life stages of bed bugs but would not prevent theirreinfestation.
Temperature Extremes - ColdExposure to low temperatures can kill bed bugs if they are keptcold enough long enough.Bed bugs can tolerate -15oC (5oF) for short periods and, ifacclimated, they can survive at or below 0oC (32oF) continuouslyfor several days.Freezing furniture or other items within containers or chambers[e.g., below 0oF (-19oC) for at least four days] may be a practicalalternative for limited infestations or to augment other controlmeasures.A new commercial technology uses CO2 from cylinders depositedas a “snow” to kill bed bugs and a variety of pests by rapidfreezing.
Pesticides - THE LABEL IS THE LAWWith the exception of dry heat, non-chemical products and techniques areincapable of efficiently or quickly controlling or eliminating establishedbed bug populations.Precise placement of a suitably labeled, registered and formulatedchemical insecticide is still the most practically effective bed bug control.The choice of chemical products and specific application techniques candepend on many factors, including the physical location and structuraldetails of the bugs’ harborages, the product’s labels (which can vary bypolitical jurisdiction), the immediate environment, and local or nationallaws.
Pesticides Available for Bed Bug Control This list is changing fairly rapidly as more products are relabeled for use in bed bug control. • Residual Applications • Crack-and-Crevice Applications • Dusts • IGRs • Fumigation • ULVs, Aerosols, & Foggershttp://cfpub.epa.gov/oppref/bedbug/http://www.techletter.com/Archive/Technical%20Articles/bedbuginsecticides.html
The use of “bug bombs” or total release foggers is NOT advised.These devices release insecticide in small droplets thatland on exposed surfaces and do not penetrate thecracks and crevices where bed bugs hide.This results in increased pesticide exposure to theresident and poor control of these pests.This has been linked to pesticide resistance andsuspected repellency to bed bugs, causing them tospread.
Control Update• The resurgence of common bedbugs is partly due to their increase resistance to insecticides — like many other nuisance species, they’ve evolved to develop an immunity to the toxins.• A team of researchers at the University of Pennsylvania say they may have discovered the key to effective biocontrol of the nuisance bugs — a natural fungus that causes disease in insects.
Control Update• As anyone who has ever had bed bugs can attest, the tiny, blood-sucking parasites are a big pain to get rid of. But a new study suggests there might soon be a new weapon in the fight against the household pests.• Stromectol, a Merck brand of the drug ivermectin, which is already used to fight worm parasite diseases, such as river blindness and elephantitis, killed three out of five bed bugs in a study presented at the annual meeting of the American Society of Tropical Medicine and Hygiene on Nov. 12, Bloomberg News reports.• The bugs fed on ivermectin-laced blood and began to get sick and die within three hours.
Special Situations• Transportation• Wheelchairs• Therapy equipment
Buses and Other Transportation• When buses (or other transportation services) are involved, ask the student where he/she sat on the school bus that morning.• The school transportation coordinator should contact the operator to bring the bus immediately to the school or maintenance facility for inspection.• Check if the bus was used subsequent to dropping off the students.• If the problem is noticed late in the day, the seat occupied by the student and those in adjacent rows, should be inspected before allowing students to board the bus.• Do not allow students/staff to use potentially infested items.• Parents should be encouraged to inspect the contents and contact their child’s school if they have questions or concerns.
Wheelchairs• While transporting a client from a bed bug infested home, take measures to protect the car used. – Use large garbage bags to contain the client’s personal items and to line the car seats. – If the client has a wheelchair that must be transported, use large garbage bags or a small tarp to cover the wheelchair. – If the infestation is high, ask the client to wear coveralls while traveling in the car.• After the client and the client’s belongings have been transported: – Vacuum the car. – Wipe down the seat belts and seat seams with wet wipes to remove any bed bugs.
Steam Cleaning a Wheelchair• http://youtu.be/Mh3WydbqDDE Using hot steam is an effective and safe method to get rid of bed bugs on a wheel chair.
What if one of my students has an infestation at home?• When a student is dealing with an infestation at home, it is important to be sensitive to their problem.• Although bed bugs have nothing to do with cleanliness or socioeconomic status, there is still a stigma that can come with having bed bugs.• As a result, parents may be hesitant to admit to having bed bugs, and students may not want others to know they have an infestation at home.• Students living in an infested home may also feel anxious or tired during the school day.
What if one of my students has an infestation at home?• Determine if the infested home is being treated.• In an infested home, parents should store their child’s freshly laundered clothing in sealed plastic bags until they are put on in the morning.• Backpacks, lunch boxes, and other items that travel back and forth to school can also be inspected daily and stored in sealed plastic containers at home to prevent bed bugs from getting into them.• At school, the student could be provided with plastic bags or bins in which to store their belongings in order to prevent any bed bugs from spreading to other students’ belongings.• Continue to use these measures until successful treatment of the home has been verified.
Bed Bugs and Book BagsThe University of Florida teamed up with theJacksonville Bed Bug Task Force to create the “Bed Bugsand Book Bags” curriculum for grades 3-5 (the kids thatseem to bring the most bed bugs to school).The "Bed Bugs and Book Bags" curriculum followslearning standards for science and health educators, butmany housing authorities have on-site after schoolprograms that could use the activities. Any organizationthat works with kids should know about these lessons.Check out the curriculum athttp://entnemdept.ufl.edu/bug_club/Bed_bugs.html.