The CDC released a Morbidity and Mortality Weekly Report a couple of weeks ago of interest:
Acute Illnesses Associated With Insecticides Used to Control Bed Bugs — Seven States, 2003–2010
Since not everyone is the kind of nerd that thinks reading a 10-page technical CDC report is a fun dinnertime activity, I thought I would give ya’ll a summary. Basically, the report analyzed data from what’s called the SENSOR system–state public health folks and poison control offices report certain categories of injuries and occupational hazards to a national database.
There is a clear increasing trend of reports of “acute illnesses” over time–over 50% of the injuries happened in the 2008-2010 time period, which nicely parallels the way both cases of bed bugs and media coverage of bed bugs have increased.
The good news is there were only 111 reported cases of people being injured by pesticides while trying to control bed bugs; and only one fatality in the 8 year period studied. The bad news is that that is almost certainly a major underestimate of the real numbers of people injured:
“Case identification in SENSOR-Pesticides relies on a passive surveillance system, so persons experiencing minor symptoms who do not seek medical treatment or advice from poison control centers are not reported to the system. Second, cases might have been excluded if insufficient information was provided …to determine that the insecticide was used for bed bug control (e.g., surveillance systems do not systematically capture whether insecticides are used for bed bug control). Cases were identified only if available narrative information contained the term “bed bug.”
Given that people might not seek treatment, or that they may not mention bed bugs specifically, I suspect the number of cases in which folks have gotten sick is much larger.
The other bad news is that the main reason that people got sick was “excessive insecticide application.” Only 2 of the 111 cases involved professional, licensed pesticide applicators. (One case involved an *unlicensed* applicator, who later plead guilty to a felony.) In nearly all the cases where people got sick, they were trying to do their own pest control, and/or failing to follow basic safety and application instructions.
The case in which there was a fatality is a tragic example of people panicking over bed bugs and making really, really bad decisions:
“The one fatality, which occurred in North Carolina in 2010, involved a woman aged 65 years who had a history of renal failure, myocardial infarction and placement of two coronary stents, type II diabetes, hyperlipidemia, hypertension, and depression. She was taking at least 10 medications at the time of exposure.
After she complained to her husband about bed bugs, he applied an insecticide to their home interior baseboards, walls, and the area surrounding the bed, and a different insecticide to the mattress and box springs. Neither of these products are registered for use on bed bugs. Nine cans of insecticide fogger were released in the home the same day. Approximately 2 days later, insecticides were reapplied to the mattress, box springs, and surrounding areas, and nine cans of another fogger were released in the home. On both days the insecticides were applied, the couple left their home for 3–4 hours before reentering.
Label instructions on the foggers to air out the treated area for 30 minutes with doors and windows open were not followed on either day. On the day of the second application, the woman applied a flea insecticide to her arms, sores on her chest, and on her hair before covering it with a plastic cap. She also applied the insecticide to her hair the day before the second application. “
The woman was taken to the hospital unresponsive and died.
This is very much the stuff Darwin Awards are made of–but it’s also important to understand why that crazy scenario happened. If you were an ill, bedridden woman being constantly bitten by bed bugs, you might very well flip out to the point where drenching yourself with household flea spray seemed like a good idea.
Ok. Maybe not.
That woman died from pesticides and bad decisions, yes. But she also died because of inadequate education about bed bugs and how they can and can’t be controlled. She may also have died because she couldn’t afford to employ a professional, licensed pest control company or applicator, which can be very expensive.
There is a reason that people do what are, frankly, really stupid things like overuse pesticides or use them off-label. They are freaking out and really unhappy about their bug problem. Bed bugs can be difficult to control, and are notorious for needing multiple applications before they are truly exorcised from a house. There are several reasons for this, some of which is just behavior unique to the nature of the little buggers. Bed bugs don’t live out in the open where they are easy to kill.
Once you are on your second…or third…or fourth cycle of trying to kill the bugs, I can see why using more pesticides, or new ones that might not be labeled for that purpose, might begin to seem like a good idea to a desperate person. It is NOT a good idea. People can get hurt, as the less dramatic cases demonstrated.
Other really bad ideas of note mentioned in this CDC report:
- Using DEET in mass quantities as an insecticide. It won’t kill insects, it’s a repellent.
- Using an agricultural pesticide inside a house (That’s the case that led to the felony conviction).
- Not telling anyone else (co-workers, neighbors, etc.) that you just applied lots of pesticide and they should avoid contact with it.
More and better education about bed bug biology, and ways they can be controlled safely, would help people make better decisions. Most health departments and State Extension offices are stepping up and working on that, and there are great online resources as well.
If you are battling bed bugs: PAUSE, take a deep breath, and read the instructions carefully before applying something. You’ll get better results in the long run, and won’t hurt yourself or others. Don’t be afraid to ask for advice–and make sure the advice comes from someone who isn’t trying to sell you something.
Generally, we have better and safer pesticides available to us now than we’ve ever had in human history. But that doesn’t mean that they are completely without risk to humans or pets when applied in ways they weren’t meant to be used.
- EPA guidance for consumers on choosing a pest control company and on pesticide safety (PDF)
I discovered that bed bug evolution–specifically resistance to pesticides–was also the subject of the National Evolutionary Synthesis Center‘s podcast this month. A FASCINATING interview with one of the grand old men of evolutionary genetics, James Crow. He worked on DDT resistance back in the late 40s and 50s.
“Like pyrethrums, DDT kills insects by acting on the sodium pores in their nerve cells — and it just so happens that many of the same mutations that protect an insect against DDT also happen to protect it from pyrethrums. When DDT was first introduced, such mutations were probably extremely rare. However, with the widespread use of DDT in the 1950s and 60s, such mutations became much more common among bed bugs through the process of natural selection. Though DDT is rarely used today because of its environmental effects, these mutations have stuck around and are still present in modern bed bug populations. Because of the action of natural selection in the past (favoring resistance to DDT), many bed bug populations today are primed with the right sort of genetic variation to evolve resistance to pyrethrums rapidly.”
Aside from a brain fart where I said “spermatheca” rather than “testis”, I think I did ok at trying to keep it non-technical!
I want to try to cover some of the newer research on bedbugs over the next few months, since it’s a hot topic. We talked about some of the new info about bedbug chemical signaling, but that didn’t make the cut into the podcast.
Since I mentioned bedbugs recently, I thought I would also cover this paper:
Kyong Sup Yoon, Deok Ho Kwon, Joseph P. Strycharz, Craig S. Hollingsworth, Si Hyeock Lee, J. Marshall Clark (2008). Biochemical and Molecular Analysis of Deltamethrin Resistance in the Common Bed Bug (Hemiptera: Cimicidae) Journal of Medical Entomology, 45 (6), 1092-1101 DOI: 10.1603/0022-2585(2008)45[1092:BAMAOD]2.0.CO;2
One of the biggest issues in bed bug control right now is the development of resistance to insecticides. In fact, the New York City population of bedbugs used in this study was 264-fold more resistant to 1% deltapermethrin compared with a population collected in Florida!
To put it another way: the Florida bed bugs were killed in 19 minutes; the New York bedbugs took 5,048 minutes, or over 3.5 days, to die. Uh Oh.
The research paper itself is a rather technical evaluation of just how and where, in terms of molecular biology, the mutation that makes the bed bugs resistant occurs. Interestingly, it’s kdr resistance once again! (kdr stands for “Knock-Down Resistance.”)
I’ve mentioned kdr mutations several times here at the Bug Blog in discussions about DDT. Basically, most insecticides act as a nerve poison for insects. Insecticides block ion flow (alternate animation) across a nerve membrane by attacking sodium channels. If the nerve can’t depolarize, the cell (and animal) is effectively paralyzed.
Kdr mutations are usually point mutations — a tiny change in one amino acid in a giant string of DNA. It makes just enough of a change to make the bugs resistant.
Kdr mutations are also problematic because they often make a bug resistant to more than one insecticide. This means that an already difficult to control insect just got a lot harder to kill, since your tools (insecticides) wear out faster.
The conclusion of the paper:
“This evidence suggests that the two mutations are likely the major resistance-causing mutations in the deltamethrin-resistant NY-BB through a knockdown-type nerve insensitivity mechanism.”
“Because DDT has been used indiscriminately to control many insect pest species including bed bug, the widespread and frequent use of DDT is likely to have predisposed bed bug populations to pyrethroid resistance through the neuronal insensitivity mechanism.“
So, what does this new information tell us?
- DDT will be utterly useless against bed bugs, so people should stop asking for it.
- We’re going to need a lot more research on ways to kill bedbugs other than just poisoning them with the usual pesticide suspects.
- In cities where there are active bed bug populations, insecticide choice for resistance management will be very important in urban entomology.
- Bedbugs are not going to go away, and you should probably be getting a little paranoid.
If, you know, you weren’t already paranoid when you read stuff like this. What a nightmare.
Remember a few weeks back when I posted about an invention to feed lice automatically?
Bedbugger alerted me to this video where Lou Sorkin demonstrates how he feeds his colony the old-fashioned way. Apparently this video is part of a promo for a new book by Bill Schutt, Dark Banquet: Blood and the Curious Lives of Blood-Feeding Creatures.
Enjoy while you have your breakfast!
I thought I would make use of my travel time to put together a new Ask An Entomologist post: a little primer on how to check your hotel room to see if there are bedbugs.
It may just be because I go to entomology conferences where there are lots of presentations about bedbugs in hotels, but I’ve developed bit of a paranoid routine that so far has worked to let me sleep happily, and not bring any uninvited guests home.
For facts about basic bedbug biology, I’ll refer you to this excellent publication from the University of Kentucky. So–on to the searching.
Step 1: Look online and see if bedbugs have been reported where you are going. Do this when you’re considering where to stay and before you book a room. The Bedbug Registry is a handy place to start, but many other online reviews will have a mention of bed bugs if they are present.
Step 2: Leave your luggage by the door when you arrive. If it turns out that the room is infested, why go all the way in? Luggage is one of the known ways that bed bugs are moved from place to place. So try to avoid picking up any hitchhikers. Another option is to put your luggage in the bathtub, if you can’t leave it out in the hall.
Bedbugs don’t live on people permanently like lice. They are active at night, and need a place to hide during the day. Headboards fastened to the wall next to the bed (common in many hotels) are a great place for a flat little insect to stay.
After feeding, they poop, creating tell-tale brown stains of your clotted blood. You typically won’t see the bugs–they are fairly tiny and can scurry quickly–but you will see these stains.
This second photo shows a severe example of what you are looking for.
Step 4: Take things apart. Start by pulling the bed away from the wall, if possible. A flashlight is handy for shining behind headboards and under beds.
Inspect the headboard and wall behind the bed. Any spots there?
Strip the bed, right down to the mattress and bed springs. You have to see what’s underneath the clean sheets and mattress pad to know what’s been there. Lift the mattress and box springs up and look underneath. If it’s a platform bed, inspect carefully under the springs and around the base.
Pay special attention to the seams of mattresses and the boxsprings. These are spots the bugs like to hide in.
I also check the closet if it has a luggage rack like this one.
Step 6: Check the next morning. The last check is to look on your sheets when you get up the next morning. If you see little blood stains on your sheets, or tiny rusty spots….beware.
Reactions to bed bug bites vary widely, from no reaction at all to lots of swelling and redness. You may be one of the people that doesn’t react with itching to the bed bug bites, so the presence of bites isn’t always a reliable check. Typically bed bugs leave bites in groups of three–but so do fleas, so that isn’t always definitive.
So there you go. This isn’t a foolproof method, but it does let me sleep in peace. And so far, I’ve not seen anything that would keep me up.