Do bedbug bites itch9/23/2023 ![]() Systemic allergic reactions to bed bug bites should be treated as any other insect-induced anaphylaxis. Sites that appear to be secondarily infected may benefit from topical mupirocin or systemic antibiotics as appropriate. Bite sites should be washed with soap and water, and if lesions are pruritic, topical application of over-the-counter or prescription antipruritic agents (paroxime, doxepin) or intermediate-potency corticosteroids (triamcinolone) may be helpful. Treatment of cutaneous reactions is usually symptomatic and not evidence-based. Although not always the case, bed bug bites are predominant on the head, neck, and upper body, and they may appear in a line. 48 The fact that blood-sucking insects may pick up disease agents while feeding is not surprising however, the ability to subsequently transmit those agents is a completely different story.ĭiagnosis and treatment Bed bugs should be suspected in any case of mysterious biting that occurs primarily at night, and/or when itchy erythematous rashes are noted on rising from sleep, no matter the time of day. 47 A recent report of bed bugs containing methicillin-resistant Staphylococcus aureus created quite a stir in the news media, but again, biological transmission (or even mechanical transmission) was not proved in that report. 42-46 At this time, however, bed bugs have never been proved to biologically transmit even one human pathogen. Bed bugs have been suspected in the transmission of more than 40 disease organisms, such as those causing anthrax, plague, hepatitis, and typhus, 41 and have been found naturally infected with many of these disease agents (especially hepatitis B virus). 40 The patient reported no bite marks some people do not react. 40 Eventually, an inquisitive physician from the hospital made a home visit and found thousands of bed bugs in the man’s mattress and bedding. 39 As for humans, a patient in Canada repeatedly presented to the hospital with anemia, and after a few days of treatment each time, was sent home. We have investigated poultry houses infested with bed bugs and found some of the birds to be anemic. In heavy infestations, blood loss from bed bug biting can be significant enough to cause anemia in humans and animals. 37 Interestingly, after his bedding was changed, the asthma attacks ceased. Evaluation of another man with asthma revealed bed bugs in his bedding, and an intradermal allergy skin test with an extract of bed bugs was positive. Eight months later, after an experimental bed bug bite, a wheal developed at the bite site along with generalized itching that required epinephrine administration to resolve his symptoms. 38 Angioedema and hypotension developed, and the man was hospitalized and had transient anterolateral ischemia on an ECG. ![]() 24,35-37 One patient awakened during the night at a hotel with severe itching and urticaria on his arm and neck and bed bugs were found in his room. Presumably, it results from antigens that reside at the bite site for an extended period, and from these antigens responding to inflammatory mediators circulating to new bites.Īlthough rare, there are a few reports of systemic allergic reactions from bed bug bites, including asthma, generalized urticaria, and anaphylaxis. 11-13 For those individuals who experience repeated bites, the time to onset of itching generally decreases and the intensity of the bite reaction increases. These usually begin itching with 72 hours and, if not scratched extensively, resolve after a week or so. 10Īs for nuisance biting, the most common cutaneous reactions are small, pruritic maculopapular, erythematous lesions at bed bug feeding sites, one per insect. 7-9 Limited evidence and anecdotal reports indicate that bed bug attacks may cause more serious psychological effects similar to posttraumatic stress disorder. There is some evidence that bed bug attacks lead to insomnia, emotional distress, and anxiety. Health effects The primary negative health effects from bed bug biting are not disease transmission, but instead, emotional trauma and the itching and inflammation (nuisance) associated with their bites. Here I review each of these potential health effects, discuss diagnosis and treatment, and offer comments about future directions in bed bug control and public health efforts to manage the pest. ![]()
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