Bed bugs were once a common public health pest worldwide, but declined in incidence through the mid 20th century.Atlanta Lawn Care Recently however in Atlanta Georgia, bed bugs have undergone a dramatic resurgence and worldwide there are reports of increasing numbers of infestations. There have been some anecdotal references that bed bug problems are on the rise because of increased tourism and changes in cockroach management shifting to an emphasis on using baits and reducing the use of liquid insecticides that may have coincidentally controlled bed bugs in the process in Atlanta Georgia.

The Atlanta Georgia Department of Health provides primary prevention through a combination of surveillance, education, enforcement, and assessment programs designed to identify, prevent and abate the environmental conditions that adversely impact human health. One of the many mandates for the Environmental Health Division Georgia Lawn Care is that of inspecting tourist accommodations in order to “minimize illnesses and injuries associated with unsanitary or hazardous conditions in Georgia’s lodging industry.” County Environmental Health Specialists working for the local health authority inspect these facilities twice a year and when there is a complaint.

Bed bugs are becoming a problem within residences of all kinds, including homes, apartments, hotels, cruise ships, dormitories and shelters. While we associate bed bugs with unsanitary conditions, the problem may be found in the cleanest of homes, hotels or other buildings.

BIOLOGY
Bed bugs are small wingless insects that feed solely upon the blood of warm-blooded animals. They are sometimes mistaken for ticks or cockroaches. A mature bed bug is oval-bodied, brown to red-brown in color, wingless and flattened top to bottom. Unfed bugs are 1/4 to 3/8 inch long and the upper surface of the body has a crinkled appearance. A bed bug that has recently fed is engorged with blood, dull red in color, and the body is elongated and swollen. Eggs are white and are about 1/25 inch long. Newly hatched bed bugs are nearly colorless or straw-colored.

Of the 90 or so species in the family Cimicidae, approximately 7 will feed on human blood, but only 2 are commonly found: Cimex lectularius (bed bug) and Cimex hemipterus (tropical bed bug).

LIFE CYCLE
Female bed bugs deposit 3 to 8 eggs at a time; a total of 200-500 eggs can be produced by one female over her 10 month life span. The eggs are 1/25 inch long and are slightly curved. They are usually deposited in clusters and fastened to cracks and crevices or rough surfaces near adult harborages with a sticky cement-type substance.

The eggs hatch in 4-12 days. The newly hatched nymph is nearly colorless or straw-colored before feeding, and then turns red or purple in color after taking a blood meal. Bed bugs go through 5 nymphal stages before reaching maturity. This usually takes 35-48 days.

Nymphs look like small adults with the exception that adults have minute wing pads; females are larger than males. Nymphs can survive months without feeding and adult bed bugs can survive for 6-7 months without a blood meal. They have been known to live in abandoned houses for at least a year. Under favorable conditions (70-90° F), the bugs can complete development in as little as a month, producing three or more generations per year. Cool temperatures or limited access to a blood meal extends the development time.

HABITS AND HABITATS
Bed bugs are active mainly at night; they reach peak activity before dawn. During the daytime, they prefer to hide close to where people sleep. Their flattened bodies enable them to fit into tiny crevices – especially those associated with mattresses, box springs, bed frames, and headboards. Bed bugs do not have nests like ants or bees, but do tend to congregate in habitual hiding places. Bed bugs do not fly, but can move quickly over floors, walls, ceilings and other surfaces.

Bed bugs respond to warmth and carbon dioxide when searching for a blood meal, but not to odors. All nymphal stages and adults of both sexes require blood for nutrition and development. Bed bugs ordinarily feed within 24 hours of hatching, once between each molt and once before egg deposition; an average period of 8 days is required between molts. Adult females will continue to take blood meals every 3-4 days depending on ambient temperature and humidity. Bed bugs take up to 10 minutes to complete a blood meal, and will consume 2-5 times their own body weight in blood during that time. Individual bed bugs usually do not feed every night but at intervals of a few days to a week. Once a bed bug is finished feeding, it quickly retreats back to its hiding place. They do not remain on the host between feedings. Bed bugs may also feed on small animals, such as pets.

MOVEMENT
Some of the most common ways new bed bug infestations may be introduced include:
 Spending a night (or longer) in an environment which is already infested by bed bugs (hotels, homes, international flights, etc).
 Having someone visit from such an infested environment (bed bugs can be transported in luggage).
 Renting furniture or buying used furniture or bedding.
 Picking up discarded bedding or furniture from a curbside, trash collection point, or dumpster.

MEDICAL IMPORTANCE
The bite of a bed bug is painless. The amount of blood loss due to bed bug feeding typically does not adversely affect the host. Unlike flea bites, which occur mainly around the ankles, 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. However, some individuals do not react to bed bug bites, while others note a great deal of discomfort often with loss of sleep from the persistent biting.

Common allergic reactions include the development of large welts, often >1cm, which are accompanied by itching and inflammation. The welts usually subside to red spots but can last for several days. Blister-like eruptions have been reported in association with multiple bed bug bites and anaphylaxis may occur in patients with severe allergies. It has been suggested that allergens from bed bugs may be associated with asthmatic reactions. Reactions to the bites may be delayed up to 9 days before lesions appear. Reactions may be accompanied by severe itching that lasts for several hours to days. Scratching may cause the welts to become infected.

Bed bugs have been found to harbor at least 28 human pathogens and have been considered in the transmission of a wide variety of infectious agents. However, bed bugs have never been proven to biologically transmit any human pathogen, including HIV and hepatitis B. Although bed bugs are considered more of a nuisance than a health concern, public health officials maintain a level of interest due to the possibility of secondary infections. In fact, 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.”

For more information, see the Georgia Dept of Health Bed Bug Handbook