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• For populations of all three bedbug species that routinely feed on people, research should be encouraged and carried out to determine the susceptibility of bugs collected
in field studies to the insecticides most frequently used at present to control them. • Research should be encouraged and carried out to determine whether or not bedbugs
can successfully transmit human pathogens, especially those that cause new or emer- ging diseases.
• Research should be encouraged and carried out to further characterize the nature and effective treatment of the effects on people of unusual, extreme or very persistent bed-
bug bites. • Research should be encouraged and carried out to clarify more specific aspects of the
physiology and behaviour of bedbugs, with a secondary goal of developing effective techniques or devices that can efficiently and quickly survey for the presence of even
small populations of bedbugs.
• Research should be encouraged and carried out to determine the effectiveness and prac- tical use of extreme temperatures especially heat to eliminate or control bedbugs in
human habitats. • Efforts should be undertaken or at least planned by appropriate government agencies
to address locally evident problems that relate to the difficulties encountered by poor and low-income people in dealing with bedbugs and their control and with housing or
building quality. Community-wide or citywide programmes may be needed and pos- sible, if properly supported and well coordinated.
• Research should be encouraged and carried out to discover and make available new insecticide active ingredients, products, and devices and techniques that will be effec-
tive in controlling bedbugs.
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of the pyrethroids labelled for control of bedbugs at any indoor site, pose no significant risk to human health, if they are used in accordance with their individual product label
directions Cooper Harlan, 2004; WHO, 2005.
4.6. Benchmarks for success in bedbug management
Some benchmarks that may help in evaluating the success of a bedbug control effort include:
• the lack of live bedbugs, cast skins after those present earlier have been removed, fae- cal spots on bed linens or harbourage sites, and unhatched eggs;
• the lack of new feeding activity, as evidenced by occupants of previously infested sites having no new bites such as no evidence of bites at new sites appear more than 10 days
after the most recent control effort; • no new complaints of bites with symptoms resembling typical bedbug bites from occu-
pants of rooms or apartments dwelling units adjacent to or near, but not included among, the most recently treated similar sites;
• new knowledge received and retained by residents, from local direct inquiry or from a survey that shows that occupants of recently treated sites and their neighbours and ser-
vicing pest management technicians have a good general knowledge of the bugs, their biology and their signs and that they have a good understanding of preventive tech-
niques and effective control strategies against bedbugs;
• careful and thorough follow-up surveillance at five weeks or longer after the most recent treatment still shows no signs of a presence of live bedbugs; and
• an absence of recent bedbug infestations or bites being reported to public health or other government agencies.
Note: The absence of new bites assumes that the victims were not suffering from delu-
sory parasitosis. Continued so-called bites in the absence of bugs and after careful inspec- tion may imply delusory parasitosis, a condition that can be only addressed by medical
professionals.
4.7. Conclusions
To improve prevention and control of bedbug infestation, the following is suggested. • Steps should be taken to make accurate and practical current information readily and
widely available to PMPs, health professionals and the general public. This should include information about the biology and behaviour of bedbugs and about effective
control and prevention strategies against them.
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Feingold B, Benjamini E, Michaeli D 1968. The allergic responses to insect bites. Annual Review of Entomology
, 13:137–158. Fletcher M, Axtell R 1993. Susceptibility of the bedbug, Cimex lectularius, to selected
insecticides and various treated surfaces. Medical and Veterinary Entomology, 7:69–72. Foster W, Olkowski W 1968. The natural invasion of artificial cliff swallow nests by
Oeciacusvicarious Hemiptera: Cimicidae and Ceratophylluspetrochelidoni Siphonaptera:
Ceratophyllidae. Journal of Medical Entomology, 5:488–491. Gbakima AA et al. 2002. High prevalence of bedbugs, Cimex hemipterusand Cimex lec-
tularius , in camps for internally displaced persons in Freetown, Sierra Leone: a pilot
humanitarian investigation. West African Journal of Medicine, 21:268–271. Gooch H 2005. Hidden profits: there’s money to be made from bed bugs – if you know
where to look. Pest Control, 73:26–32. Hayes R et al. 1977. Role of the cliff swallow bug Oeciacusvicarious in the natural cycle
of a western equine encephalitis-related alphavirus. Journal of Medical Entomology, 14:257–262.
Herrmann J et al. 1999. Efficacy of controlled atmospheres on Cimex lectularius L. Heteroptera: Cimicidae and Argus reflexus Fab. Acari: Argasidae. In: Robinson WH,
Rettich F, Rambo GW, eds. Proceedings of the T hird International Conference on Urban Pests
, 19–22 July 1999, Prague, Czech Republic. H ronov, Czech Republic, Grafické Závody:637.
H wang SW et al. 2005. Bed bug infestations in an urban environment. Emerging Infectious Diseases
, 11:533–538. Johnson A 2005. The hotel industry is beginning to wake up to bedbug problem. The
Wall Street Journal , April 21 2005, 24578: Section A-1, Column 4; Section A-12, columns
5–6. Jupp PG et al. 1991. Attempts to transmit hepatitis B virus to chimpanzees by arthro-
pods. South African Medical Journal, 79:320–322. Krinsky W 2002. True bugs. In: Mullen G, Durden L, eds. Medical and veterinary ento-
mology . Orlando, FL, Academic Press: 67–86.
Krueger L 2000. Don’t get bitten by the resurgence of bed bugs. Pest Control, 683:58–64.
Liebold K, Schliemann-Willers S, Wollina U 2003. Disseminated bullous eruption with systemic reaction caused by Cimex lectularius. Journal of the European Academy of
Dermatology and Venereology , 17:461–463.
Bedbugs
150
References
1
Abou Gamra EM et al. 1991. The relation between Cimex lectulariusantigen and bron- chial asthma in Egypt. Journal of the Egyptian Society of Parasitology, 21:735–746.
Bauer-Dubau K 2004. Invasion in deutschen Betten: Bettwanzen. Ärzte Zeitung, 176:9. Blow J 2001. Stercorarial shedding and transstadial transmission of hepatitis B virus
by common bed bugs Hemiptera: Cimicidae. Journal of Medical Entomology, 38:694–700. Brown C, Brown M 2005. Between-group transmission dynamics of the swallow bug,
Oeciacus vicarious . Journal of Vector Ecology, 30:137–143.
Burton G 1968. Bedbugs in relation to transmission of human diseases. Review of the literature. Public Health Reports, 78:513–524.
Calisher C 1980. Characterization of Fort Morgan virus, an alphavirus of the western equine encephalitis virus complex in an unusual ecosystem. T he American Journal of
Tropical Medicine and Hygiene , 29:1428–1440.
Cooper R, Harlan H 2004. Ectoparasites. Part three: bed bugs kissing bugs. In: Hedges S, ed. Mallis’ handbook of pest control, 9th ed. Cleveland, OH, GIE Publishing: 494–529.
Cornwell PB 1974. The incidence of fleas and bedbugs in Britain. International Pest Control
, 16:17–20. Doggett S, Geary M, Russell R 2004. The resurgence of bed bugs in Australia: with
notes on their ecology and control. Environmental Health, 4:30–38. Dosland O 2001. The Heat is on. IPM Extra, Brookfield, WI, Copesan, 2nd Quarter:
1–2. el-Mofty MM, Sakr SA, Younis MW 1989. Induction of skin papillomas in the rabbit,
Oryctologus cuniculus , by bites of a blood-sucking insect, Cimex lectularius, irradiated by
gamma rays. The Journal of Investigative Dermatology, 93:630–632. Faulde M, Uedelhoven W, Robbins R 2003. Contact toxicity and residual activity of dif-
ferent permethrin-based fabric impregnation methods for Aedes aegypti Diptera: Culicidae, Ixodes ricinus Acari: Ixodidae, and L episma saccharina T hysanura:
Lepismatidae. Journal of Medical Entomology, 40:935–941.
1
The citations quoted are from scientific literature, anecdotal observations and trade journals. The authors have carefully scrutini- zed the references and have judged the references to be credible. Little scientific literature is available about recent observations and
research on bedbugs; however, the sources quoted are, to the authors’ best knowledge, credible and may be used with confidence.
Public Health Significance of Urban Pests
153
Webb P et al. 1989. Potential for insect transmission of HIV: experimental exposure of Cimex hemipterus
and Toxorhynchitesamboinensisto human immunodeficiency virus. The Journal of Infectious Diseases
, 160:970–977. WH O 1985. Bed bugs. Geneva, World H ealth Organization Vector Control
Series, Training and Information Guide; document WHOVBC85.2; http:whqlibdoc.who.inthq1985-86VBCTS85.2.pdf, accessed 6 November 2006.
WH O 2005. Safety of pyrethroids for public health use. Geneva, World H ealth Organization document WHOPCSRA2005.1;
http:whqlibdoc.who.inthq2005WHOCDSWHOPESGCDPP2005.10.pdf, accessed 6 November 2006:iv, 69.
Wigglesworth V 1984. Insect physiology, 8
th
ed. New York, Chapman and Hall.
Bedbugs
152
Lindsay SW et al. 1989. Permethrin-impregnated bednets reduce nuisance arthropods in Gambian houses. Medical and Veterinary Entomology, 3:377–383.
Myamba J et al. 2002. Pyrethroid resistance in tropical bedbugs, Cimex hemipterus, asso- ciated with use of treated bednets. Medical and Veterinary Entomology, 16:448–451.
Parsons DJ 1955. Bedbug bite anaphylaxis misinterpreted as coronary occlusion. Ohio Medicine
, 51:669. Potter M 2004. Your guide to bed bugs. Pest Control Technology Magazine, 328: pul-
lout supplement between pages 12 13. Ryckman RE, Bentley DG 1979. Host reactions to bug bites Hemiptera, Homoptera:
a literature review and annotated bibliography, Parts I and II. California Vector Views, 2612:1–49.
Sansom JE, Reynolds NJ, Peachey RD 1992. Delayed reaction to bed bug bites. Archives of Dermatology
, 1282:272–273. Scott TW, Bowen GS, Monath TP 1984. A field study on the effects of Fort Morgan
virus, an arbovirus transmitted by swallow bugs, on the reproductive success on cliff swal- lows and symbiotic house sparrows in Morgan County, Colorado, 1976. The American
Journal of Tropical Medicine and Hygiene , 33:981–991.
Silverman AL et al. 2001. Assessment of hepatitis B virus DNA and hepatitis C virus RNA in the common bedbug Cimex lectularius L. and kissing bug Rhodnius prolixus.
The American Journal of Gastroenterology , 96:2194–2198.
Snetsinger R 1997. Bed bugs other bugs. In: Hedges S, ed. Mallis’ handbook of pest control,
8th ed. Cleveland, OH, GIE Publishing, Inc.:392–424. Stutt AD, Siva-Jothy MT 2001. Traumatic insemination and sexual conflict in the bed
bug Cimex lectularius. Proceedings of the National Academy of Science of the United States of America
, 98:5683–5687. Takahashi M, Ohtaki T 1975. Ovicidal effects of two juvenile hormone analogs, metho-
prene and hydroprene, on the human body louse and the bed bug. Japanese Journal of Sanitary Zoology
, 26:237–239. Usinger RL 1966. Monograph of Cimicidae Hemiptera: Heteroptera. T homas Say
Foundation, Vol. VII. College Park, MD, Entomological Society of America. Weatherston J, Percy JE 1978. Venoms of Rhyncota Hemiptera. In: Bettini S, ed.
Arthropod venoms. Handbook of experimental pharmacology , Vol. 48. Berlin, Springer-
Verlag:489–509.
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5. Fleas
Nancy C. Hinkle
Summary
The two groups of fleas most significant to human health are rodent fleas and fleas found on domestic animals and non-rodent urban wildlife cat fleas, Ctenocephalides felis.
All adult fleas require frequent blood-meals, making them a suitable vehicle to spread blood-borne disease agents among hosts. While cat fleas play no significant role in trans-
mitting human disease, their bites may produce substantial irritation and itching. Unlike cat fleas, rodent fleas transmit the causative agent of one of humanity’s most important
diseases, bubonic plague, as well as the pathogen that produces murine typhus.
Exclusion or elimination of wild flea hosts, coupled with flea control on pets and in the home, provides the best options for protecting people from exposure to cat fleas. The
options for non-chemical flea suppression are limited, so most pet owners still rely on pesticides as part of their flea management strategy. Also, products are available for trea-
ting outdoor flea infestations and fleas in the home. Products applied to the flea host are particularly efficacious, because they use the animal itself as the flea lure, assuring that all
fleas are exposed to the toxicant as they attempt to feed.
Rodent fleas may occur on both wild and peridomestic rodents. Human behaviour is the main predisposing factor in exposure to plague-infected fleas on wild rodents.
Government agencies inspect campgrounds, parks and other locations where wild rodents may be encountered by people, closing these venues when plague is detected and
then initiating flea control measures. When plague is found in urban rodents, concomi- tant flea and rodent eradication programmes are mobilized, to eliminate the vertebrate
reservoir and ensure that residual fleas do not remain to feed on people.
Flea control is intimately tied to host control. In particular, wild and feral hosts should be excluded from residential neighbourhoods, to prevent their interaction with domes-
tic animals. Buildings should be rodent-proofed and maintained in good repair, and human activities such as garbage disposal should be directed towards avoiding the crea-
tion of conditions conducive to rodents.
