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1 Pascal DELAUNAY Global Emergence of Bed bugs Cimex lectularius An Increasing cause of Dermatitis Pascal DELAUNAY Parasitologie - Entomologie Médicale Centre Hospitalier Universitaire de Nice FRANCE
2 Bed bugs Cimex lectularius Terzi in R.L.USINGER 1966, The Thomas Say Foundation VII, Baltimore, USA. Ectoparasite Hematophagous for both sexs Feed on humans and/or domestic animals Adults and Nymphs walking insect wingless Reddishbrown, flat, ovals, resembling confetti cosmopolite insects living preferently in house
3 Bed bugs Cimex lectularius 1 mm 1 to 4 mm nymph stage 1 Eggs and faecal traces Nymph stages 2 ou 3
4 Adult male Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Bed bugs Cimex lectularius N5 Traumatic insemination N4 Adult female Egg Nymphs N1-N2-N3-N4-N5 Adult male or femelle Egg N2 N1 Time of a blood meal 10-20mn Adult life span 6-24 months Duration of life cycle (egg to egg) days from 30 to 200 days Time to egg laying after mating Female egg-laying rate Hatching time Time between 2 nymph stages Lifetime total number of eggs 3-10 days 5-15 eggs per day 7-15 days 3-7 days eggs N3 Bedbugs number = secret increase then exponential increase
5 Active Bed bugs - DISPERSAL Passive
6 Pascal DELAUNAY Active Dispersal. Bed bugs do not have wing Bed bugs walk! From hiding place to a new hiding place Local spreading Pascal DELAUNAY Véronique BLANC Pascal DELAUNAY bedbugs, feces, eggs..hiden in mattress, cracks, furnitures, curtains.
7 Passive Dispersal. Bedbugs do not have wing! But.Bed bugs travel! clothing, luggage, furniture World spreading
8 Human vs Bed Bugs BALANCE MILLENNIUM Adaptation, years ago KNOWLEDGE correlated to the age > 70 years «Commentaires sur la matière médicale de Dioscoride» par MATTHIOLI Bois gravé de l édition de John GOODYER 1655 Who knows the bed bug? Knowledge of adult bed bug appearance increases with people's age in three counties of Great Britain. Reinhardt K et al. J Med Entomol Sep;45(5):956-8.
9 Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Number Increase in the 1990s WHY? Increasing number of PubMed citations for the search words "Bedbugs - Bed bugs - Cimex " 2012
10 Type Time Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Volume Increase in the 1990s WHY? TRANSPORT Number Confort Distance Enhanced resistance to pyrethroid insecticides The re-emergence of the bed bug as a nuisance pest implications of resistance to the pyrethroid insecticides. Davies TG, Field LM, Williamson MS. Med Vet Entomol Sep 26(3): doi: /j x. Epub 2012 Jan 11.
11 MEDICAL IMPACT Bed bug infestation. Bernardeschi C, Le Cleach L, Delaunay P, Chosidow O. BMJ Jan 22;346. Delaunay Olivier CHOSIDOW Delaunay
12 Del-guidice MEDICAL IMPACT A Del-guidice B Bites are painless. but in the morning Typical skin lesions: - curve or line - located in unclothed zones - Pruritic erythematous maculopapules, - 5 mm to 2 cm in diameter - Central hemorrhagic crust or vesicle Delaunay C Delaunay D
13 Are bed bugs considering as vector of infectious diseases? NO but research is on going
14 VECTOR = Competence Capacity Bedbugs and infectious diseases Delaunay P, Blanc V, Del Giudice P, Levy-Bencheton A, Chosidow O, Marty P, Brouqui P. Clinical Infectious Disease 2011 Jan 15;52(2): Review 45 pathogens have been evocated
15 45 pathogens have been evocated Bacteria: Bacillus anthracis, Bartonella quintana, Borrelia recurrentis, Borrelia duttoni, Brucella melitensis, Candidatus Midichloria mitochondrii, Coxiella burnetii, Francisella tularensis, Leptospira, Mycobacterium leprae, Mycobacterium tuberculosis, Rickettsia africae, Rickettsia conorii, Rickettsia prowazekii, Rickettsia rickettsii, Rickettsia typhi, Salmonella typhi, Staphylococcus aureus, Streptococcus pneumonia, Wolbachia, Yersinia pestis. Viruses Hepatitis B, Hepatitis C, Hepatitis E, Human immunodeficiency, Influenza, O nyong-nyong, Polio, Rabies, Reovirus, Smallpox, Yellow Fever Parasites Brugia malayi, Wuchereria bancrofti, Mansonella ozzardi, Onchocerca volvulus, Leishmania braziliensis, Leishmania donovani, Leishmania tropica, Plasmodium spp., Trypanosoma cruzi, Trypanosoma gambiense Bed Bugs and Infectious Diseases Pascal Delaunay, Véronique Blanc, Pascal Del-Giudice, Anna Levy-Bencheton, Olivier Chosidow, Pierre Marty, and Philippe Brouqui Clinical Infectious Diseases, 2011:52 (15 January)
16 Artificial infection of the bed bug with Rickettsia parkeri. Rickettsia parkeri inoculated by an infectious blood meal of Rickettsia parkeri After few weeks Bed bugs are not able to amplificate R. parkeri Rickettsia parkeri is a Rickettsi in the Spotted Fever group transmitted by tick Goddard J, Varela-Stokes A, Smith W, Edwards KT. Journal Med Entomol Jul;49(4): Artificial infection of the bed bug with Rickettsia parkeri.
17 Not vector but Bed bugs may transportation pathogens as any biting insect or walking insect Fungi Bacteria: Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis PHORESY = Pathogens transport Aspergillus, Penicillium, Scopulariopsis Streptococci, Stapylococci Canadian staff report recovery of methicillin resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) from bedbugs Bed bugs as Vectors for Drug-Resistant Bacteria Christopher F. Lowe and Marc G. Romney Emerging Infectious Diseases Vol. 17, No. 6, June 2011
18 PSYCHOLOGICAL IMPACT Anxiety, nervousness, insomnia, crying, depression!!!
19 PHRC - France Clinical Research Hospital Programm Collected Bed Bugs found homestays Establish laboratory colonies of Bed Bugs Start test on resistance to pyrethroid Analyse bacteria and virus in body with collected Bed Bugs
20 1 Collected bed bugs to infested places PHRC - France Clinical Research Hospital Programm PHRC FRENCH STAFF Visited places 285 Positive places 81 Collected BED BUGS 2891
21 Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis adults F0 Nymph F0 Bed bugs F Laboratory colony of bed bugs S S S S S S6 --
22 3 Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Resistance to pyrethroid insecticides Durand R, Cannet A, Berdjane Z, Bruel C, Haouchine D, Delaunay P, Izri A. Infestation by pyrethroids resistant bed bugs in the suburb of Paris, France. Parasite Nov;19(4): building at Saint Ouen (93) Suburb of Paris (France) 198 flats flats investigated 76 infested flats - 97 people - 53 people were disturbed by these bedbugs bed bugs collected
23 4 Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Bacteria 499 bed bugs collected 339 bed bugs investigated 8 BACTERIA genus investigated : Rickettsies sp., Coxiella like, Coxellia burnetti, Bartonella sp Bartonella quintana, Erlhichia sp., Wolbachia sp., Acinetobacter sp. BACTERIA detected: for 32 bed bugs 9.4% 29 bed bugs for Acinetobacter 8.5% 3 for Wolbachia 3 for Erlichia 2 for Coxellia
24 Bed bugs Eradication Efficient search-and-destroy operation 6 STEPS IDENTIFICATION ASSESSMENT OF THE SPREADING NON CHIMICAL ERADICATION CHIMICAL ERADICATION ASSESSMENT OF YOUR FIGHT PREVENTION
25 Bed bugs Eradication Efficient search-and-destroy operation - Dismantling or Removing all furniture to access all bed bugs hiding places - Destroy eggs, nymphs, and adults Insecticide, vacuum, brush. - Clothes, Linens : Warming at 60 C Freezing at minus - 20 C
26 Human travel and traveling bed bugs. Delaunay P. J Travel Med Oct;19(6):373-9
27 DURING THE TRAVEL Short inspection for bed bugs or black spots (faeces) Separate used linen and clean linen with small bags Luggage deposit preferentially in the bathroom AFTER THE TRAVEL Luggage deposit in the bathroom Take a shower Wash your clothes over 60 C or Freeze at minus - 20 C Rub or Wash your suitcase with a brush do not forget the zip area
28 Pascal DELAUNAY Thank you have a good trip without any bed bugs Pascal DELAUNAY Parasitologie - Entomologie Médicale Centre Hospitalier Universitaire de Nice FRANCE
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