US authorities received 111 cases of acute illness, including one death, after DYI bed bug exterminations from 2003-2010, with 73% of those cases occurring during the last two years, according to an MMWR report by the CDC (Centers for Disease Control and Prevention). The authors explained that although bed bugs are not disease vectors, they can seriously disrupt sleep and undermine some people’s quality of life.

Of the 111 reported cases of acute illness during that period, 81% were of low severity. 58% of all reported cases occurred in New York City. Most cases occurred among individuals aged at least 25 years. 93% occurred in private homes, and 40% in multi-unit housing.

39% of those who became ill applied pesticides without being certified to do so. In the majority of cases, those who became ill had been exposed to pyrethrins, pyrethroids or both – and were in toxicity category III.

The most common signs and symptoms included:

  • Dizziness
  • Headache
  • Respiratory problems – including pain in the upper-respiratory tract, irritation and shortness of breath (dyspnea)
  • Gastrointestinal problems – including vomiting and nausea

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Cimex lectularius, the most common bed bug. Electron microscope photograph, with its skin-piercing mouthparts digitally colorized in purple and red

Cimex lectularius is the most common bed bug. It is a wingless insect, reddish-brown in color. The bug feeds off blood from humans, other mammals and birds – they feed by hematophagy, exclusively on the blood of warm blooded animals.

Bed bugs have evolved as nest parasites, inhabiting bird nests, bat roosts, and human beds, sofas and other soft furniture. Newborns (nymphs or hatchlings) are extremely small, about the size of a poppy seed – they grow to about ¼ of an inch in length as adults. They have an oval, flattened shape. Humans with good vision are able to see adults, eggs and nymphs with the naked eye.

According to the CDC, the bed-bug population in the USA has been progressively growing for several years. They are seen as a growing problem in all types of dwellings, homes, dormitories, ships (especially cruise ships), military quarters, and shelters.

Insecticides are used to control infestations. However, resistance to several products is an ever-increasing challenge. Untrained individuals may be tempted to exceed the recommended dosages when their first extermination attempt fails – this considerably raises the risk of human toxicity.

The authors assessed the frequency of illnesses form insecticides used for controlling bed bug infestations by gathering data from the SENSOR-Pesticides program, as well as the New York City Dept. of Health and Mental Hygiene. (SENSOR = Sentinel Event Notification System for Occupational Risks). Cases of acute illness were reported in New York, Texas, Washington, California, Florida, Michigan and N. Carolina. The investigators identified 111 cases of acute illness linked to bed bug-related insecticide usage. One person died.

A 65-year old woman in North Carolina died. She had several underlying medical problems, including two coronary stents, type 2 diabetes, hyperlipidemia, high blood pressure, renal failure and myocardial infarction. Before using the insecticides, she had been on at least ten medications.

Her husband applied Ortho Home Defense Max to their interior baseboards, bed area, and walls, and Ortho Lawn and Garden Insect Killer to their mattress and box springs. The authors stress that neither product is authorized for bed bug control. They also used nine cans of insecticide Hot Shot Fogger in their home on the same day. About 48 hours later he repeated the process on the box springs and mattress; he also applied nine cans of Hot Shot Bedbug and Flea Fogger around the interior of the house.

Each time they applied these insecticides to the house, they left their home for three to four hours before coming back in. They had not followed some of the instructions on the packet, e.g. the foggers said the treated areas had to be aired out for 30 minutes with windows and doors wide open.

During the second application day, the woman applied Hot Shot Bed Bug and Flea Killer to some sores on her chest, hair, and arms. She then covered her head with a plastic cap. On the previous day she had applied insecticide to her hair.

Two days after the husband carried out the second application he found his wife nonresponsive. She was hospitalized, placed on a ventilator and died nine days later.

Written by Christian Nordqvist