In 2010, the bed bug (or, in entomology-speak, Cimex lectularius) for the first time triggered more calls to exterminators in the United States than did roaches and termites. Unfortunately, when doctors are confronted with the naturally stressed-out patient with an unexplained rash and itching generally seen with these elusive and almost-microscopic insects, the initial diagnosis often involves some psychosomatic explanation. Bed bugs are rarely found on a patient’s body or clothing, and sometimes there is only itching and no rash.

It is important health care workers not underestimate the mental health impact of having bed bugs. An article this past January in the American Journal of Medicine describes cases of post-traumatic stress disorder due to bed bug infestations. It is not unusual for individuals to suffer persistent fear of infestation, even after a successful extermination. Physicians should not simply treat the itching with a cream, but allow time for a little discussion of the emotionally negative experience of having dealt with such an infestation.

Don’t expect the incidence of bed bug infestation to diminish any time soon. Many cities in the United States have been experiencing these, and the bugs appear to be developing resistance to the chemicals used to destroy them. This is not surprising, as the earliest historical records describe what appear to be bed bugs; they have staying-power on their side.

How can you determine if that new itch you have is due to a bed bug? Probably the best way is to pull back your mattress cover and examine the cords of the mattress. Bed bugs are smaller than fleas, and defecate along the cord the blood they have sucked from you if you are unlucky enough to successfully find bed bugs.

Whence this new plague upon us? Some theorize from travels overseas, likely Europe. Of course, now travel to any city and a stay in any hotel can sow the seeds of an infestation. One pregnant female bed bug in your suitcase, brought back home, is enough to start a new infestation. It is not a bad idea, upon checking into a hotel to immediately place your luggage in the bathroom, and close the door. Next, pull back the mattress cover and examine those cords; if you see something, go to the bathroom and grab your luggage. And try another hotel.

Alas, the homebodies among us are not immune. There were recently reports that bed bugs are finding homes in the binding material of books. It’s enough to make you want to curl up near the fireplace with a good Kindle.

So, Merry Christmas to all; and to all, don’t let the bed bugs bite.

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