Dr. Stephane Perron, M.D. Speaks on
Bed Bug Bites and Health Issues
Bed Bug University—2015 Bed Bug Summit
Dr. Stephane Perron, M.D. Montreal, QC Public Health Dept. presents at 2015 Bed Bug Summit. He is known for his clinical work and occupational environmental medicine with the University of Montreal Hospital Center. His work focuses on health issues within the environment. This article has been written according to the way in which I interpreted what he said at the conference and is subject to other interpretations.
His speech covered six main points:
- Disease Transmission with bed bugs
- Skin Conditions
- Normal Stress Reactions
- Vulnerable Groups Dealing with Bed Bugs
- Abnormal Stress Reactions
- Insecticides
In a nutshell his findings are as follows:
- Bed bugs do not transmit infectious disease
- They can and often do cause skin reactions to their bites
- Most people are stressed by bed bugs and those that are not stressed by being bitten by bedbugs are showing an abnormal stress reaction.
- Insecticides for the most part are safe unless they are used in an improper manner and not according to label.
Beg Bug Bites and Skin Rashes
As we all know ticks may carry Lyme disease and mosquitoes can transmit Malaria, but bed bugs have not been shown to transmit any infections disease. Hepatitis C, HIV, Hepatitis B, are not an issue with bed bugs because the virus dies off and are not able to replicate. You are more likely to get MRSA or other infectious diseases from being in close contact with humans that carry the pathogens than from a bed bug. Normal skin problems that are caused by bed bugs are bites which resemble mosquitoes or more severe reactions like Hives also known as Urticaria. Bumps that are caused by bed bugs are rashes, hive like-reactions are known as Urticaria.
Itchy Skin and Red Spots on Skin
Papular Urticaria resembles small clusters of itchy bumps or even Chicken Pox. Most of these bites will itch, but it is important not to scratch to prevent secondary infections. It is important to search for bed bugs, their excrement, eggs or castings in order to determine if the bumps are from bed bugs or something else. In his research studies, Dr. Perron has found that bites can be from fleas, Scabies (mites), mosquitoes and even Carpet Beetles fur can cause an irritation or allergic-like reaction on some people’s skin. He stated that there are many reasons for people to think they may have bed bugs.
Two Patterns of Beg Bug Bites
Dr. Perron also stated that there are two patterns of bites that he usually sees in the field. The first is bites that are found in an “Introduction” setting in which person will have an insect bite here or there, but after about two weeks the number of bites doubles and then two weeks later continue to see more bites as the population of bed bugs doubles. The other pattern he notes is the Line Bite which is often seen when someone goes into a setting which has high bed bug populations such as a hotel. They sleep on a mattress and the side closest to the edge of mattress is where all the bed bugs come up to feed and do not venture all over the person, but just closest to where they are in the mattress edging.
Stress Symptoms from Bites (Normal and Abnormal)
The third area of discussion was on Mental Health issues that affect the most people. Dr. Perron said went over two major points in this category. The first is Normal Stress Reactions, which is the body having a “fight or flight” response to stress, blood pressure goes up, stress hormones are released in the body, blood sugars may go up and the immune system may become weaker. People with prolonged exposure to bed bugs should have a normal stress reaction and it can be even more stressful when they have other stress factors in their life. An abnormal stress reaction is when a person is not bothered by being bitten by bed bugs and shows little concern for the bed bug infestation.
Bed Bug Research Study
In 2010 Dr. Perron discussed some research studies in Montreal. The first study went into an unfit housing unit to intervene, study and make recommendations. This is common and some other reasons for intervention are: mold, water damage, vermin, roaches, and bed bugs. The housing unit is unfit either due to the landlord or because of bad tenants.
Mental Health Disorders and Getting Rid of Bed Bugs
A follow-up study was done at Municipal Housing Corporation of Montreal. They are good owners in that they do try to eradicate bed bug issues with their tenants. Dr. Perron used two randomized groups for the study. One group was given additional help in prepping their home prior to a professional pest control company entering it to eradicate the bed bugs. The other group was given all the information, but they did not get “extra help”. Extra help meant that outside people came into the dwelling to help declutter and make the home ready to be treated. Both groups had good and thorough treatments with professional pest control companies. (Note: Hoarders were not randomized for this study.) The study targeted those that had mental health disorders (bipolar, schizophrenia, depression and substance abuse), cognitive disabilities and low income. 53 Families were randomized within an 18 month period. The study noted that 30% of families needed 2 chemical treatments while the rest needed 3, 4 or 5 treatments to get rid of the bed bugs. The trend was that those with fewer treatments were those that had received the “extra help”. The very vulnerable (old and sick) needed more help than the rest. Regardless of having “extra help” or not those with mental health issues took longer to get rid of bed bugs.
Dr. Perron also discussed a case which had occurred in which a 62 year old woman that had bi-polar, borderline personality, and a history of drinking and gambling (drinking & gambling were under control at the time) was affected by bed bugs. Six weeks before her death she found a bed bug. A PCO (Pest Control Operator) came out and treated for bed bugs, but four weeks later she found more bed bugs. She then began to develop a fear of bed bugs and asked her landlord if she could relocate and was told, “No”. She then began gambling and drinking and lost quite a bit of money. Finally on her last day, she saw a drop of blood on her night gown and wrote a suicide letter saying, “I am panicking now and I choose to take my life...” she then called her boss to call out of work. He could tell there was a problem so he called 911, but by the time they could get there she had jumped from the 17th floor. It’s important to understand that bed bugs can cause major stress for people and especially those that are already suffering and vulnerable.
Post-Traumatic Stress Disorder from Bed Bugs
Some people will develop Post-Traumatic Stress Disorder from bed bugs. This is where the stress of bed bugs causes problems in accomplishing daily activities at work, socially or at leisure.
Skin Rashes and Lesions
Delusions of Parasitosis have been seen by Pest Control Operators (PCO’s). When clients that have never had bed bugs or had bed bugs and been completely treated for them continue to call the pest company complaining that they still have bed bugs. Often the client will show the PCO a ziplock with bits of dirt that they have collected. When the pest control operators realize that there are no bed bugs or never were any bed bugs it is best not to go back to the client as this can trigger the client to feel validated and they will continue to claim there are bed bugs when there are not. It is best to explain to the client that they do have a problem, but the problem is not bed bugs. You may remind them that detergents, medications, stress and other irritants may be the issue, but the issue is not bed bugs. It is a proven fact that really stressed people may have skin lesions or rashes from the high stress. An example is when psoriasis flares up under stress.
It is important to note that Hoarders that have bed bugs are very hard to treat. Dr. Perron states that they often end up being evicted or kicked out onto the streets. The only real help for hoarders are social services which use a team effort.
Insecticide and Health Problems
The last area to be touched upon is the use of insecticides. The biggest issue is when people try to use outside insecticides inside the home or structure and thereby cause exposure to toxins not meant to be in the home. Dr. Perron stated that approximately 25% of families try to treat bed bugs on their own while about 60-70% try treating for roaches on their own. High exposure to chemicals can cause many issues including: muscle issues, headaches, nausea /vomiting and even hallucinations so it is important to use chemicals as directed on the label and in the smallest amount possible. Many of the bed bug chemicals contain organophosphates which are very potent and act on the central nervous system, paralyzing the bed bugs. Carbonates also are dangerous and can effect learning and memory. When chemicals are properly used according to their label they are usually safe. Dr. Perron continue to study bed bugs in the Montreal area as he estimates that 5% of households have bed bug infestations.
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