The bedtime nursery rhyme “Good night, sleep tight, don’t let the bed bugs bite” is good advice indeed, as the insect can be a real nightmare.

The bedbug or Cimex lectularius is a global pest. Its population dwindled in the 20th century because of the widespread use of pesticide but has been on the rise in developed countries since the late 1990s.

The reason for its surging population is unknown, but the United States Centers for Disease Control (CDC) and Prevention have pointed to the increase in international travel as a likely factor. Bed bugs can hitchhike undetected on bags or shoes, unlike lice or ticks that hide in hair or stick on the skin.

The Profile of Bed Bugs

Bed bugs are flat, oval-shaped insects

Shaped like flat ovals, bed bugs are tiny. Adults are just five millimetres long—as big as an apple seed—but are fully capable of almost doubling in size after a meal. They are most active at night when they feed by piercing the skin and drinking the blood of humans or animals, with each meal lasting between five and 10 minutes.

Bed bugs are wingless and cannot fly or jump, although they can crawl over 30 metres in a single night. They are also able to survive for extended periods without food.

Their bites are extremely itchy and appear as clusters of red bumps overexposed areas, such as the neck, arms and legs. While the bites do not transmit diseases and rarely trigger allergic reactions, their saliva contains an anaesthetic and anti-clotting agent, which causes intense itching.

Severe scratching to relieve the itch can result in infection, scarring or hyperpigmentation, says Dr Yew Yik Weng, Consultant at the National Skin Centre.

The good news is that treatment for bed bug bites if needed, is straightforward. Patients rarely develop complications, and for most cases, symptomatic treatment in the form of topical steroids or oral antihistamines can relieve the itch quickly.

“Consulting a doctor may not be necessary unless symptoms worsen or persist after more than five days. Bed bug bites usually recover within a week,” says Dr Yew. Because many patients do not seek formal medical treatment, the exact number of bed bug cases in Singapore is unclear.

But, while the itchiness may eventually subside, bed bug bites can extract a huge emotional toll. People living with bed bugs can feel uncomfortable, embarrassed and sometimes, even too fearful to sleep.

“Many people can get very anxious or stressed from bed bug bites. Sometimes, patients who were bitten previously also display an irrational fear or phobia,” says Dr Yew.

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Breeding Spaces of Bed Bugs

Bed bugs can leave you with intense itchy bites

While commonly associated with unhygienic surroundings, the truth is that bed bugs are not drawn to dirt and grime. In fact, bed bugs have been found in five-star hotels in New York. Instead, they are attracted to warmth, blood and the carbon dioxide we exhale.

Unlike their name, bed bugs can be found in many other types of furniture and household items such as cushions or curtains. They can also be found in cinemas or concert halls. In December 2016 and January this year, there were reports of passengers being bitten in a bug-infested coach travelling from Kuala Lumpur to Singapore.

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Spotting a Bed Bug Infestation

A bed bug infestation is hard to get rid of

Spotting live bed bugs is another tell-tale sign of infestation.

Researchers from the University of Sheffield in England showed that finding just one bug is cause for alarm. Their study showed that a single pregnant bed bug could rapidly produce generations of offspring, leading to an infestation in weeks.

An adult female bed bug lays about 200 to 500 eggs in her lifetime. Other tell-tale signs of an infestation are reddish-brown streaks on mattresses (from squashed bed bugs), faecal stains, as well as brown shells shed as the insects grow. A sweet, musty odour—similar to the smell of coriander—is also commonly reported.

Bed bugs are incredibly equipped for survival, making them one of the hardest pests to kill. They are hard to see and can hide in nooks and crannies. They can live up to a year without feeding, so starving them is not an option.

The effectiveness of insecticides has also been mixed; a study published in the Journal of Medical Entomology in 2016 found that bed bugs from Michigan and Cincinnati in the United States have developed resistance to neonicotinoids, the most widely used insecticide in the world.

The findings complement previous research that highlighted the insect’s ability to develop a resistance to poisons. The species has evolved a thicker skin that stops poisons from penetrating, and a nervous system that is immune to toxins.

If you’re thinking about how to kill bed bugs, heat treatment remains a common but limited solution. Bed bugs die at temperatures above 50°C. While clothes can be washed at high heat, infested mattresses and furniture must be replaced.

Vacuuming is not a sure-fire way of getting rid of the eggs. Therefore, if there are signs of a bed bug infestation, it is advisable to contact a licensed pest control company to assess the severity of the problem and provide fumigation services.

Prevention is definitely better than cure. For one, keeping the living environment clutter free will reduce the number of potential hiding places. Also, don’t bring home furniture, especially upholstered items that have been discarded at a disposal area or other public spaces. If you must, inspect and clean them thoroughly before bringing the items into your home.

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