Bedbugs

What are bedbugs?

These are small insects that feed on human blood by biting through the skin. Bedbugs are most active between 2:00 and 5:00 am. They can travel 10 to 15 feet to feed and go without feeding for up to 6 months. Their bites may look like a small rash and are itchy. Bedbugs are not known to transmit or spread any disease. Bed bugs are not generally found in early education and school settings because they feed at night when children are not present. But they can "hitchhike" on clothing and backpacks from a child's home into the educational setting.

What are the signs or symptoms?

• Bites typically occur on exposed skin, such as the face, neck, arms, and hands. These are itchy bites, which often occur in a row, on areas of skin that are exposed during the night.

• Bites often have a red dot where the bite occurred in the middle of a raised red bump.

• Look for specks of blood, rusty spots from crushed bugs, or dung spots the size of a pen point on bedsheets and mattresses or behind loose wallpaper.

• Look for reddish/brown live bugs, about 1/8 of an inch, in crevices or seams of bedding.

What are the incubation and contagious periods?

• Bedbugs do not reproduce on humans like scabies or lice. They bite humans at night and then hide in cracks or crevices on mattresses, cushions, or bed frames during the day.

• Children or staff members may bring bedbugs to school in book bags and outer garments and clothes.

How are they spread?

• Bedbugs are not spread from one person to another. They are not an indication that people or their homes are dirty. They may hide in belongings or clothing that allow them to spread to others in group care settings.

• These insects crawl at the speed of a ladybug.

How do you control them?

• Avoid overreacting. One bedbug is not an infestation. It is not necessary to send the child home. Do not throw anything away. Nap mats and mattresses can be cleaned.

• Bedbugs in child care and school settings are almost always "hitchhikers" brought from home and usually do not represent a problem at the program.

• Educate staff members and families about bedbugs.

• Reduce clutter and limit items that travel back and forth between homes and the facility.

• Clean up any bedbug debris with detergent and water.

• Seal cracks and crevices to eliminate hiding places for bedbugs and other pests. Caulk and paint wooden baseboards or molding around ceilings.

• Separate the backpack and coat of one child from those of another child to avoid cross contamination.

• Provide enough space between coat hooks so each child's belongings do not touch those of another child.

• Empty and clean cubbies, lockers, and child storage areas at least once every season.

• Inspect the nap area regularly (preferably by a trained pest control operator). Use a flashlight to examine nap mats, mattresses (especially seams), bedding, cribs, and other furniture in the area.

• In the unlikely event bedbugs are identified in the facility, contact a professional exterminator. Extermination involves vacuuming and one of the following approaches: application of the least toxic (preferably "bio-based") products, heating the living area to 122°F (50°C) for about 90 minutes, freezing infested articles, or (if necessary) use of synthetic chemical insecticides. Use integrated pest management, which involves a combination of nonchemical strategies, such as maintenance and sanitation, followed by pesticides, if other methods are not effective.

• Laundering bedding and clothing (hot water and hot drying cycle for 30-60 minutes), vacuuming cracks and crevices (in furniture, equipment, walls, and floors), and freezing smaller articles that may have been used as hiding places for bedbugs may reduce infestation until extermination can be performed. Dispose of the vacuum cleaner filter and bags in a tightly sealed plastic bag.

• Use encasements/covers around the mattress, box spring, and pillows to trap bedbugs. These encasements/covers are readily available by searching the internet for "mattress or pillow encasement." They are marketed for bedbug or allergy control.

What are the roles of the teacher/caregiver and the family?

• Usually, the teacher/caregiver will not know which children with insect bites have been bitten by bedbugs because they are hard to distinguish from other insect bites.

• Children with bedbug bites are not infested and so do not require treatment to prevent spread to others.

• Fingernails should be kept short to avoid damaging and infecting the skin due to itching. Observe for signs of skin infection, such as boils, abscesses, or cellulitis (see Boil/Abscess/Cellulitis Quick Reference Sheet).

• Affected children may receive steroid skin creams or oral antihistamines to relieve the itch.

Exclude from group setting?

No.

Comments

• Unlike lice or scabies, bedbugs do not infest or require treatment of that person. Bedbugs infest the living area and require extermination. During the daytime, bedbugs do not stay on the affected person.

• Good resources for identifying and controlling bedbugs are the US Environmental Protection Agency (www.epa.gov/bedbugs) and the New York City Department of Health and Mental Hygiene (www.nyc.gov/bedbugs).

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.