• Bed Bugs

    This Chapter

    • Bed Bugs Symptoms, Transmission, Treatment
    • Frequently Asked Questions
    • Additional Bed Bug Control Information for Parents/Guardians

    BED BUGS (Cimex lectularius and Cimex hemipterus)

    Click here for a picture of a bed bug

    Signs and Symptoms

    • Bites are usually red, often with a darker red spot in the middle
    • Bites are arranged in a rough line or clustered and commonly located on the face, neck, arms, and hands
    • Some people may experience an allergic reaction that can include itching, blisters, and hives. 
    • Scratching causes sores, which may become infect

    Click here for pictures of bed bug bite


    • Bed bugs are reddish –brown in color, oval and flat.
    • They are about the size of an apple seed.
    • Bed bugs feed on the blood of humans when people are asleep.  
    • During the day they hide in cracks and crevices and can be found in seams of mattresses, box springs, bed frames, nightstands, electrical outlets, carpeting, walls, etc. 

    The life cycle of the bed bug involves 7 stages:

    • Female bed bugs lay about 5 eggs daily throughout their adult lives
    • Eggs hatch in about 12 days into instar nymphs which must take a blood meal before molting into the next stage. Nymphs although lacking wing buds resemble smaller versions of the adults and are the size of poppy seeds
    • The nymphs molt 5 times before becoming an adult which takes about 35 to 48 days.
    • Adults live 6 to 12 months and may survive for weeks to months without feeding.

    Life Cycle

    Click here for pictorial life cycle.

    Bed bugs are not known to transmit disease but are definitely a nuisance. An increase in international travel has facilitated the spread of these insect hitchhikers. In most cases, bed bugs are transported from infested areas to non-infested areas when they cling onto someone’s clothing or crawl into luggage, furniture or bedding that is then brought into homes.  Bed bugs may find their way into schools by hitching a ride on personal belongings such as backpacks, clothing, or other items.

    Signs of an infestation in a home include:

    • Dark rusty colored droppings, typically found along mattress seams
    • Empty exoskeletons (shed skin from molting, light brown in color)
    • Blood stains from engorged bed bugs accidentally crushed on bed sheets


    • Wash the affected area/s with soap and water and cover with a Band-Aid/s or dressings.
    • Apply calamine lotion and ice to itchy areas.
    • Contact parent.
    • Consider the rash to be contagious until diagnosis or status of contagion is confirmed with a note from a licensed health care provider.  Give the Unidentified Medical Condition form to the parent or guardian.

    School Action

    Bed Bugs are the nuisances, not the students nor the family.  Remember to keep the best interest of the child in mind by providing as much privacy and confidentiality as possible.  Handle the situation kindly, gently and with sensitivity.  Strive to ensure that the child does not feel bad about himself/herself because of bed bugs.  Keep in mind that anyone can get them.

    If a student is identified by the parent/guardian /health care provider as having a home infestation or has a rash due to bed bugs, the student should not be excluded from school.

    Steps for treatment for a student with a known bed bug infestation at home:

    Step 1
    The School Nurse and Health Room Aide are to have the student come to the health room upon arrival at school.  Clothes worn from home are to be removed and placed into a dryer, along with the backpack and coat, for 20 minutes on high.  Heat kills bed bugs that may be hitchhiking onto clothing or hidden in backpacks.  A change of clothes should be provided by the family or school and kept in the health room for changing.  

    Step 2
    The student may or may not change back into the arrival clothing at the end of the day, per parent request.  

    Step 3
    Monitor the student for signs of bites on exposed skin.  Notify parent if bites are seen to update progress of treatment.  Treat bites per protocol.

    Step 4
    This procedure will continue for two weeks to ensure the bed bugs have been removed and the life cycle has been broken.  

    CDC Frequently Asked Questions- Bed Bugs

    What are bed bugs?

    Bed bugs (Cimex lectularius) are small, flat, parasitic insects that feed solely on the blood of people and animals while they sleep. Bed bugs are reddish-brown in color, wingless, range from 1mm to 7mm (roughly the size of Lincoln’s head on a penny), and can live several months without a blood meal.

    Where are bed bugs found?

    Bed bugs are found across the globe from North and South America,to Africa, Asia and Europe. Although the presence of bed bugs has traditionally been seen as a problem in developing countries, it has recently been spreading rapidly in parts of the United States, Canada, the United Kingdom, and other parts of Europe. Bed bugs have been found in five-star hotels and resorts and their presence is not determined by the cleanliness of the living conditions where they are found. 

    Bed bug infestations usually occur around or near the areas where people sleep. These areas include apartments, shelters, rooming houses, hotels, cruise ships, buses, trains, and dorm rooms. They hide during the day in places such as seams of mattresses, box springs, bed frames, headboards, dresser tables, inside cracks or crevices, behind wallpaper, or any other clutter or objects around a bed. Bed bugs have been shown to be able to travel over 100 feet in a night but tend to live within 8 feet of where people sleep. 
    Do bed bugs spread disease?

    Bed bugs should not be considered as a medical or public health hazard. Bed bugs are not known to spread disease. Bed bugs can be an annoyance because their presence may cause itching and loss of sleep. Sometimes the itching can lead to excessive scratching that can sometimes increase the chance of a secondary skin infection.
    What health risks do bed bugs pose?

    A bed bug bite affects each person differently. Bite responses can range from an absence of any physical signs of the bite, to a small bite mark, to a serious allergic reaction. Bed bugs are not considered to be dangerous; however, an allergic reaction to several bites may need medical attention. 
    What are the signs and symptoms of a bed bug infestation?

    One of the easiest ways to identify a bed bug infestation is by the tell-tale bite marks on the face, neck, arms, hands, or any other body parts while sleeping. However, these bite marks may take as long as 14 days to develop in some people so it is important to look for other clues when determining if bed bugs have infested an area. These signs include:

    • the bed bugs’ exoskeletons after molting,
    • bed bugs in the fold of mattresses and sheets,
    • rusty–colored blood spots due to their blood-filled fecal material that they excrete on the mattress or nearby furniture, and
    • a sweet musty odor.  

    How do I know if I've been bitten by a bed bug?

    It is hard to tell if you've been bitten by a bed bug unless you find bed bugs or signs of infestation.  When bed bugs bite, they inject an anesthetic and an anticoagulant that prevents a person from realizing they are being bitten. Most people do not realize they have been bitten until bite marks appear anywhere from one to several days after the initial bite. The bite marks are similar to that of a mosquito or a flea -- a slightly swollen and red area that may itch and be irritating. The bite marks may be random or appear in a straight line. Other symptoms of bed bug bites include insomnia, anxiety, and skin problems that arise from profuse scratching of the bites.  

    Because bed bug bites affect everyone differently, some people may have no reaction and will not develop bite marks or any other visible signs of being bitten. Other people may be allergic to the bed bugs and can react adversely to the bites. These allergic symptoms can include enlarged bite marks, painful swellings at the bite site, and, on rare occasions, anaphylaxis. 
    How did I get bed bugs?

    Bed bugs are experts at hiding. Their slim flat bodies allow them to fit into the smallest of spaces and stay there for long periods of time, even without a blood meal. Bed bugs are usually transported from place to place as people travel. The bed bugs travel in the seams and folds of luggage, overnight bags, folded clothes, bedding, furniture, and anywhere else where they can hide. Most people do not realize they are transporting stow-away bed bugs as they travel from location to location, infecting areas as they travel.  
    Who is at risk for getting bed bugs?

    Everyone is at risk for getting bed bugs when visiting an infected area. However, anyone who travels frequently and shares living and sleeping quarters where other people have previously slept has a higher risk of being bitten and or spreading a bed bug infestation. 
    How are bed bugs treated and prevented?

    Bed bug bites usually do not pose a serious medical threat. The best way to treat a bite is to avoid scratching the area and apply antiseptic creams or lotions and take an antihistamine. Bed bug infestations are commonly treated by insecticide spraying. If you suspect that you have an infestation, contact your landlord or professional pest control company that is experienced with treating bed bugs. The best way to prevent bed bugs is regular inspection for the signs of an infestation. 

    This information is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care provider. 

    Bed bug control can only be maintained through a treatment strategy that includes a variety of techniques plus careful attention to monitoring. Proper use of pesticides may be part of the strategy, but will not by itself eliminate bed bugs. 

    Households with bed bugs should take precautions to prevent transporting bed bugs to school. Heat is an excellent bed bug killer and nothing is more effective for killing all bed bug life stages than a hot clothes dryer At home, clothing to be worn outside of the home should be washed and dried in a hot dryer for at least 20 minutes and then placed in a tightly sealed container such as a plastic bin until just before the child exits the home. This also applies to coats and backpacks. 

    Any items that must be stored near beds or other furniture should be placed in a clear plastic bag/bin until the student needs to take them out of the home. 

    The best way to get rid of these pests is to clean, disinfect and remove them from their hiding places. Cleaning activities include removing clutter, frequently vacuuming the mattress and surrounding areas, washing and heat drying linens, blankets and clothing etc. Soap and water is effective in removing bud bugs, eggs and debris from surfaces. After vacuuming the vacuum cleaner bag should be sealed in a tightly sealed plastic bag and removed from the house. The mattress seams can be scrubbed with a stiff brush to loosen the eggs. Once the mattress has been cleaned it can be put in a zippered mattress cover such as that used for house dust mites. Any bed bugs remaining on the mattress will be trapped inside the cover. Leave the cover in place for at least a year because bed bugs can live for a long time without a blood meal. Another option is to get rid of the mattress and get a new mattress but only if the bed bugs are completely removed. Otherwise, the new mattress can become infested.

    Seal up all cracks, holes and covered outlets and glue down loosened wallpaper to eliminate bed bug harborage sites. 

    Note: This information was obtained from the U.S. Environmental Protection Agency. For more information about bed bugs, access this website:  www.epa.gov/bedbugs