Human Health Considerations: Bed Bugs as Potential Disease Vectors

2016

Lai, O., D. Ho, S. Glick, and J. Jagdeo. 2016. Bed bugs and possible transmission of human pathogens: a systematic review. Archives of Dermatological Research. 308: 531–538. doi: 10.1007/s00403-016-1661-8

“The global population of bed bugs (Cimex lectularius and Cimex hemipterus, family Cimicidae) has undergone a significant resurgence since the late 1990s. This is likely due to an increase in global travel, trade, and the number of insecticide-resistant bed bugs. The global bed bug population is estimated to be increasing by 100–500 % annually. The worldwide spread of bed bugs is concerning, because they are a significant socioeconomic burden and a major concern to public health. According to the United States Environmental Protection Agency, bed bugs are “a pest of significant health importance.” Additionally, 68 % of U.S. pest professionals reported that bed bugs are the most challenging pest to treat. Upwards of 45 disease pathogens have been reported in bed bugs. Recent studies report that bed bugs may be competent vectors for pathogens, such as Bartonella quintana and Trypanosoma cruzi. However, public health reports have thus far failed to produce evidence that major infectious disease outbreaks have been associated with bed bugs. Since many disease pathogens have previously been reported in bed bugs and the worldwide bed bug population is now drastically increasing, it stands to reason to wonder if bed bugs might transmit human pathogens. This review includes a literature search on recently published clinical and laboratory studies (1990–2016) investigating bed bugs as potential vectors of infectious disease, and reports the significant findings and limitations of the reviewed studies. To date, no published study has demonstrated a causal relationship between bed bugs and infectious disease transmission in humans. Also, we present and propose to expand on previous hypotheses as to why bed bugs do not transmit human pathogens. Bed bugs may contain “neutralizing factors” that attenuate pathogen virulence and, thereby, decrease the ability of bed bugs to transmit infectious disease.”


2015

Leulmi, H., et al. 2015. Competence of Cimex lectularius bed bugs for the transmission of Bartonella quintana, the agent of trench fever. PLoS Neglected Tropical Diseases. 9(5): e0003789. doi:10.1371/journal.pntd.0003789

Bartonella quintana, the etiologic agent of trench fever and other human diseases, is transmitted by the feces of body lice. Recently, this bacterium has been detected in other arthropod families such as bed bugs, which begs the question of their involvement in B. quintana transmission. Although several infectious pathogens have been reported and are suggested to be transmitted by bed bugs, the evidence regarding their competence as vectors is unclear.”


2014

Barbarin, A. M., B. Hu, I. Nachamkin, and M. Z. Levy. 2014. Colonization of Cimex lectularius with methicillin-resistant Staphylococcus aureus. Environmental Microbiology. 16: 1222–1224.

Researchers investigated the potential for bed bugs to transmit methicillin-resistant Staphylococcus aureus (MRSA) to humans. Results indicated that the bed bug midgut was capable of maintaining the bacteria for up to 9 days, but the bacteria did not replicate within that environment. They concluded that bed bugs are unlikely to transmit MRSA to humans.


2013


2012

Goddard, J., A. Varela-Stokes, W. Smith, and K. T. Edwards. 2012. Artificial infection of the bed bug with Rickettsia parkeri. Journal of Medical Entomology. 49: 922–926. doi: 10.1603/ME11282

“Although a variety of disease agents have been reported from bed bugs, the mechanical and biological disease transmission potential of bed bugs remains unelucidated. In this study we assayed survivability of the mildly pathogenic spotted fever group rickettsia, Rickettsia parkeri, in bed bugs after feeding on R. parkeri-infected chicken blood. Two groups of 15 adult bed bugs each were fed on infected or noninfected blood, and two groups of fourth-instar bed bugs also were fed on either infected or noninfected blood. One group of 15 adult bed bugs received no bloodmeal and was included as an additional control. Two weeks postfeeding, two pools of five live bed bugs from each group were surface sterilized, macerated, and placed in Vero cell cultures in an attempt to grow live organism. The remaining five individual bed bugs from each group were dissected, their salivary glands were removed for immunofluorescence assay (IFA) staining, and the remaining body parts were processed for polymerase chain reaction (PCR) analysis. Results indicated that no immature (now molted to fifth instar) bed bugs were positive for R. parkeri by IFA or PCR, indicating that organisms did not survive the molting process. After 4 wk of cell culture, no organisms were seen in cultures from any of the treatment or control groups, nor were any cultures PCR positive. However, two of the adult bed bugs were IFA positive for rickettsia-like organisms, and these two specimens were also PCR positive using R. parkeri-specific primers. These IFA and PCR results indicate that remnants of Rickettsia parkeri (possibly whole organisms) survived in the bugs for 2 wk, but the viability of the organisms in these two specimens could not be determined.”


2011

Delaunay, P., V. Blanc, P. Del Giudice, A. Levy-Bencheton, O. Chosidow, P. Marty, and P. Brouqui. 2011. Bedbugs and infectious diseases. Clinical Infectious Diseases. 52: 200–210.

“Bedbugs (C. lectularius or C. hemipterus) are cosmopolite hematophagus insects, and recent outbreaks have been reported in all major occidental countries. Although they are suspected of transmitting more than 40 infectious agents, no report has yet definitively demonstrated that capacity., Bedbugs are brown and flat hematophagous insects. The 2 cosmopolite species, C. lectularius and C. hemipterus, feed on humans and/or domestic animals, and recent outbreaks have been reported in occidental countries. Site assessment for bedbug eradication is complex but can be assured, despite emerging insecticide resistance, by hiring a pest-control manager. The common dermatological presentation of bites is an itchy maculopapular wheal. Urticarial reactions and anaphylaxis can also occur. Bedbugs are suspected of transmitting infectious agents, but no report has yet demonstrated that they are infectious disease vectors. We describe 45 candidate pathogens potentially transmitted by bedbugs, according to their vectorial capacity, in the wild, and vectorial competence, in the laboratory. Because of increasing demands for information about effective control tactics and public health risks of bedbugs, continued research is needed to identify new pathogens in wild Cimex species (spp) and insecticide resistance.”


Lowe, C. F., and M. G. Romney. 2011. Bedbugs as vectors for drug-resistant bacteria. Emerging Infectious Diseases. 17: 1132–1134.

Letter to the editor describing how methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) were isolated from bed bugs that were found on patients. The prevalence of infections with these two bacteria and bed bugs in the Vancouver population are discussed.


2010


2009

Richard, S., P. Seng, P. Parola, D. Raoult, B. Davoust, and P. Brouqui. 2009. Detection of a new bacterium related to “Candidatus Midichloria mitochondrii” in bed bugs. European Society of Clinical Microbiology and Infectious Diseases. 15: 84–85.

Molecular techniques were used to identify bacteria from bed bugs collected from bunks on six French warships. Bed bug samples stored in ethanol were subjected to PCR. Wolbachia spp., a common endosymbiont, and Candidatus Midichloria mitochondrii, recently identified in ticks, were isolated and identified.


2008


2007


2006


2005


1977

Werner, B. G., S. Diallo, M. Pourtaghva, and B. S. Blumberg. 1977. Hepatitis-B virus in bedbugs (Cimex hemipterus) from Senegal. The Lancet. 310: 217–219.

Tropical bed bugs, Cimex hemipterus, collected from village huts in Senegal, West Africa, were sampled for the presence of hepatitis-B surface antigens. Their data represented the highest field infection-rates of hepatitis B virus reported in any insect species. They concluded that bed bugs must be considered as a potential vector of hepatitis B virus.


1963

Burton, G. J. 1963. Bedbugs in relation to transmission of human diseases. Public Health Reports. 78: 513–524.

A literature review to evaluate the potential for bed bugs to carry and transmit disease causing organisms. Disease-causing organisms can survive for several days to several weeks inside bed bugs. However, Burton concluded that disease transmission by bed bugs in nature is unlikely.

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