Human Health Considerations: Asthma and Allergies


Sheele, JM. 2021.  Association between bed bugs and allergic reactions. Parasite Immunology. 43:e12832. DOI:

“Aims: To evaluate whether bed bugs are associated with allergic reactions in patients seen in the emergency department (ED).

Methods and Results: This retrospective study included data from 9 EDs in Ohio between February 2011 and February 2017. The study comprised 332 patients with bed bug infestation matched 1:15 with 4952 control patients without bed bugs on the basis of age, sex and the presenting ED. Compared with uninfested patients, patients infested with bed bugs were more likely to have an ED or inpatient diagnosis of pruritus, hives or urticaria (odds ratio [OR], 9.12 [95% CI, 3.41‐24.42]) and to be treated in the ED with an antihistamine (OR, 3.20 [95% CI, 1.87‐5.50]) or albuterol (OR, 1.59 [95% CI, 1.07‐2.36]) (P ≤ .02 for all). There were no significant differences in the rates of anaphylaxis and angioedema diagnosed in patients with and without bed bugs, which occurred in <1% in both groups.

Conclusion: Bed bug–infested patients are more likely to be diagnosed and treated for itchy cutaneous rashes, but are not clearly associated with more severe allergic reactions.”


Divjan, A., H. A. daSilva, L. M. Acosta, A. G. Rundle, A. Weichsel, W. R. Montfort, G. Freyer, R. L. Miller, and M. S. Perzanowski. 2019. Detectable IgG against a Cimex lectularius allergen after a report of bed bug bites among NYC children. Journal of Allergy and Clinical Immunology. 143(2): AB236. doi: 10.1016/j.jaci.2018.12.721.

“Rationale: The common bed bug, continues to be a major pest in New York City (NYC). Previously we demonstrated an IgE response to C. lectularius nitrophorin protein (cNP) among children and adults with a report of being bitten by bed bugs. We hypothesized that some children bitten by bed bugs would have IgG antibodies against cNP.

Methods: As part of the New York City Neighborhood Asthma and Allergy Study, an asthma case-control study, 7-8 year-old children were recruited through a middle-income health insurance plan and followed to age 10-11. Serum samples were collected and their parents queried about ever being bitten by bed bugs at ages 7-8 and 10-11. Biotinylated cNP was bound to an ImmunoCAP and IgG antibodies measured in a subset of 20 children with and 30 children without a report of being bitten.

Results: All 50 samples had some measurable IgG response. Children with a report of ever being bitten by age 10-11 had a higher geometric mean of IgG (2.3 mg/L [95% C.I. 1.5, 3.6]) than children without (1.1 mg/L [95% C.I. 0.81, 1.5])(P=0.007). Of those reporting bed bug bites, 15 out of 20 had above median anti-cNP IgG values vs. 10 out of 30 among those without a report of ever being bitten (P=0.004).

Conclusions: Among NYC children, we detected serum IgG antibodies to a protein from C. lectularius. IgG concentrations were higher among children with a report of being bitten; however, we also observed some responses among those without a report of being bitten.”


DeVries, Z. C., R. G. Santangelo, A. M. Barbarin, and C. Schal2018. Histamine as an emergent indoor contaminant: accumulation and persistence in bed bug infested homes. PLoS One. 13: e0192462. doi: 10.1371/journal.pone.0192462

“Histamine is used in bronchial and dermal provocation, but it is rarely considered an environmental risk factor in allergic disease. Because bed bugs defecate large amounts of histamine as a component of their aggregation pheromone, we sought to determine if histamine accumulates in household dust in bed bug infested homes, and the effects of bed bug eradication with spatial heat on histamine levels in dust. We collected dust in homes and analyzed for histamine before, and up to three months after bed bug eradication. Histamine levels in bed bug infested homes were remarkably high (mean = 54.6±18.9 μg/100 mg of sieved household dust) and significantly higher than in control homes not infested with bed bugs (mean <2.5±1.9 μg/100 mg of sieved household dust). Heat treatments that eradicated the bed bug infestations failed to reduce histamine levels, even three months after treatment. We report a clear association between histamine levels in household dust and bed bug infestations. The high concentrations, persistence, and proximity to humans during sleep suggest that bed bug-produced histamine may represent an emergent contaminant and pose a serious health risk in the indoor environment.”


Ukleja-Sokolowska, N., L. Sokolowski, E. Gawronska-Ukleja, and Z. Bartuzi. 2013. Application of native prick test in diagnosis of bed bug allergy. Postepy Dermatologii i Alergologii. 30(1): 62-64. doi: 10.5114/pdia.2013.33382

“The aim of the study was case report of the patient with systemic reaction after a bed bug (Cimex lectularius) bite. A 23-year-old female, previously healthy, reports systemic reaction, including rash on her corpus and limbs, itching, nausea, conciseness disorder, forcing her to call the ambulance. The interview revealed that the bed bug occurs in the patient’s apartment. A prick-by-prick test with bed bug excretion was made. The skin test with native allergen was strongly positive (histamine 5 mm/5 mm, prick-by-prick 12 mm/8 mm). The prick-by-prick test was useful in objective confirmation of the source of symptoms.”


Abou Gamra, E. M., F. A. el Shayed, T. A. Morsy, H. M. Hussein, and E. S. Shehata. 1991. The relation between Cimex lectularius antigen and bronchial asthma in Egypt. Journal of the Egyptian Society of Parasitology. 21(3): 735–746.

Groups of asthmatic and non-asthmatic individuals were tested for their sensitivity to several common inhaled antigens that cause allergic reactions including two extracts from bed bugs. The asthmatic group had more individuals with positive reactions to the bed bug extracts than the control group.


Jimenez-Diaz, C., and B. S. Cuenca. 1935. Asthma produced by susceptibility to unusual allergens. The Journal of Allergy. 6: 397–403. doi: 10.1016/S0021-8707(35)90095-8

Researchers describe patient cases where asthma was induced due to bed bugs, linseed, tobacco, or chicory.