Aaron: A friend and colleague has been asking me to do an episode on bedbugs for quite some time.  I've been pushing it off because I hate bugs, but they're back and he asked me again, and you can only avoid the pain for so long.  Bedbugs are the topic of this week's Healthcare Triage.

(HT Intro)

Bedbugs are tiny flat bugs whose only source of nutrition is the blood of humans and other animals.  They're about 1-7mm in length, and they're also pretty hardy, in that they can go without a blood feast for months and still live.  They're found all over the world, they infest the places people sleep, because they feed on sleeping animals.  They hide during the day in all kinds of nooks and crannies that are around beds.  They can move up to about a hundred feet a night, but they spend the vast majority of their time in about an eight foot radius around where people sleep.  The good news is that they don't fly, and they aren't crazy fast either.  They can maybe do a meter a minute if they're really pushing it.  They also reproduce slowly, maybe an egg a day, which might sound fast until you consider the fact that a fly can lay about 500 eggs in a couple of days.

The bad or awesome news, depending on your viewpoint, is how they reproduce.  They use what's known as traumatic insemination.  Turns out the male bedbugs are (bleep), female bedbugs have genital tracts reproduction, but male bedbugs don't seem to care.  Instead, they use their genitals to literally stab the female bedbugs in the abdomen, then they deposit their sperm into the wound they just caused.  Then they leave the female, wounded and bleeding, 'cause she was just stabbed in the abdomen by a male bedbug's genitals.  This, not surprisingly, isn't so good for the female.  She slinks off and tries to heal.  Meanwhile, the sperm in her abdomen swim around until they find the ovaries, then they start to fertilize eggs.  These eggs get dropped for about 4-6 weeks, since females want to hide and heal while this is going on.  It's actually more likely that they will move on to luggage or backpacks when they're pregnant.  Therefore, the bedbug you bring into your house or bedroom is slightly more likely to be one to drop eggs for weeks.  Awesome!

This next bit isn't terribly relevant information, but I wanna share it with you anyway.  Consider this a behind the scenes look at how I make a script.  While I was reviewing the literature, I came upon a paper in the journal Animal Behavior.  Homosexual interactions in bedbugs: alarm pheromones as male recognition signals.  Turns out that the signal for a male to mate with another bedbug is being all full of blood, but since they don't use female genitals to mate, 'cause they're (bleep), they can actually stab just about any bedbug in the gut, since the other males don't like this, they've developed a pheromone to tell other males to back off after they've eaten.  If scientists block this pheromone, the males start traumatically inseminating each other.  If they give that pheromone to the females, less traumatic insemination takes place.  Go ahead, try and unremember all of that.  Now you know what it's like to make Healthcare Triage.

Anyway, bedbugs don't spread disease, but the bites can cause allergic reactions.  This can lead to itching, discomfort, and if you scratch it enough, you can get a secondary infection.  They're not a dirty thing either.  Sure, they can live in dumps, but they can also live in amazingly fancy places.  They can live in movie theaters, trains, couches, lots of locations.  The CDC lists some helpful hints to check and see if you have a bedbug infestation.  These include the bedbugs' exoskeletons after molting, bedbugs in the folds of mattresses or sheets.  Rusty-colored blood spots due their blood-filled fecal material that they excrete on the mattress or nearby furniture, and a sweet, musty odor. 

Lots of people never know that they've been bitten, so they don't freak out and get concerned, and that's how the bedbugs exploit us.  We're often the means by which they travel.  They hide in our luggage and in our clothes when we travel.  Then they move into the next place we go.  That's why they're a real concern in hotels, 'cause traveling people can take them home and cause further problems.  But they don't travel on people.  They don't like the heat our bodies put off, so don't worry that you're infested, like you might be with lice.  Won't happen.  It's also a way we can kill them.  Make a room hot enough, 45 degrees Celsius, or 113 degrees Fahrenheit, and they die.  But that's not easy to do. 

If you've been bitten, there's not much you should do.  Try not to scratch the site, take an antihistamine if you think you're having a mild allergic reaction, and call a doctor if you think it's more serious than that.  This, of course, should not be construed as medical advice, we're not telling you to take any pills, and if you think you might need to do anything, you should call and talk to your physician.  The biggest and most important thing to do is to get rid of the bedbug infestation, and that's hard to do.

They're resistant to most of the common pesticides we might use, so buying bug spray is a waste of time.  Fumigation and heat treatments can work, but they can costs thousands of dollars for a house.  You can try cleaning them away, and that sometimes works, but you need to get all of them, and it's hard to be sure of that.  And bedbugs have been on the rise.  In the early 1990s, we were relatively free of them here in the United States, but world travel has changed that.  Now bedbugs are in all 50 states and all over the world.  If you're in high class hotels and sometimes  causing a panic.  But you should keep calm.  They're not gonna hurt you.  They're more of a nuisance than a crisis.

Healthcare Triage is supported in part by viewers like you through Patreon, a service that allows you to support this show through a monthly donation.  We'd like to thank all our Patreon supporters in general, and thank our honorary research associate, Cameron Alexander, specifically.  Thanks, Cameron!  Learn how you can become a patron at patreon.com/healthcaretriage. 

(HT Outro)