Post on 18-Mar-2020
Pascal DELAUNAY
Global Emergence of Bed bugs
Cimex lectularius
An Increasing cause of Dermatitis
Pascal DELAUNAY Parasitologie - Entomologie Médicale
Centre Hospitalier Universitaire de Nice FRANCE
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Bed bugs Cimex lectularius Ectoparasite Hematophagous for both sexs
Feed on humans and/or domestic animals
cosmopolite insects living preferently in house
Adults and Nymphs walking insect wingless Reddishbrown, flat, ovals, resembling confetti
Terzi in R.L.USINGER 1966, The Thomas Say Foundation VII, Baltimore, USA.
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Eggs and faecal traces Nymph stages 2 ou 3
1 mm
1 to 4 mm
nymph stage 1
Bed bugs Cimex lectularius
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Time of a blood meal 10 - 20mn Adult life span 6 - 24 months Duration of life cycle (egg to egg) 40 - 70 days from 30 to 200 days Time to egg laying after mating 3 - 10 days Female egg-laying rate 5 - 15 eggs per day Hatching time 7 - 15 days Time between 2 nymph stages 3 - 7 days Lifetime total number of eggs 150 - 500 eggs
♂ ♀
N1
N2
N3
N4
N5
Egg
Adult
female
Adult
male
Traumatic insemination
Egg Nymphs
N1-N2-N3-N4-N5
Adult male or femelle
Bed bugs Cimex lectularius
Bedbugs number = secret increase then exponential increase
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Bed bugs - DISPERSAL
Active Passive
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Pascal DELAUNAY
Pascal DELAUNAY
Véronique BLANC
bedbugs, feces, eggs…..hiden in mattress, cracks, furnitures, curtains….
Pascal DELAUNAY
Bed bugs do not have wing… …Bed bugs walk !
From hiding place to a new hiding place
Local spreading
‘‘Active Dispersal.’’
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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World spreading
Bedbugs do not have wing ! But….Bed bugs travel !
clothing, luggage, furniture…
‘‘Passive Dispersal.’’
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
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« Commentaires sur la matière médicale de Dioscoride » par MATTHIOLI Bois gravé de l’édition de John
GOODYER 1655
Human vs Bed Bugs BALANCE
MILLENNIUM
Adaptation, 40.000 years ago
KNOWLEDGE correlated to the age > 70 years
Who knows the bed bug? Knowledge of adult bed bug appearance increases with people's age in three counties of Great Britain.
Reinhardt K et al. J Med Entomol. 2008 Sep;45(5):956-8.
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Increasing number of PubMed citations for the search words "Bedbugs - Bed bugs - Cimex "
2012
Increase in the 1990s…WHY ?
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Volume
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TRANSPORT Enhanced resistance to pyrethroid insecticides
The re-emergence of the bed bug as a nuisance pest
implications of resistance to the pyrethroid insecticides.
Davies TG, Field LM, Williamson MS.
Med Vet Entomol. 2012 Sep
26(3):241-54. doi: 10.1111/j.1365-2915.2011.01006.x. Epub 2012 Jan 11.
Increase in the 1990s…WHY ?
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
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Bed bug infestation. Bernardeschi C, Le Cleach L, Delaunay P, Chosidow O. BMJ. 2013 Jan 22;346.
Olivier CHOSIDOW
Delaunay
Delaunay
MEDICAL IMPACT
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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A B
C D
Del-guidice Del-guidice
Delaunay Delaunay
Bites are painless… …. but in the morning Typical skin lesions: - curve or line - located in unclothed zones - Pruritic erythematous maculopapules, - 5 mm to 2 cm in diameter - Central hemorrhagic crust or vesicle
MEDICAL IMPACT
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Are bed bugs considering as vector of infectious diseases ?
… NO … …but research is on going
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Competence Capacity VECTOR =
Bedbugs and infectious diseases
Delaunay P, Blanc V, Del Giudice P,
Levy-Bencheton A, Chosidow O, Marty P, Brouqui P.
Clinical Infectious Disease 2011 Jan 15;52(2):200-10.
Review
45 pathogens have been evocated
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
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“Bed Bugs and Infectious Diseases” Pascal Delaunay, Véronique Blanc, Pascal Del-Giudice, Anna Levy-Bencheton, Olivier Chosidow, Pierre Marty, and Philippe Brouqui
Clinical Infectious Diseases, 2011:52 (15 January) 201-210
Bacteria: Bacillus anthracis, Bartonella quintana, Borrelia recurrentis, Borrelia duttoni, Brucella melitensis, Candidatus Midichloria mitochondrii, Coxiella burnetii , Francisella tularensis, Leptospira, Mycobacterium leprae, Mycobacterium tuberculosis, Rickettsia africae, Rickettsia conorii, Rickettsia prowazekii, Rickettsia rickettsii, Rickettsia typhi, Salmonella typhi, Staphylococcus aureus, Streptococcus pneumonia, Wolbachia, Yersinia pestis….
Viruses Hepatitis B, Hepatitis C, Hepatitis E, Human immunodeficiency, Influenza, O’nyong-nyong, Polio, Rabies, Reovirus, Smallpox, Yellow Fever
Parasites Brugia malayi, Wuchereria bancrofti, Mansonella ozzardi, Onchocerca volvulus, Leishmania braziliensis, Leishmania donovani, Leishmania tropica, Plasmodium spp., Trypanosoma cruzi, Trypanosoma gambiense
45 pathogens have been evocated
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Rickettsia parkeri is a Rickettsi in the Spotted Fever group transmitted by tick
Goddard J, Varela-Stokes A, Smith W, Edwards KT.
Journal Med Entomol. 2012 Jul;49(4):922-6. Artificial infection of the bed bug with Rickettsia parkeri.
Rickettsia parkeri inoculated by an infectious blood meal of Rickettsia parkeri After few weeks…Bed bugs are not able to amplificate R. parkeri
Artificial infection of the bed bug with Rickettsia parkeri.
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
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Not vector but … Bed bugs may transportation pathogens as any biting insect or walking insect
Fungi Aspergillus, Penicillium, Scopulariopsis … Bacteria: Streptococci, Stapylococci
Canadian staff report recovery of methicillin resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) from bedbugs
Bed bugs as Vectors for Drug-Resistant Bacteria Christopher F. Lowe and Marc G. Romney
Emerging Infectious Diseases Vol. 17, No. 6, June 2011
PHORESY = Pathogens transport
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Anxiety, nervousness, insomnia, crying, depression …!!!
PSYCHOLOGICAL IMPACT
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
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PHRC - France Clinical Research
Hospital Programm
Collected Bed Bugs found homestays Establish laboratory colonies of Bed Bugs
Start test on resistance to pyrethroid
Analyse bacteria and virus in body with collected Bed Bugs
1 2
3 4
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Collected bed bugs to infested places 1
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
PHRC FRENCH STAFF Visited places 285 Positive places 81 Collected BED BUGS 2891
PHRC - France Clinical Research
Hospital Programm
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Laboratory colony of bed bugs 26
6 29
2 30
5 381 420
374 411 50
1 537 66
1 725
746
719 78
1
941
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1323
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S1 -- -- -- -- -- -- S2 -- -- -- -- -- -- S3 -- -- -- -- -- -- S4 -- -- -- -- -- -- S5 -- -- -- -- -- -- S6 --
adults F0 Nymph F0 Bed bugs F1
2
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Durand R, Cannet A, Berdjane Z, Bruel C, Haouchine D, Delaunay P, Izri A. Infestation by pyrethroids resistant bed bugs in the suburb of Paris, France. Parasite. 2012 Nov;19(4):381-7
- 2 building at Saint Ouen (93) Suburb of Paris (France) 198 flats - 196 flats investigated 76 infested flats - 97 people - 53 people were disturbed by these bedbugs - 564 bed bugs collected
Resistance to pyrethroid insecticides 3
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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499 bed bugs collected
339 bed bugs investigated 8 BACTERIA genus investigated : Rickettsies sp., Coxiella like, Coxellia burnetti, Bartonella sp Bartonella quintana, Erlhichia sp., Wolbachia sp., Acinetobacter sp. BACTERIA detected: for 32 bed bugs 9.4% 29 bed bugs for Acinetobacter 8.5% 3 for Wolbachia 3 for Erlichia 2 for Coxellia
Bacteria 4
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Bed bugs Eradication
Efficient search-and-destroy operation
6 STEPS
IDENTIFICATION
ASSESSMENT OF THE SPREADING
NON CHIMICAL ERADICATION CHIMICAL ERADICATION
ASSESSMENT OF YOUR FIGHT
PREVENTION
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
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Bed bugs Eradication
Efficient
search-and-destroy operation
- Dismantling or Removing all furniture to access all bed bugs hiding places - Destroy eggs, nymphs,
and adults Insecticide, vacuum, brush….
- Clothes, Linens… : Warming at 60°C Freezing at minus - 20°C
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Human travel and traveling bed bugs. Delaunay P.
J Travel Med. 2012 Oct;19(6):373-9
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Short inspection … for bed bugs or black spots (faeces)
Separate … used linen and clean linen …with small bags
Luggage deposit preferentially in the bathroom
DURING THE TRAVEL
AFTER THE TRAVEL
Luggage deposit in the bathroom
Take a shower
Wash your clothes over 60°C Freeze at minus - 20°C or
Rub or Wash your suitcase with a brush…do not forget the zip area
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
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Thank you… … have a good trip … without any bed bugs
Pascal DELAUNAY
Pascal DELAUNAY Parasitologie - Entomologie Médicale
Centre Hospitalier Universitaire de Nice FRANCE
Global Emergence of Bed Bugs Cimex lectularius - An Increasing Cause of Dermatitis Pascal DELAUNAY Entomologie-Parasitologie-Mycologie CHU de Nice - FRANCE
ESCMID Online Lecture Library
© by author