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Published on: March 15, 2017
Investigating the association of bed bugs with infectious diseases: A retrospective case-control study
Johnathan M Sheele1, Claudia R Libertin2, Bobbi S Pritt3
1Department of Emergency Medicine, Mayo Clinic, Jacksonville, FL, USA.
Abstract:
Bed bugs are common urban pests. Unlike many other blood-feeding human ectoparasites, bed bugs are not known to be vectors of human infectious diseases, but clinical and epidemiological studies to directly interrogate this link have been limited. Here, we aimed to determine whether bed bugs were associated with infectious diseases in a set of infested patients presenting to emergency departments (ED) in the greater Cleveland, OH area. We performed a retrospective case-control study involving 332 ED patients with bed bugs and 4,952 control patients, seen from February 1, 2011, through February 1, 2017. Cases and controls were matched by age, sex, and the presenting ED. Additionally, data were adjusted for ≥20 sociodemographic variables, triage data, and comorbidities in multivariable regression analyses. Seventeen laboratory values, ten different ED and inpatient diagnoses, chest radiographs, infectious disease consults, and blood cultures were examined. The odds of bed bug infestation were significantly higher for patients that had positive blood cultures, had blood cultures growing coagulase-negative Staphylococcus, were diagnosed with pneumonia, were diagnosed with cellulitis, received an infectious disease consult, received a chest radiograph, and had higher percentages of eosinophils in the blood (P < .05 for all). Additional investigations are needed to determine whether bed bugs directly contribute to disease by transmitting causative agents, whether bed bug exposure contributes secondarily contributes to infections, or whether these associations are better explained by other environmental and social determinants of health.
Insights
Bed bug infestations are linked to increased risks of certain infections, including pneumonia and cellulitis. Further research is needed to understand if bed bugs transmit diseases or if other health factors are involved.
Area of Science:
- Public Health
- Infectious Diseases
- Urban Entomology
Background:
- Bed bugs (Cimicidae) are prevalent urban pests, but their role as vectors for human infectious diseases remains under-investigated.
- Limited clinical and epidemiological data exist to confirm or refute the association between bed bug infestations and disease transmission.
- Understanding this link is crucial for public health initiatives in urban environments.
Purpose of the Study:
- To investigate the association between bed bug infestations and infectious diseases in patients presenting to emergency departments.
- To determine if specific laboratory values, diagnoses, or medical interventions correlate with bed bug exposure.
- To explore potential links between bed bugs and secondary infections or broader social determinants of health.
Main Methods:
- A retrospective case-control study was conducted using data from emergency department (ED) patients in Cleveland, OH, from February 2011 to February 2017.
- 332 patients with confirmed bed bug infestations (cases) were matched with 4,952 control patients based on age, sex, and ED.
- Multivariable regression analyses adjusted for over 20 sociodemographic variables, triage data, and comorbidities, examining laboratory values, diagnoses, and medical procedures.
Main Results:
- Bed bug infestation was significantly associated with positive blood cultures, including those with coagulase-negative Staphylococcus.
- Patients with bed bugs showed higher odds of pneumonia and cellulitis diagnoses.
- An increased likelihood of infectious disease consults, chest radiographs, and elevated blood eosinophil percentages was observed in infested patients.
Conclusions:
- Bed bug infestations are associated with several indicators of infection and increased healthcare utilization.
- The findings suggest a potential link between bed bugs and infectious diseases, warranting further investigation into direct transmission, secondary infection contribution, or shared social determinants of health.
- These results highlight the need for comprehensive public health strategies addressing urban pests and associated health outcomes.
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