Bed Bugs

[meeka720]

Has anyone had any problems in their school with bed bugs? We recently had a student return to school covered in "bed bug" bites. Of course the teacher freaked out and wanted her sent home. All though bed bugs are a unwanted problem they are not a communicable disease. The critters can hitch hike via back pack, purse, shoes etc. which is a cause of concern. This is a new problem for us. We do not have any current policies on bed bugs.

Have you had any problems?

What are your current policies?

[Flare, ASN, BSN]

have not had that issue yet, but will bring it up during our next group meeting. Have dealt with this a few times in the hospital - usually the room is quarantined until an exterminator can come in - but i don't think a one time brief visit to an ER and a daily visit to a school can be managed the same. This would make a good PIP.

[Purple_Scrubs, BSN, RN]

IMO excluding a child with bed bug bites would be no different than excluding one for flea bites. In either case, there is the possibility that one of the critters could hitch a ride to school. But, I find that possibility remote and think it would be ridiculous to exclude for this reason. How is one supposed to know exactly what critter caused the bites, anyway?

In any event, my district follows CDC guidelines for exclusions, and they have no recommendations for bed bugs.

[LACA, BSN, LPN, RN]

Would bedbugs, fleas, and lice pretty much be in the same category as far as the CDC is concerned? Just curious.

[meeka720]

I did some research. I found a lot of helpful information from the state of Michigan and from the "Ohio Bug Taskforce". They encourage to have a staff person check the student's belongings (bookbag, purse, shoes, etc) to make sure there are no hitchhikers. Michigan states that they do not exclude a student unless the problems is repetitive and no measures are being taken at home to help the problem. I gave administration all information that I could find. They are currently having me check the students belongings when they get to school as well as monitor the bite marks.

[bergren]

Dr. Richard Pollack's Bedbug site: BED BUGS | IdentifyUS

Dr. Pollack is a entomologist.

[Spidey's mom, ADN, BSN, RN]

i posted this on the school resource thread a few days ago.

just got this:

what we offer | identifyus

diagnosis of lesions as bed bug bites:

in my professional opinion, the only way to confirm, with full assurance, that a bite-like skin lesion was caused by a bed bug would be to observe a bed bug in the act of biting.

it is reasonable, however, to conclude that a bed bug was likely the cause of the insult if a bona fide bed bug (or recent evidence of bed bug activity) is discovered associated in time and place with the injury (for example, in the home or office occupied by the 'bitten' person). this is somewhat circumstantial evidence, but it carries much weight. it generally would be the basis to pursue abatement efforts directed against bed bugs.

without such evidence, it is unreasonable to conclude that a bite-like reaction (or array of such reactions) resulted from bed bug contact. one may take a somewhat 'educated' (or 'wild') guess, but it is merely a guess. i am unaware of any physician (or entomologist for that matter) who can honestly state, with sufficient assurance, the specific cause of most kinds of arthropod bites without more objective evidence. i neither can nor would render such a conclusion.

so, a physician (or other medical professional) may render an opinion as to the cause, and s/he may claim some amount of certainty in that opinion, but it would merely be a presumptive diagnosis. of the countless presumptive diagnoses of 'bed bug bite' for which i've been asked to review, only a tiny fraction were likely correct. in more than a few cases, the patient presented with what appeared to be such bite reactions and had encountered bed bugs. the cause-effect seems obvious, and likely would be correct. in a few cases, however, the observable 'bites' were caused not by bed bugs but instead from a skin infection unrelated to the bites. the patients were treated and the lesions cleared, but the bites continued (and were asymptomatic).

hence, be skeptical. of all the specimens presumed to be 'bed bugs' submitted to me for evaluation, fewer than 10% are bed bugs. this is even worse than the situation with head lice. for those, fewer than half were correctly named. scabies? it seems that overall the diagnostic acumen for that condition drops to about 1%, but this condition is better recognized by a few experienced (and often foreign-trained) diagnosticians.

one last comment. whereas i have academic affiliations with harvard and boston university, my services and resources pertaining to bed bugs, lice and many other pests are unaffiliated with those institutions. instead, these are offered through a private venture. those interested in my insight and services are welcome to visit and bookmark my websites listed below (we have a https secure server accessible to those who have problems reaching 'dot-com' addresses from their institutions). this secure server is used for all private discussions.

feel free to contact me with any questions or comments.

best wishes,

-rich

richard j. pollack, phd

identifyus llc