Hygiena 2017, 62(3):77-84 | DOI: 10.21101/hygiena.a1541

ECTOPARASITE BED BUG (CIMEX LECTULARIUS) HAS ONCE AGAIN RETURNED TO HUMAN HABITATS ALSO IN SLOVAKIA

Anna Totková¹, Ľudmila Ševčíková², Ľubica Argalášová², Daniel Böhmer¹, Vanda Repiská¹, Jana Malová¹, Andrej Karkalík³, Adrián Totka³

¹ Univerzita Komenského v Bratislave, Lekárska fakulta a UN, Ústav lekárskej biológie, genetiky a klinickej genetiky, Bratislava, Slovenská republika

² Univerzita Komenského v Bratislave, Lekárska fakulta, Ústav hygieny, Bratislava, Slovenská republika

³ Univerzita Komenského v Bratislave, Lekárska fakulta a UN, II. gynekologicko-pôrodnícka klinika, Bratislava, Slovenská republika

Introduction: In the 1970s and 1980s we noticed the occurrence of bed bugs (Cimex lectularius Linné, 1758) in flats, family houses and accommodation facilities in Slovakia and only sporadically in the Czech Republic. Under regular monitoring of this ectoparasite by hygienists from a department of disinfection, disinsection, and deratization, it was possible not only to eliminate the occurrence of the parasite but in the 1980s even to eradicate it. Today, it is necessary again to address this major global health issue. Cimex lectularius has once again returned to human habitats. Its biological development and activity are bond to its habitat. It feeds mainly on human blood. Bed bug bites are in their appearance and symptoms similar to hives (urticaria cimicina), so the occurrence of skin problems is not being associated with this ectoparasite. Skin reactions are hardly distinguishable from bites by other biting insects (fleas, lice, mosquitoes, and others).

Material and methods: Over the period 2006-2015, we examined 102 patients with suspected ectoparasitosis in the diagnostic laboratory of human parasitology at the Faculty of Medicine CU in Bratislava. Specialists and general practitioners for children and adults sporadically referred patients with various incurable skin heavily itching red efflorescences to a consultation parasitological examination. Within differential diagnosis, we considered insect bites (fleas, lice, mosquitoes, bed bugs, and others), or infestation by intestinal geohelminths whose toxins can cause allergic reactions in the form of various skin changes (urticaria, macula, papula). Therefore, we examined some unclear cases for intestinal parasites using a coprological method. By parasitological examination of patients and entomologic analysis of insects brought by patients, we managed to clearly confirm in many of them that it was skin ectoparasitosis caused by Cimex lectularius and in one case Oeciacus hirudinis.

Results: A total number of 102 parasitologically examined patients with suspected ectoparasitosis included 62 (60.8%) adults and 40 (39.2%) children. Out of 62 adults, there were 57 (91.9%) patients positive for cimicosis. In 5 (8.1%) patients, cimicosis was not confirmed. However, in 4 of them, we diagnosed an intestinal geohelminth Ascaris lumbricoides and in one female patient Sarcoptes scabiei. Out of the 57 adult patients with cimicosis, there were 3 patients with anaemia, 6 patients with asthma, and 10 patients with various forms of allergy were treated by an allergist/immunologist. Patients in addition to itching skin suffered from insomnia, fatigue, irritability, and depression. Out of 40 children, there were 34 (85%) positive for cimicosis. In 6 (15%) children, ectoparasitosis was not confirmed. In 4 children, a coprological examination revealed an intestinal geohelminth Ascaris lumbricoides and in one child a double infection with Ascaris lumbricoides and Enterobius vermicularis. One female patient was diagnosed with the itch mite (Sarcoptes scabiei). Out of 34 children with cimicosis, there were 2 children with anaemia, 8 children with asthma and 15 children were treated with various forms of allergy by an allergist/immunologist. Children also suffered from itching skin, insomnia, fatigue, and irritability.

Conclusion: Today, there are no eradication plans in the struggle against bed bugs. Bed bugs should again be subject to the reporting service to public health authorities, as it was in the past, and thus better record monitoring of its incidence and spread in the population. It is again essential to pay the same attention to this ectoparasitosis as to other ectoparasitoses in order it not to be underestimated nor forgotten in medical practice.

Keywords: Cimex lectuarius, cimicosis - prevention, tourism, migration

Published: September 2017  Show citation