Bed Bugs

About This Disease

Bed bugs (Cimex lectularius) are small, flat, parasitic insects that only feed on the blood of humans and animals while they sleep. They are reddish-brown in color, about 1mm to 7mm in size, and can live for several months without a blood meal. Bed bugs are not known to spread diseases, but their presence can cause itching and loss of sleep. Excessive scratching can increase the chance of secondary skin infections. Bed bugs are found all over the world and the cleanliness does not determine the presence of bed bugs.

Signs and Symptoms

Symptoms usually appear one to several days after initial bite, and may take up to 14 days to appear. Symptoms include:

  • Bite marks–a swollen and red area that may or may not itch
  • Insomnia
  • Anxiety

Some people may not have a reaction to the bites and may not develop bite marks at all.


Bed bugs hide in seams of mattresses, box springs, bed frames, headboards, dresser tables, inside cracks or crevices, behind wallpaper, or any other clutter or objects around a bed during the day. Bed bugs are transmitted from place to place as people travel. They can be in the seams and folds of luggage, overnight bags, folded clothes, bedding, furniture, or anywhere else they find a place to hide.


There is no laboratory test to confirm bed bug bites. Bed bug infestations can be determined from an inspection and finding eggs or bed bugs.


Bed bug bites can be treated with antiseptic or hydrocortisone creams or lotions. An antihistamine can also be taken.

Bed bugs infestations can be treated by pesticides (make sure it specifically treats for bed bugs) or call a professional. Clean laundry and bedding by washing in hot water and drying with high heat. Steam cleaning can be effective, but be sure to check for bugs in a week or two. Concentrate in the areas they like to hide such as the seams. Bed bugs are sensitive to heat, so putting your mattress in a tight plastic bag and leaving it in the heat for several days can kill adults and the eggs. Vacuum your mattress and the areas around it. Be sure to immediately empty the vacuum cleaner and throw it out. If your mattress is infested, you may also consider getting a new mattress, but be sure to take care of the rest of your home so that your new mattress doesn’t get infested.

Risk in Hawaii

There are no statistics on how many homes have been infested with bed bugs in Hawaii. However bed bugs can be found everywhere, and can be transported through travelers.


Inspect furniture before bringing into your home. Remove any clutter around your bed. Eliminate hiding places for bed bugs such as sealing crevices, repair peeling wall paper, and tighten loose light switches. Be aware when you travel so you do not bring bed bugs home with you.

Information for Clinicians