A procession of bed bugs


Okay, so we had a patient present with a skin rash. She was itchy all over especially on her back with wheals and flares.

Wheals are raised, itchy (pruritic) area of skin that is sometimes an overt sign of allergy. Wheals reflect circumscribed dermal edema (fluid collection in the layer of skin below the surface). A wheal is also sometimes called a welt and often a hive. Anyway, this is not an English lesson!


An allergic reaction

Naturally, we thought she had reacted to some medication and this was quickly managed with steroid injections and Piriton tablets. It all subsided pretty well and she calmed down till the very next day. It happened all over again. We stopped all drugs in order to determine the offender. Then, the penny dropped when we found a bed bug on her.
Feeding fat! Oh goodness gracious!


Bed bugs in hospitals


Bed bugs are parasitic insects in the genus Cimex that feed exclusively on blood. Cimex lectularius, the common bed bug, is the best known as it prefers to feed on human blood. These things have a peculiar look and a peculiar smell when squashed. Squashed they make a bloody mark on the walls.
Anyway, this is not a Biology lesson!


A procession of bed bugs


Suddenly, they were everywhere. They were visible all over the bed sheets. Some were in the nooks and crannies in the furniture throughout the room. Yes, on the walls too! They seemed to be having meetings, processions, strikes or even elections all over the place. We elected to deal with them with all seriousness: before they take over, like Herdsmen!
Anyway, this is not a lesson in Politics!


Isolation

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We isolated the clueless patient and moved everyone else out to another hospital. All the furniture were removed and searched thoroughly, cleaned and sprayed, soaked with the appropriate insecticide. Others were dumped and burned. Or else, some needy person may remove the furniture to decorate their homes with bed bugs!


Success brings smiles as we disrupted the activities of these rampaging marauders. The place was cleared of bed bugs unlike the situation in Sambisa forest. We are pretty sure they will not mount an attack again. We have also trained all staff on bug recognition, alarm and immediate action to exterminate, wherever and whenever.


Who bears the cost?


Of course, we cannot blame our patient. Yes, poor personal hygiene and lack of general awareness may have rendered her culpable. But, the fact is that a sick person is sick and perhaps sickness leads to lowering of the guards. We cannot also reasonably ask for reparative costs. Costs of De-infestation, repaired materials and destroyed furniture running into almost a quarter of a million Naira.
Anyway, not a lesson in finance!


Surveillance


Children carry head lice to schools, travellers carry mosquitoes onto aeroplanes and patients bring cockroaches and bed bugs to hospitals. As they say, shit happens and perhaps in hospitals more than other areas. So, we bit the bullet and cleared the house of bed bugs. We also had to phone all other patients who were on admission at the time, including relatives, to beware of the bug. We encouraged them to heighten security and sleep with one eye, one ear open. As we would from now on!


What have you learnt?


When coming to the hospital, please check yourself and your carry on.
Keep your pets at home.

Written by Dr. Biodun Ogungbo

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