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Background Heat can be effective for bed bug elimination. However, in some cases bed bugs survive heat treatments. The objectives of this study were to determine the behavioral responses of bed bugs to rising harborage temperatures (23.0-49.0 °C) and identify which heat shock protein (HSP) genes are expressed after heat exposure. First, a custom-made copper arena and harborage were used to determine the escape behaviors of six bed bug populations. Next, HSP gene expression responses of select populations were determined after heat exposure using real time quantitative polymerase chain reaction (RT-qPCR). Results Analysis of the 25 min behavioral experiment data found that harborage top temperatures associated with 25%, 50% and 75% probabilities of bed bugs to flee the harborage did not differ significantly between populations. Also, the percentage of insects that escaped from heated areas and survived (4.0-12.0%) was not different between populations. However, when specific temperatures at which successful escapes occurred were statistically compared, the Poultry House population was found to flee the harborage at statistically higher temperatures (43.6 ± 0.5 °C) than others (40.5 ± 0.6-42.0 ± 0.7 °C). The RT-qPCR experiments revealed that the HSP70.1, HSP70.3, and Putative Small HSP genes were significantly up-regulated 15 min, 2, and 4 h post-heat exposure and decreased back to baseline levels by 24 h. Conclusions This study shows that when harborage top temperatures approach 40.0-43.0 °C, bed bugs will disperse in search for cooler areas. This work implicates the HSP70.1, HSP70.3, and Putative Small HSP genes in heat induced stress recovery of bed bugs.

Introduction Bed bugs are hematophagous insects that can be problematic in some urban emergency departments. The objective was to determine if red blood cell (RBC) and coagulation indices of bed bug–infested emergency department (ED) patients differed from those of noninfested control patients. Methods A chart review from a single health system was performed for ED patients between February 1, 2011, and February 1, 2017. Bed bug–infested patients were matched to noninfested control patients on the basis of age, sex, and the presenting ED. Variables were analyzed with the t-test and Pearson χ2 test and were modeled with multivariable logistic regression. Results The study had 332 bed bug–infested patients and 4952 controls. Infested patients had lower hemoglobin (11.7 g/dL vs 12.8 g/dL), hematocrit (35.0% vs 37.9%), RBC counts (4.1 × 109/L vs 4.4 × 109/L), mean corpuscular volume (86.0 vs 87.5 fL/cell), and mean corpuscular hemoglobin concentrations (33.2 vs 33.7 g/dL) and higher RBC distribution width-coefficient of variation (RDW-CV) (15.2% vs 14.2%) than noninfested patients (all P ≤ .003). Infested patients were more likely to be anemic (59.5% vs 36.9%) and to have severe anemia (4.4% vs 0.7%) (P Conclusion Bed bug infestated patients in the ED are associated with anemia.

BACKGROUND The common bed bug, Cimex lectularius L., and the tropical bed bug, Cimex hemipterus (F.), are now widely regarded as important public health pests following their rapid global resurgence, largely due to insecticide resistance and an increased rate of global travel. The insecticide resistance mechanisms are well documented in C. lectularius, however, only one mechanism is validated in C. hemipterus thus far. This demands further understanding on the resistance mechanisms involved in C. hemipterus. RESULTS Here, we identified differences in resistance to fenitrothion (organophosphate) and imidacloprid (neonicotinoid) related cuticle thickness in C. hemipterus. There is evidence of a possible association between cuticle thickness and resistance, but the association can be tenuous, likely because resistance is multifactorial in C. hemipterus. We also discovered a novel T1011 residue in domain IIS6 of the voltage-gated sodium channel that likely enhanced susceptibility to deltamethrin (pyrethroid) despite the presence of a L1014F mutation known to confer pyrethroid resistance in C. hemipterus. Our findings also confirmed that the M918I mutation enhanced resistance to pyrethroid when present with the L1014F mutation, which was consistent with a super-kdr phenotype, as reported previously. Multiple resistance mechanisms can be found within a single C. hemipterus population, and the presence of both M918I + L1014F mutations likely masked the influence of cuticle thickness in conferring resistance against deltamethrin. The elevated metabolic enzyme activities in some strains were not necessarily associated with increased insecticide resistance. CONCLUSION This study has enhanced our understanding on the penetration resistance mechanism and target site insensitivity of sodium channels in C. hemipterus.

Methyl benzoate is a natural product (floral volatile organic compound) that is currently used as a food flavoring ingredient. This compound has shown to be insecticidal in laboratory studies against agricultural and urban pests, including spotted wing drosophila Drosophila suzukii, brown marmorated stink bug Hyalomorpha halys, the diamondback moth Plutella xylostella, and the common bed bug Cimex lectularius, to name several insect taxa. In this study we topically treated adult Aedes aegypti females with methyl benzoate and analogs and determined their toxicities. We found that among adult females, 4 analogs—butyl benzoate, n-pentyl benzoate, vinyl benzoate, and methyl 3-methoxybenzoate—were more toxic than the parent compound, methyl benzoate.

The bacterium Burkholderia multivorans is an opportunistic nosocomial pathogen of humans. A previous study reported molecular detection of this bacterium in several specimens of the common bed bug (Cimex lectularius L.) collected from an elderly care facility in the U.S.A., raising questions about the possibility of vector-borne transmission. However, the ability of B. multivorans to colonize bed bugs and the ability of bed bugs to transmit the bacteria both remained untested. To resolve this knowledge gap, here we performed a set of experiments to examine the persistence and shedding of B. multivorans following ingestion by bed bugs in a blood meal. We isolated viable B. multivorans from the bodies of bed bugs for up to 13 days post-ingestion, but bacterial load substantially diminished over time. By 16 days post-ingestion, the bacteria could not be isolated. Further, B. multivorans was not shed in the saliva of infected bugs during feeding nor was it transmitted vertically from infected insects to their progeny. Based on these results, significant biological or mechanical transmission of B. multivorans to humans by bed bugs appears unlikely. Nonetheless, some viable bacteria were passively shed into the environment through defecation, a process which could potentially contribute to transmission through indirect contamination under rare circumstances.

This study reports the first baseline information on tropical bed bug, Cimex hemipterus (F.) (Hemiptera: Cimicidae), infestations in Ghana. The purpose of this study was to assess bed bug infestation levels, and the efficacy of locally available insecticides and long-lasting insecticidal nets (LLINs) in controlling field bed bugs populations in the Cape Coast region. A survey was undertaken to assess bed bug infestation levels and current control practices by residents. In total, 205 bed bug affected households were identified in 20 communities and live bed bug infestations were associated with most of these premises. Many homeowners knew of other households (from 1 to 3) with a bed bug infestation. Residents reported itching and swelling of the skin from the bed bug bites and the bites were considered severe. The most common household bed bug control strategy was the application of insecticides. However, LLINs and commercially formulated insecticides commonly used by households (notably chloropyrifos and pyrethroid-based formulations) did not efficaciously suppress field collected strains of C. hemipterus. Using a dipping bioassay, mean mortality ranged from 0 to 60% for eggs, nymphs, and adults, and less than 40% mortality was observed in bed bugs placed on insecticide-treated filter paper. Each LLINs (all are pyrethroid based) produced a mean mortality of less than 20% in adult bed bugs. For a more effective response to the global bed bug resurgence in developing countries, government and supporting agencies need to render assistance to bed bug affected residents through the provision of improved pest management strategies.

The bed bug, Cimex lectularius L., is a common ectoparasite found to live among its vertebrate hosts. Antennal segments in bugs are critical for sensing multiple cues in the environment for survival. To determine whether the thermo receptors of bed bugs are located on their antennae; innovative bioassays were created to observe the choice between heated and unheated stimuli and to characterize the response of bugs to a heat source. Additionally, the effect of complete antenectomized segments on heat detection were evaluated. Heat, carbon dioxide, and moisture are cues that are found to activate bed bug behavior; a temperature at 38°C was used to assess the direction/degree at which the insect reacts to the change in distance from said stimulus. Using a lightweight spherical ball suspended by air through a vacuum tube, bed bugs and other insects are able to move in 360° while on a stationary point. Noldus EthoVision XT was used to capture video images and to track the bed bugs during 5-min bioassays. A bioassay was created using four Petri dish arenas to observe bed bug attraction to heat based on antennae segments at 40°C. The purpose of this study was to evaluate the effects of heat on complete antenectomized segments of the antennae. The results in this experiment suggest that bed bugs detect and are attracted to heat modulated by nutritional status. Learning the involvement of antennae segments in heat detection will help identify the location and role of thermoreceptors for bed bug host interaction.

This study investigated the efficacy of using Vikane gas fumigant (sulfuryl fluoride) at the 1.9× dosage rate for eliminating bed bugs (Cimex lectularius L.) in two challenging infestation situations: personal vehicles, and confined spaces densely packed with personal belongings. The vehicles used in this study were large minivans with seating that folded into the floor. The confined spaces were cargo trailers filled to 85% capacity with books, furniture, and other household items. Each van and trailer was equipped with ~90 sentinel bed bugs consisting of three groups of 9–11 bed bug eggs, 10 nymphs, and 10 adults. The Vikane Fumiguide calculator was used to determine the target dosage (g-h/m3) to apply in each replicate (e.g., one van or trailer). Sulfuryl fluoride concentrations were measured throughout the fumigation process using a Spectros SF-ReportIR. Concentration readings were input into the Fumiguide to determine when the accumulated dosage (g-h/m3) was achieved, and when aeration should be initiated. After aeration was complete, the sentinel bed bugs were removed from the replicates and bed bug nymph and adult mortality was recorded. Bed bug eggs were monitored for 23 d to determine latent mortality. Fumigated bed bug mortality for each replication was 100% regardless of life stage. Latent mortality was observed in a single bed bug egg, but the first instar never fully eclosed. This study determined that fumigation with sulfuryl fluoride at the 1.9× dosage factor is an effective method for eliminating resistant bed bugs from vehicles and personal belongings in densely packed situations.

Bed bug repellents should not only prevent humans from being bitten but impede an infestation of personal belongings. Only a few test proposals for evaluating the efficacy of repellents against bed bugs have been published so far. In the present study, two test systems were assessed for efficacy testing with five potential bed bug repellents (cinnamon oil, icaridin, N,N-diethyl-3-methylbenzamide (DEET), permethrin, and margosa extract). The first test setup was a harborage choice test system that consisted of a crystallizing dish with a treated and an untreated harborage. Sixty minutes and 24 h after treatment, DEET, icaridin, and cinnamon oil showed the highest repellency with a median proportion of at least 99% repelled bed bugs. The second test system was a barrier test. Bed bugs were attracted by CO2 and heat to cross filter papers treated with the potential repellents. The repellency of substances was significantly lower in comparison to the harborage choice test, except for DEET. The latter showed the highest repellency (97%) against bed bugs 24 h after application compared to controls. Results show that bed bugs are less sensitive to repellents when searching for a bloodmeal than when searching for a shelter.

Reproductive fitness and survival are enhanced by adaptive behaviors that are modulated by internal physiological states and external social contexts. The common bed bug, Cimex lectularius, is an obligate hematophagous ectoparasite that requires host blood for growth, development, and reproduction. We investigated how mating, starvation and social interactions affect host-seeking, blood feeding, oviposition, and survival of female bed bugs. The percentage of females that fed and the amount of blood they ingested were greater in mated females (90–100%) than in unmated females (48–60%). Mating state also modulated the female’s orientation towards human skin odor in an olfactometer; more mated (69%) than unmated (23%) females responded to human odors. The response rate of unmated females (60%) to skin odor increased with longer starvation period, while the opposite pattern was observed in mated females (20%). Although fecundity after a single blood meal was unaffected by long or short residence and interaction with males, females subjected to frequent copulation attempts had lower survivorship and lifespan than females housed with males for only 24 h. Taken together, these results indicate that by adaptively and coordinately expressing behaviors based on the internal physiological state, females maximize their survival and reproductive fitness.

Knockdown-resistance (kdr) against pyrethroids in bed bugs (Cimex lectularis) is associated with the presence of several point mutations in the voltage-sensitive sodium channel α-subunit gene and/or an increased metabolic detoxification by cytochrome P450 monooxygenases (CYPs). In the present study, pyrosequencing assays were developed to quantify the presence of the kdr substitutions (V419L or L925I substitution) in bed bugs in Berlin, Germany. In 14 of 17 bed bug field strains, pyrosequencing revealed the presence of the substitution L925I with allele frequencies between 30% and 100%. One field strain additionally carried the substitution V419L with allele frequencies of 40% in males and 96% in females. In seven of the 17 field strains, mRNA levels of four CYP genes were examined using RT-qPCR. Relative to a susceptible laboratory reference strain, five field strains showed significantly higher mRNA levels of cyp397a1 with 7.1 to 56-fold increases. One of these strains additionally showed a 4.9-fold higher mRNA level of cyp398a1 compared to the reference strain, while cyp4cm1 and cyp6dn1 showed no significant differences. Our findings indicate that multiple resistance mechanisms are present in German C. lectularius populations simultaneously., Graphical abstract Image 1, Highlights • Multiple pyrethroid resistance mechanisms in bed bugs from Germany. • Occurrence of substitutions V419L and L925I in voltage-sensitive sodium channel. • New pyrosequencing assays to quantify V419L and L925I in beg bug populations. • Increased mRNA expression levels of the cytochrome P450 genes cyp397a1 and cyp398a1.

The common bed bug, Cimex lectularius L., resurged as an important urban pest in the last 20 yr. Yet, there are no commercial repellent products labeled for bed bugs available in the United States. We evaluated the repellency of two catnip oils from newly developed cultivars, CR3 and CR9, and compared each to 10 and 25% N,N-diethyl-meta-toluamide (DEET). CR3 contains 63.4% E,Z-nepatalactone and 27.5% Z,E-nepatalactone, and CR9 contains 94.9% Z,E-nepatalactone. Arena studies showed that CR3 and CR9 oils were more effective than DEET within a 24-h period. At 10% concentration, both CR3 and CR9 oils exhibited a repellency of over 94% during the first 8 h. At 25% concentration, the repellency of CR3 and CR9 oils increased to 100%, and repellency of DEET was 92% during the first 24 h. Repellency of 25% CR3 and CR9 oils became lower than 25% DEET after being aged for 3 d. After 28-d aging, repellency of 25% CR3, CR9, and DEET reduced to 25, 64, and 92%, respectively. Soiled socks were placed above repellent treated bands to determine if the repellent can protect soiled socks from being infested. The 20% CR3 oil prevented 100% of bed bugs from infesting soiled socks showing that it was more effective than DEET. These results indicate that catnip oils from CR3 and CR9 cultivars are more repellent than DEET over a 24-h period following application, but their longevity is shorter than DEET after 72 h.

Bed bugs spend most of their lives hiding in harborages, usually in the seams of mattresses and box springs and in crevices of bed frames. For insecticidal products that target these shelters, the repellency of the products for bed bugs may influence their duration of contact. Bed bugs are known to avoid contacting surfaces treated with certain insecticides. The fungal biopesticide Aprehend contains spores of the entomopathogen, Beauveria bassiana. It is sprayed around bed frames, box springs, and furniture where bed bugs are likely to walk, which includes potential shelters. Here, I investigated the influence of a permethrin-impregnated cover, ActiveGuard, on bed bug sheltering behavior and the effectiveness of combining ActiveGuard with Aprehend. Bed bugs avoided harboring in a shelter constructed with ActiveGuard compared to a nontoxic encasement-type cover. This avoidance behavior reduced mortality induced by ActiveGuard shelters compared to forced continuous contact on the ActiveGuard cover. However, while bed bugs also avoided Aprehend-treated ActiveGuard shelters, the combined treatment induced almost complete mortality and more quickly than Aprehend-treated shelters made of the encasement-type cover. This suggests compatibility between the two integrated pest management (IPM) tools even though the bed bug’s avoidance behavior would suggest otherwise. Since Aprehend is highly effective against pyrethroid-resistant bed bugs, its use would provide more effective control where bed bug populations are more resistant to the permethrin-impregnated cover.

Bed bugs (Cimex lectularius L.) have returned as a nuisance pest in the last 20 years. Different bed bug control measures in combination have not been thoroughly studied, although induction of multiple stressors may improve extermination. The effects of heat stress only, heat stress followed by exposure to insect pathogenic fungi, and heat stress followed by exposure to desiccant dust on starved and blood-fed bed bugs were investigated. Five days at 22 °C (control), 32 °C, 34 °C, or 36 °C (heat stress) did not cause mortality in adults. However, their starved first instar nymphs produced after heat stress suffered mortalities of 33%, 56% and 100%, respectively. Exposure to insect pathogenic fungi after heat stress increased the mortality of adults and their progeny compared to exposure to fungi without heat stress. The beneficial effects of heat stress were not observed in blood-fed bed bugs. Desiccant dust killed all nymphs within 2 days and all adults within 3 days regardless of previous heat stress, but survival time was prolonged by access to blood. This study highlights the advantage of combining different methods in pest management, and points to heat stress combined with blood deprivation as possible management elements to increase the control success.

Bed bugs (Cimex spp.) are common ectoparasites of humans. Their ubiquity across diverse human environments combined with their blood-feeding behavior creates an ideal interface for the transmission of pathogenic microbes. Despite this potential, the current dogma is that bed bugs are not vectors of any known infectious agents. However, this conclusion is based largely on the results of studies conducted before the advent of modern molecular biology and the resurgence of bed bugs on a global scale. More importantly, a small but compelling body of modern research suggesting that bed bugs can potentially vector some human pathogens exists but is often overlooked. This article critically examines the current classification of the bed bug as an insect that does not transmit disease agents. In doing so, it highlights key knowledge gaps that still exist in understanding the potential of bed bugs as pathogen vectors and outlines several arguments for why new research on the topic is necessary.

In the last two decades, bed bugs (Cimex lectularius L. and Cimex hemipterus F.) have become perennial and difficult to control indoor pests. Current pest control options are severely constrained by high prevalence of insecticide resistance and availability and relatively high costs of alternative interventions. Among various measures to counter the drawbacks of insecticide resistance include efforts to diversify the modes of action of insecticides with residual applications of combinations of insecticides, which include a juvenile hormone analog (JHA). JHAs, such as hydroprene and methoprene, have a desirable safety profile and are effective against a variety of indoor pests. We evaluated the potential of hydroprene and methoprene to be incorporated into an ingestible bait, with dose–response studies on fifth-instar male and female bed bugs. Females were more susceptible than males to both JHAs, and methoprene was more effective by ingestion than hydroprene at inducing both lethal and sublethal effects. Ingestion of ≥10 µg/ml blood of either JHA by last instar nymphs reduced oviposition; untreated females that mated with males exposed to high concentrations of either JHA also exhibited lower oviposition. We suggest that methoprene could be incorporated into integrated pest management programs in liquid baits and residual sprays in combination with other active ingredients.

Two-point mutations (V419L and L925I) on the voltage-sensitive sodium channel of bed bugs (Cimex lectularius) are known to confer pyrethroid resistance. To determine the status of pyrethroid resistance in bed bugs in Korea, resistance allele frequencies of bed bug strains collected from several US military installations in Korea and Mokpo, Jeollanamdo, from 2009-2019 were monitored using a quantitative sequencing. Most bed bugs were determined to have both of the point mutations except a few specimens, collected in 2009, 2012 and 2014, having only a single point mutation (L925I). No susceptible allele was observed in any of the bed bugs examined, suggesting that pyrethroid resistance in bed bug populations in Korea has reached a serious level. Large scale monitoring is required to increase our knowledge on the distribution and prevalence of pyrethroid resistance in bed bug populations in Korea. Based on present study, it is urgent to restrict the use of pyrethroids and to introduce effective alternative insecticides. A nation-wide monitoring program to determine the pyrethroid resistance level in bed bugs and to select alternative insecticides should be implemented.

Background The tropical bed bug, Cimex hemipterus, is an important ectoparasite causing various health problems. This species is mainly confined to tropical regions; however, insecticide resistance, global warming, and globalization have changed its distribution map. Molecular information on pyrethroid resistance, which is essential for the development of control programs, is unknown for C. hemipterus in expanded areas. The present study was designed to determine the permethrin resistance status, characterize the pyrethroid receptor sites in voltage-gated sodium channel (vgsc) gene, and identify the resistance-related mutations in the populations of tropical bed bug in Iran. Methods Live bed bugs were collected, and adults of C. hemipterus were selected for bioassay and molecular surveys. Bioassay was performed by tarsal contact with permethrin 0.75% in mixed-sex of samples. Conventional and quantitative TaqMan and SYBR Green real-time PCR assays were conducted to characterize the vgsc gene and genotypes of studied populations. Results In the bioassay tests, the mortality rates were in the range of 30.7–38.7% and 56.2–77.4% in 24 and 48 h, respectively. The knockdown rates of studied populations were in the range of 32.2–46.6% and 61.5–83.8% in the first and second days, respectively. The KT50 and KT90 values in the Cimex lectularius Kh1 strain were presented as 5.39 and 15.55 h, respectively. These values in the selected populations of C. hemipterus varied from 27.9 to 29.5 and from 82.8 to 104.4 h, respectively. Knockdown time ratios (KR50 and KR90) in these populations varied from 5.17 to 6.17-fold compared with those of the C. lectularius Kh1 strain. Fragments of vgsc gene with 355 bp and 812 bp were amplified. Analysis of sequences revealed the A468T substitution, kdr-associated D953G, and super-kdr M918I and L1014F mutations in all populations. Conclusions The specific/sensitive, safe, and rapid diagnostic assays developed in this study are recommended for detection of kdr/super-kdr mutations and frequency of mutant alleles. The presence of super-kdr mutations and high resistance to permethrin in all the populations necessitate the reconsideration of control approaches against C. hemipterus. Graphical Abstract

Bed bugs, Cimex lectularius L. and C. hemipterus (F.) (Hemiptera: Cimicidae) are hematophagous ectoparasites of humans. Since the resurgence of bed bugs in the late 1990s there has been a corresponding emphasis on development and implementation of integrated pest management (IPM) programs to manage infestations. One critical requirement of IPM is the ability to detect and monitor the target pest. We outline and describe the majority of all known existing devices and technologies developed for bed bug detection and monitoring as well as much of the underlying science. Almost 40 detection and monitoring products have flooded the marketplace, but for various reasons, including price, size, complexity and lack of independent scientific evaluation, they have not been widely adopted for IPM in structures. One product, the ClimbUp® Insect Interceptor, has nine competitors that utilize a similar design. This review also discloses many other technologies and products that are either too expensive or too impractical for use as either consumer or industrial products. We conclude that there is a critical need for inexpensive and effective detection and monitoring traps and lures suitable for widespread adoption by the urban pest control industry. © 2021 Society of Chemical Industry.

Introduction In the 1970s and 1980s, the occurrence of bedbugs ( Cimex lectularius Linnaeus, 1758) was noticed only sporadically in accommodation facilities in Slovakia. Under regular monitoring, it was possible to even eradicate its occurrence in the 1980s. Today, the problem is once again a major global health issue. Objective The aim of the study was to point out the occurrence of cimicosis in the case of atypical urticaria in patients referred to parasitological examination by inpatient and outpatient physicians. Material and methods During the period 2006–2015, 102 patients with suspected ectoparasitosis were examined in the Diagnostic Laboratory of Human Parasitology at the Faculty of Medicine of Comenius University in Bratislava. Specialists and general practitioners referred the patients with itching red efflorescences. Parasitological examination and entomologic analysis of insects confirmed in many of them the presence of skin ectoparasitosis caused by Cimex lectularius , and in one case Oeciacus hirundinis . Results A total number of 102 parasitologically patients were examined – 62 adults and 40 children. Among the 62 adults, there were 57 patients positive for cimicosis. In 5 patients cimicosis was not confirmed, in one of them ( Sarcoptes scabiei Linnaeus, 1758) was detected. Among the 40 children, there were 34 positive for cimicosis. One female child was diagnosed with lesions caused by Sarcoptes scabiei. Conclusions The bed bug should again be subjected to the reporting service to public health authorities, and thus recording the monitoring of its incidence and spread in the population.

Common bed bug Cimex lectularius (L.) (Hemiptera: Cimicidae) infestations are on the rise and due to the development of pesticide resistance they are becoming more difficult to control, affordably. We evaluated a naturally occurring compound methyl benzoate (MB) and related analogs, previously reported to have insecticidal activity on several agricultural pests, for its fumigant action on the common bed bug, C. lectularius L. A discriminating concentration was used to determine the effectiveness of MB, and several of its analogs as fumigants in a laboratory assay. It was found that MB provided >90% control of adult bed bugs in this laboratory fumigant assay. LC50 values were calculated for MB against both a pyrethroid-susceptible and a pyrethroid-resistant strain of common bed bugs. It was determined that both strains were susceptible in this laboratory assay. However, when MB was tested in a field-like assay and compared to a commercially available bed bug control product, it was found to be significantly less effective compared to the commercial product. Our study has found that while MB has the potential to be used as a bed bug control agent, refinements in the delivery system will be needed to increase efficacy under field-like conditions.

Bed bugs have become a common urban pest with consequences on human health and economic costs to the hotel and tourism sectors. Insecticide resistance is considered an important factor in the current bed bug resurgence, and multiple resistance mechanisms could be working in the resistant bed bug populations. In the present study, we determined the resistance profile to four insecticides with a different mode of action in Cimex lectularius L. (Heteroptera: Cimicidae) field-collected colonies from Argentina. Furthermore, the synergism effect of piperonyl butoxide (PBO) with deltamethrin was investigated to explore the contribution of detoxification metabolism to resistance. Our results showed that most of the field-collected colonies are extremely resistant to deltamethrin and propoxur, much more than to azametiphos and imidacloprid. The differences in resistance ratios among field-collected colonies could be associated with different modes of action of insecticides used in control pest and the mechanisms involved in the resistance. PBO pretreatment led to a significantly decreased RR in pyrethroid-resistant colonies, suggesting an upturn of monooxygenase activity for deltamethrin detoxification. However, the high RR detected could involve other mechanisms as part of the whole resistant phenotype in colonies of C. lectularius resistant to pyrethroids.

The common bed bug, Cimex lectularius (Linnaeus 1758), is a nocturnal blood-sucking ectoparasite of humans that is highly prevalent in the northeast of Iran. In recent years, the efficacy of those insecticides that have been frequently used to control bed bugs in Iran has not been studied. Due to frequent complaints about bed bug treatment failures in Mashhad city (northeastern Iran), this study assessed the susceptibility of C. lectularius collected from a student residence hall to Diazinon, Malathion, and λ-cyhalothrin. The desired concentrations of each insecticide were prepared in acetone, and bioassays were performed using insecticide-impregnated filter paper method. The concentration–response data were subjected to POLO-PC software and data were analyzed by the log-probit procedure. The LC50 values of Diazinon and λ-cyhalothrin for examined bed bugs were 1,337.40 and 2,022.36 ppm, respectively. Malathion at the highest concentration (10,000 ppm) did not exhibit any toxicity to examined C. lectularius. Comparing these results to the same previous studies showed that susceptibility of examined bed bugs to these insecticides has been highly decreased. This study revealed an occurrence of insecticide resistance in bed bug populations in northeastern Iran. It also suggests that Malathion, Diazinon, and λ-cyhalothrin are ineffective against bed bugs in this region.

Objectives. To compare outcomes when pesticides are used to control bed bugs by professionals and nonprofessionals. Methods. All US National Pesticide Information Center inquiries from 2013 to 2017 were assessed to identify scenarios involving bed bugs and pesticide applications. Cases were evaluated with respect to types of applicators, misapplications, and human pesticide exposures. Results. Misapplications were more than twice as likely to be reported in cases involving nonprofessional applications (14%) as in cases involving professional applications (5%). Human exposures to pesticides were reported more often when pesticides were misapplied (70%) than when there were no apparent misapplications (31%). Conclusions. Both professionals and nonprofessionals may misuse pesticides to control bed bugs, which may increase the risks of exposure and adverse outcomes. Policy interventions may reduce pesticide incidents related to bed bug control by promoting professional involvement and adherence to product label instructions.

PURPOSE OF THE REVIEW This review will update pediatric providers on the recent data regarding the epidemiology, diagnosis, and treatment of common skin infestations affecting children and adolescents. RECENT FINDINGS Standard superficial skin biopsy for scabies and the vacuum method for head lice can increase diagnostic accuracy and efficiency. There is growing resistance to some of the traditional treatments for scabies and head lice, and progress has been made in finding newer and potentially more effective treatments, such as oral moxidectin for scabies and abametapir for head lice. Recent studies have established the safety of traditional treatments, such as permethrin and oral ivermectin in infants and small children. SUMMARY Permethrin and ivermectin are both considered safe and effective for children and adolescents with scabies. Permethrin is generally considered safe in infants less than two months of age. Proper application of permethrin is critical, and providers should emphasize proper application technique. Treatment of head lice should only be initiated with active infestations. Resistance to permethrin continues to increase and other options are now available, including an over-the-counter topical ivermectin formulation. Identification and eradication of bed bug infestations are crucial in preventing bedbug bites.

AIMS To evaluate whether bed bugs are associated with allergic reactions in patients seen in the emergency department (ED). METHODS AND RESULTS This retrospective study included data from 9 EDs in Ohio between February 2011 and February 2017. The study comprised 332 patients with bed bug infestation matched 1:15 with 4952 control patients without bed bugs on the basis of age, sex and the presenting ED. Compared with uninfested patients, patients infested with bed bugs were more likely to have an ED or inpatient diagnosis of pruritus, hives or urticaria (odds ratio [OR], 9.12 [95% CI, 3.41-24.42]) and to be treated in the ED with an antihistamine (OR, 3.20 [95% CI, 1.87-5.50]) or albuterol (OR, 1.59 [95% CI, 1.07-2.36]) (P ≤ .02 for all). There were no significant differences in the rates of anaphylaxis and angioedema diagnosed in patients with and without bed bugs, which occurred in

Common bed bugs (Cimex lectularius L.) are hematophagous pests present in urban environments across the globe. It is widely established that they have a strong host preference for humans. However, there are records of C. lectularius feeding upon a range of mammalian and avian hosts, including rodents, in the field. There is little information available about how frequently common bed bugs feed on alternative hosts in residential settings, but understanding this phenomenon has implications for both management of infestations and public health. Here, we examined cohorts of C. lectularius collected from 13 different dwellings in the state of New Jersey, USA, that were known to be simultaneously infested with house mice (Mus musculus domesticus). Host-specific quantitative polymerase chain reaction (qPCR) was used to determine if blood meals were taken from mice, while 16S rRNA gene amplicon sequencing was used to screen the bed bugs for the presence of zoonotic bacterial pathogens. We found no evidence that any of the bed bugs we collected fed on mice. Furthermore, the insects harbored depauperate bacterial communities that did not include known human pathogens. However, host-specific qPCR detected feline DNA in a pool of bed bugs from one dwelling, suggesting that interaction with domestic pets should be further investigated. Although sampling in this study was limited, the approach described herein will be useful for additional studies of the interactions between bed bugs and alternative blood meal hosts.

Made available in DSpace on 2021-06-25T12:37:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01. Added 1 bitstream(s) on 2021-07-15T14:36:34Z : No. of bitstreams: 1 S0037-86822021000100709.pdf: 1630376 bytes, checksum: 5eb29c6975737ce5898632d20ea6354b (MD5) Bed bugs are hematophagous arthropods that can parasitize humans. During the coronavirus disease pandemic, there has been an increase in elderly neglect. A man in his 90s came to the hospital complaining of generalized pruritus. Despite being a dependent patient, he was left alone in a home by his relatives during the pandemic. Examination revealed inflammatory nodules in addition to a live bed bug crawling over his trunk. Identifying a bed bug during consultation is an uncommon feature that can help determine a particular diagnosis. As this case shows, the need for social isolation during pandemics can contribute to elder abuse and neglect. Hosp Santa Casa Curitiba, Dept Dermatol, Curitiba, Parana, Brazil Univ Estadual Paulista, Fac Med, Dept Dermatol, Botucatu, SP, Brazil Univ Estadual Paulista, Fac Med, Dept Dermatol, Botucatu, SP, Brazil

Bed bug outbreaks pose a major challenge in urban environments and cause significant strain on public resources. Few studies have systematically analyzed this insect epidemic or the potential effects of policies to combat bed bugs. Here we use three sources of administrative data to characterize the spatial-temporal trends of bed bug inquiries, complaints, and reports in New York City. Bed bug complaints have significantly decreased (p < 0.01) from 2014–2020, the absolute number of complaints per month dropping by half (875 average complaints per month to 440 average complaints per month); conversely, complaints for other insects including cockroaches and flies did not decrease over the same period. Despite the decrease of bed bug complaints, areas with reported high bed bug infestation tend to remain infested, highlighting the persistence of these pests. There are limitations to the datasets; still the evidence available suggests that interventions employed by New York City residents and lawmakers are stemming the bed bug epidemic and may serve as a model for other large cities.

Numerous arthropod taxa are important in human and veterinary medicine. The salivary secretions and feces of arthropods can cause allergic reactions in host vertebrates or harbor pathogens. Also, bites can be a risk factor for secondary infections. Documenting the diversity of arthropods of medical and veterinary importance remains an important aspect of disease control and prevention. We provide new records of ectoparasitic arthropods from Mexico that are of potential medical or veterinary relevance. Scanning electron microscopy along with amplification and sequencing of a fragment of the mitochondrial gene (16S rRNA) was used to confirm some species identities. We report the cat louse Felicola subrostratus from cats and the chewing louse Heterodoxus spiniger from dogs, which are common ectoparasites but largely not reported in Mexico. The chigger Eutrombicula alfreddugesi is common on wild lizards (Squamata). For the first time, E. alfreddugesi is reported on Hemidactylus frenatus (common house gecko). This reptile has a close relationship with humans and its chiggers can cause dermatitis (i.e., trombiculiasis) or transmit pathogens. In addition, the common bed bug Cimex lectularius is reported for the first time in the state of Yucatan, an atypical area for its natural distribution. Phylogenetic analysis revealed that Cimex lectularius from Yucatan is closely related to genetic sequences of Cimex lectularius from China. Knowing the regional distribution of arthropods allows the design and implementation of prevention strategies for those that have potential roles as reservoirs or vectors.

Cimex lectularius L. populations have been documented worldwide to be resistant to pyrethroids and neonicotinoids, insecticides that have been widely used to control bed bugs. There is an urgent need to discover new active ingredients with different modes of action to control bed bug populations. Fipronil, a phenylpyrazole that targets the GABA receptor, has been shown to be highly effective on bed bugs. However, because fipronil shares the same target site with dieldrin, we investigated the potential of fipronil resistance in bed bugs. Resistance ratios in eight North American populations and one European population ranged from 1.4- to >985-fold, with highly resistant populations on both continents. We evaluated metabolic resistance mechanisms mediated by cytochrome P450s, esterases, carboxylesterases, and glutathione S-transferases using synergists and a combination of synergists. All four detoxification enzyme classes play significant but variable roles in bed bug resistance to fipronil. Suppression of P450s and esterases with synergists eliminated resistance to fipronil in highly resistant bed bugs. Target-site insensitivity was evaluated by sequencing a fragment of the Rdl gene to detect the A302S mutation, known to confer resistance to dieldrin and fipronil in other species. All nine populations were homozygous for the wild-type genotype (susceptible phenotype). Highly resistant populations were also highly resistant to deltamethrin, suggesting that metabolic enzymes that are responsible for pyrethroid detoxification might also metabolize fipronil. It is imperative to understand the origins of fipronil resistance in the development or adoption of new active ingredients and implementation of integrated pest management programs.

The common bed bug (Cimex lectularius L.) is a known pest and an obligate blood-feeding ectoparasite. Bed bugs can feed on warm-blooded animals including humans, bats, poultry, and rabbits, but no research has investigated the use of companion animals (canines and/or felines) as a blood source. This study investigates how long known host DNA could be detected in a bed bug and the prevalence of bed bugs feeding on companion animals. Laboratory-reared bed bugs were fed host blood to determine how long DNA of human, feline, canine, and rabbit blood could be detected up to 21 d postfeeding. Additionally, 228 bed bugs were collected from 12 apartments with pets (6: canine, 5: feline, and 1: canine and feline), characterized as engorged or unengorged, and then screened with host-specific primers to identify the bloodmeal. Host meals of human, rabbit, feline, and canine blood were detected up to 21 d after feeding laboratory strains. All bed bugs died after feeding on the canine blood, but DNA could be detected up to 21 d post feeding/death. Of the field-collected bed bugs analyzed, human DNA was amplified in 158 (69.3%) bed bugs, canine DNA amplified in 7 bed bugs (3.1%), and feline DNA amplified in 1 bed bug (0.4%). Results of this study suggest that bed bugs predominately feed on humans and rarely feed on companion animals when they cohabitate in low-income, high-rise apartments. Additionally, results from this study warrant future investigations into host use by bed bugs in different housing structures and socioeconomic environments.

Infection induces the migration of immune cells to the heart of insects., The immune and circulatory systems of mammals are functionally integrated, as exemplified by the immune function of the spleen and lymph nodes. Similar functional integration exists in the malaria mosquito, Anopheles gambiae, as exemplified by the infection-induced aggregation of hemocytes around the heart valves. Whether this is specific to mosquitoes or a general characteristic of insects remained unknown. We analyzed 68 species from 51 families representing 16 orders and found that infection induces the aggregation of hemocytes and pathogens on the heart of insects from all major branches of the class Insecta. An expanded analysis in the holometabolous mosquito, Aedes aegypti, and the hemimetabolous bed bug, Cimex lectularius, showed that infection induces the aggregation of phagocytic hemocytes on the hearts of distantly related insects, with aggregations mirroring the patterns of hemolymph flow. Therefore, the functional integration of the immune and circulatory systems is conserved across the insect tree of life.

The common bed bug (Cimex lectularius L.) is an obligate hematophagous ectoparasite that has significant impacts on human health and well-being. All life stages of bed bugs (except eggs) feed solely on blood, which is required to molt and reproduce. Bed bugs use multiple cues to locate their hosts, including heat, CO2, and body odors. Of these cues, detection of heat appears limited to a short distance of 50% of the bed bugs fed even when the entire antenna was removed, suggesting redundancy in sensory cues that drive feeding. These results will be used to better understand the role heat plays in bed bug host attraction and design of traps.

International audience

Plant essential oils (EOs) are secondary metabolites derived from aromatic plants that are composed of complex mixtures of chemical constituents. EOs have been proposed as one of the alternative methods for bed bug (Cimex lectularius L.) control. In insecticide resistant mosquitoes and tobacco cutworm, EOs synergize pyrethroid toxicity by inhibiting detoxification enzymes. However, whether EOs and their constituents enhance pyrethroid toxicity in C. lectularius has remained unknown. Therefore, this study was designed to (i) determine the effects of binary mixtures of deltamethrin (a pyrethroid insecticide) with EOs or EO constituents or EcoRaider® (an EO-based product) on mortality of insecticide resistant and susceptible bed bugs, and (ii) evaluate the effects of EO constituent pre-treatment on detoxification enzyme activities of resistant and susceptible populations. Topical bioassays with binary mixtures of deltamethrin and individual EOs (e.g., thyme, oregano, clove, geranium or coriander oils) or their major constituents (e.g., thymol, carvacrol, eugenol, geraniol or linalool) or EcoRaider® at doses that kill approximately 25% of bed bugs caused significant increases in mortality of resistant bed bugs. However, in the susceptible population, only coriander oil, EcoRaider®, thymol, and carvacrol significantly increased the toxicity of deltamethrin. Detoxification enzyme assays with protein extracts from bed bugs pre-treated with EO constituents suggested selective inhibition of cytochrome P450 activity in the resistant population, but no impacts were observed on esterase and glutathione transferase activities in either population. Inhibition of P450 activity by EO constituents thus appears to be one of the mechanisms of deltamethrin toxicity enhancement in resistant bed bugs.

Lateral flow strip tests are a cost-effective method for detecting specific proteins in biological samples, which can be performed in the field without specialized expertise. While most recognizable in the pregnancy tests, there are many other applications for lateral flow strip technology. The pest control industry has increasingly emphasized the importance of pest monitoring to reduce unnecessary applications, focus interventions into locations with active pest infestations, and to develop records of pest infestation. Due to their cryptic behavior, the detection of bed bugs often necessitates labor-intensive, time-consuming and invasive visual inspections. A lateral flow strip test for the detection of bed bugs would represent a novel use for a well-established technology, which can enable pest control operators to rapidly confirm the presence or absence of bed bugs in a room. In the current report, we present an effort to develop and calibrate the lateral flow test devices for the detection of a bed bug specific protein. A variety of bed bug residue samples were prepared by varying several parameters: bed bug infestation level (1 bed bug/3 bed bugs), surface type (wood/fabric), feeding status (fed/unfed), and bed bug time-on-surface (1 d/7 d). Using a prototype sensor and test strip, we examined how these variables influenced the detection of the bed bug specific proteins in the sample and to what degree. We discuss how this lateral flow test device can be an effective tool to determine the presence or absence of bed bug proteins on a surface, providing highly credible evidence on bed bug infestations.

From the 1960s to the 1980s, with the implementation of nationwide ‘Four-Pest Elimination’ campaigns (bed bugs, Cimex lectularius L. and Cimex hemipterus (F.) (Hemiptera: Cimicidae), were listed as one of the targeted pests), bed bug infestations were gradually eliminated in most provinces in China. However, during the last two decades, reports of bed bug infestations in the Pearl River Delta of China have shown an upward trend. Up to now, the bed bug species occurring in this area was much less frequently reported. In this study, we used both morphological and molecular methods to accurately identify the species of bed bugs collected from the cities of Guangzhou and Foshan, China. Results indicated that no significant difference was observed in the mean pronotum width-to-length ratio of Guangzhou (2.6) and Foshan (2.4) specimens; however, both were significantly lower than that of a laboratory strain C. lectularius (3.1). The genetic distances of our specimens with C. hemipterus and C. lectularius were 0–0.2% and 22.2–22.6%, respectively. On the basis of the morphological characteristics and mitochondrial DNA sequence data, it can be affirmed that bed bugs collected from Guangzhou and Foshan were C. hemipterus.

Aims To investigate the immunoglobulin (Ig) G response after being fed upon by Cimex lectularius L. Methods and results Participants were fed upon by three male C lectularius insects weekly for a month. Blood was obtained before the feeding and at the last feeding, which was used for immunoblots against bed bug salivary gland extract, with antihuman Immunoglobulin G (IgG) secondary antibodies. No consistent IgG changes developed in 11 humans serially fed upon by C lectularius. Two participants had new IgG responses to proteins at molecular weights of approximately 12-13 kDa, and one had an IgG response to a protein at approximately 40 kDa. At the last study visit, more intense IgG bands to proteins at molecular weights of 12-13 kDa had developed in 55% of participants (6/11) and at molecular weights of ≈30, ≈40 and ≈70 kDa in 45% (5/11) compared with the first study visit. Nitrophorin and apyrase were the most common C lectularius proteins identified with liquid chromatography-tandem mass spectrometry in both crushed bed bug salivary gland extract and post-bed bug feeding extract. Conclusions Human participants did not have consistent IgG responses to crushed C lectularius salivary gland extract.

When children present with features of bed bug bites, many parents are reluctant to accept the diagnosis. Furthermore, standard methods to detect arthropods in or around one's home can be expensive, time-consuming, and frustrating. We developed a simple, inexpensive way to provide evidence that the lesions are in fact due to arthropod bites. The Modified Onesie Biting Bug Assessment (MOBBA) suit utilizes simple alterations to a full-body onesie-type footed pajama, exposing some body surfaces to insect predators while protecting other areas.

Bed bugs are pests of public health importance due to their relentless biting habits that can lead to allergies, secondary infections and mental health issues. When not feeding on human blood bed bugs aggregate in refuges close to human hosts. This aggregation behaviour could be exploited to lure bed bugs into traps for surveillance, treatment efficacy monitoring and mass trapping efforts, if the responsible cues are identified. The aim of this study was to identify and quantify the bed bug aggregation pheromone. Volatile chemicals were collected from bed bug-exposed papers, which are known to induce aggregation behaviour, by air entrainment. This extract was tested for behavioural and electrophysiological activity using a still-air olfactometer and electroantennography, respectively. Coupled gas chromatography-electroantennography (GC-EAG) was used to screen the extract and the GC-EAG-active chemicals, benzaldehyde, hexanal, (E)-2-octenal, octanal, nonanal, decanal, heptanal, (R,S)-1-octen-3-ol, 3-carene, β-phellandrene, (3E,5E)-octadien-2-one, (E)-2-nonenal, 2-decanone, dodecane, nonanoic acid, 2-(2-butoxyethoxy)ethyl acetate, (E)-2-undecanal and (S)-germacrene D, were identified by GC-mass spectrometry and quantified by GC. Synthetic blends, comprising 6, 16, and 18 compounds, at natural ratios, were then tested in the still-air olfactometer to determine behavioural activity. These aggregation chemicals can be manufactured into a lure that could be used to improve bed bug management.

Insecticide dust formulations are considered as more effective for controlling the common bed bug, Cimex lectularius (L) (Hemiptera: Cimicidae), than residual sprays. Various environmental factors may affect the efficacy of insecticide dusts. In this study, we evaluated the effect of moisture on the efficacy of three insecticide dusts against C. lectularius. Moisture was created using two methods: applying steam to insecticide dust-treated tiles and aging insecticide dust-treated tiles in chambers with various levels of relative humidity (RH). In the steam treatment, three insecticides including Cimexa (92.1% amorphous silica gel), Alpine (0.25% dinotefuran, 95% diatomaceous earth), and Tempo (1% cyfluthrin) were evaluated. Exposure to steam significantly reduced the efficacy of all three insecticide dusts. Among the three insecticides, the efficacy of Cimexa was significantly higher than Alpine and Tempo. In the different RH treatments, Cimexa treated tiles that were aged under different (52, 75, and 100%) RH conditions for 1 and 2 mo caused significantly lower mortality to C. lectularius than nonaged Cimexa. We conclude that both, a short period of exposure to steam and long-period aging in a moist environment, can significantly reduce the efficacy of insecticide dusts. Moisture needs to be considered when applying insecticide dusts for controlling bed bug infestations.

In recent years, bed bugs have experienced a remarkable resurgence on a near global scale. While reports have primarily focused on the common bed bug, Cimex lectularius (L.), which has resurged largely in temperate regions, in tropical regions the tropical bed bug, Cimex hemipterus (F.) (Hemiptera: Cimicidae), has reemerged as well. Recent reports of C. hemipterus introductions to subtropical and temperate regions, outside of the species natural distribution, suggest the potential for establishment and further spread. Establishment may be aided by insecticide resistance mechanisms, such as the presence of knockdown resistance (kdr)-associated mutations, which potentially confer resistance to pyrethroid, pyrethrin, and organochloride insecticides. Here, we present the first report of the detection and likely establishment of C. hemipterus in Honolulu, Hawaii, from samples collected in 2009 and 2019. Furthermore, through partial sequencing of the voltage-gated sodium channel, we report the presence of kdr-associated mutations in all samples. These findings have implications for the implementation of control strategies aimed at eradicating infestations.

During an ongoing virome metagenomics project we identified hepatitis C virus (HCV) in a pool of recently blood-fed common bed bug (Cimex lectularius) nymphs sampled from domestic residences in Europe. Additional PCR and genomic analysis revealed that the virus was a member of HCV genotype 3A, one of the most prevalent genotypes in Europe. Although the role of the common bed bug in the transmission of human hepatitis viruses remains unclear, our study suggests that it merits additional investigation.

Bed bugs (Cimex lectularius L.) are blood-feeding human ectoparasites. Their cryptic nature and pesticide resistance have led to an upsurge in infestation abundance and increased difficulty to achieve control. A dosage-response study was conducted for fumigation with sulfuryl fluoride against bed bug eggs at 25 and 15°C. The least accumulated dosage that resulted in 100% mortality was then used in a confirmation study in which adults, third-instar nymphs, and additional eggs were fumigated. It was determined that all life stages tested were killed after fumigations at 88.40 and 170.00 g-h/m3, at 25 and 15°C, respectively. These dosages correspond to an application rate of 1.7× (multiplier of the drywood termite rate of 1×). However, sulfuryl fluoride fumigations at 80.08 and 154.00 g-h/m3 (25 and 15°C, respectively) each yielded >99.6% mortality of bed bug eggs, the most fumigant-resistant life stage. These dosages, rounded to the closest tenth, correspond to an application rate of 1.5×. Thus, this study supports that the MasterFume label rate against bed bugs should be decreased from 3× to 1.7×, at the minimum, because fumigation at 1.5× would suffice due to overly conservative estimation of field factors when calculating fumigant dosage.

The common bed bug, Cimex lectularius L. (Hemiptera: Cimicidae), is an obligate hematophagous insect that has resurged worldwide since the early 2000s. Bed bug control is largely based on the widespread, intensive application of pyrethroid-based insecticide formulations, resulting in the emergence of insecticide-resistant bed bug populations. Insecticide resistance is frequently linked to metabolic detoxification enzymes such as cytochrome monooxygenase (P450s), esterases, glutathione S-tranferase, and carboxylesterase. Therefore, one way to overcome insecticide resistance could be the formulation of insecticides with synergists that counteract metabolic resistance. To test this hypothesis, we evaluated the impact of four synergists-piperonyl butoxide (PBO), diethyl maleate (DEM), S,S,S-tributyl phosphorotrithioate (DEF), and triphenyl phosphate (TPP)-on deltamethrin efficacy in two pyrethroid-resistant bed bug strains. A statistically significant difference in synergism ratios (SR) of a highly resistant field-derived strain (Jersey City, resistance ratio [RR] = 20,000) was noted when any of the four synergists (PBO SR = 20.5; DEM SR = 11.7; DEF SR = 102.3; and TPP SR = 9.7) were used with deltamethrin. In a less deltamethrin-resistant strain, Cincinnati (RR = 3,333), pretreatment with PBO and DEM significantly synergized deltamethrin (PBO SR = 158.8; DEM = 58.8), whereas application of DEF and TPP had no synergistic effect. The synergism data collected strongly suggest that detoxification enzymes play a significant role in the metabolic mechanisms that mediate deltamethrin resistance in bed bugs. The development and use of safe metabolic synergists that suppress detoxification enzymes offers an interesting avenue for the management of insecticide-resistant field populations.