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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 <1% in both groups. Conclusion: Bed bug–infested patients are more likely to be diagnosed and treated for itchy cutaneous rashes, but are not clearly associated with more severe allergic reactions. [ABSTRACT FROM AUTHOR]

Bed bugs are a significant and under-studied public health nuisance. We surveyed 706 emergency department patients and found bed bug infestations were more likely (p < 0.05) among subjects having persons 19-64 years of age in the house, living in a group home, a previous history with bed bugs, and knowing someone who currently has bed bugs. Sleeping in a hotel, recent homelessness, obtaining used clothing or furniture and using a laundromat were not associated with increased risk (p > 0.05) for infestation. Individuals with less education and income were more likely (p < 0.05) to have bed bugs and express concern about getting bed bugs. Younger persons were more likely to correctly identify a picture of a bed bug compared to those over the age of 60 years (p < 0.001).