Hantavirus: - First Nations Telehealth

Hantavirus:What you need to knowPresented by:Environmental Public Health ServicesFirst Nations Inuit HealthHealth CanadaAlberta RegionPresentation Outline• Background on Hantavirus and Hantavirus PulmonarySyndrome (HPS)• HPS in Canada• HPS in Alberta• Precautions and Cleaning Procedures• Commonly asked questions• Summary• QuestionsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat is Hantavirus ?Hantaviruses are group of virusesthat are carried by rodents.Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

What is Hantavirus ?• Hantaviruses are a group of viruses that are carriedby rodents and spread to humans by breathing in thevirus.• Hantavirus is found throughout the Americas (North,South and Central).• It is not a new virus, it was discovered in 1993, buthas probably been around for many years before this.• Because it is a virus, antibiotics cannot prevent ortreat the disease.Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat is Hantavirus ?• If a person becomes infected by Hantavirus, the disease iscalled Hantavirus Pulmonary Syndrome (HPS).• The disease affects the lungs and ability to breath. It is fatalin approximately 30% of people who develop HPS.• Not all people exposed to Hantavirus will develop HPS.• There is currently no screening method to determine who is atgreater risk of contracting the disease.• There is currently is no approved vaccine in North America.• The disease is not spread from person to person.Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat is Hantavirus?Reservoir• Major reservoir in North America forSin Nombre Virus (SNV) is Deer Mice(Peromyscus maniculatus).• Hantaviruses have also been found inother wild rodents.Transmission• Transmitted among mice and otherrodents by physical contact.• Transmitted to humans through theinhalation of aerosolized rodentexcreta (urine, faeces and saliva).Incubation Period• Usually two weeks with a range of afew days to 6 weeks. (American Public Health Association, 2004)Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

What is Hantavirus ?Deer mouseWhite strip onunder bellyField mouseNo white strip onunder bellyHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionDeer Mice Range in North AmericaHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionDeer Mice Range in North America• A few types of rodents carry Hantavirus• In Alberta the most common carrier is the Deer Mouse.• Deer mice are found throughout rural Alberta• This includes Northern AlbertaHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Deer Mice Range in North AmericaNot all Deer Mice carry Hantavirus, however,Precautions should be taken with any and all micedroppings.Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHow is it transmitted?• Once the virus becomes airborne it can be breathedinto the lungs resulting in possible infection anddevelopment of HPS.• People may also become infected if contaminateditems contact broken skin, eyes, mouth or nose (notcommon).• Mice are not affected by the disease, neither are catsand dogs.• Generally, the virus is not spread between people.Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHow is it transmitted?• The disease is transmitted to humans throughexposure to rodent droppings and urine contaminatedwith Hantavirus.• Infected rodents shed the virus their in saliva, urine,and droppings• When the mice droppings and urine dry up and aredisturbed, the virus can become airborneHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

How you get Hantavirus (HPS)Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat are the symptoms?• Symptoms of Hantavirus Pulmonary Syndrome (HPS)include:• Illness begins with flu-like symptoms:• Fever, sore muscles, headaches, nausea, vomitingand shortness of breath• In later stages of the disease:• Fluid builds up in the lungs making it difficult tobreath• Symptoms may appear from a few days afterexposure, and as long as 45 days laterIn Alberta, we have seen illness approximately 3 daysto two weeks after being exposed to mice droppingsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat are the symptoms?If you suffer from any flu-like like symptoms afterexposure to mouse droppings,Visit your doctor immediately !!Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Hantavirus in Canada• Hantavirus Infection: British Columbia• Interior Health (IH) released that a fourteen year old Okanagan boyhas died of hantavirus infection on 16 June 2006. The MedicalHealth Officer for the Okanogan, stated the teen was most likelyinfected in his home, which was in a semi-rural area and had aninfestation of mice. Hantavirus causing HPS was only first identifiedin North America in 1993, and since that time nine cases are knownto have occurred in British Columbia, with seven of the cases in theIH region. Two of the previous six IH residents with Hantavirushave died of the disease.• Source: News Release, Interior Health, 20 June 2006Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHPS in Canada and AlbertaThere are four different hantaviruses associated with HPS in NorthAmerica, however only the Sin Nombre virus has been identified asthe etiological agent in Canada (Safronetz et al, 2008)As of January 2009 there have been 72 laboratory confirmed casesof HPS in Canada (Artsob, 2009)Majority of cases in Canada have been in Alberta with 39Of those 39 cases, 9 have been in Alberta First Nations (AB FN)communities with the majority being in a small area in centralAlbertaHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHPS in Alberta• Alberta has the majority of HPS cases with 39confirmed cases as of March 2010.• Fatality rate has been 26% (10/39) in Alberta• Cases have been spread throughout rural Alberta• The risk is considered the same anywhere in AlbertaHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

HPS in Alberta – Case Cluster• 4 laboratory confirmed cases of HPS in Alberta in May2005. Common exposure source for 3 out of 4 cases(Case Cluster)• 1 st reported household cluster in Canada with 3 cases.• First child under the age of 10 documented in Canada• 4 th case did not have same exposure as the cluster• 25% (1/4) mortality rateHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCase Cluster – Common Exposure• Family was conducting springcleanup in the garageGarage• Garage-missing door and otherentry points for rodents• Large infestation of mice &accumulation of droppingsthroughout• No protective measures orprecautions being followed duringcleanupGrass Seed inGarageHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionBasementFloorCase Cluster – Conditions inside dwellingGarage WallDeer Mice in the homeMice droppings bythe bedHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Case 4 Probable Exposure SiteHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCase 4 Probable Exposure SiteOccupantinvolved incleaning up ofgarageAccumulation of droppings.Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHPS Cases 2007• 2 additional case of HPS in central Alberta in Mayand August 2007. Both lab confirmed• 1 case in Northern Alberta (High Level Area) in June2007. Lab confirmed. Represents the furthest northdocumented case of HPS• All cases were involved in some cleaning/disturbanceof mice droppings.Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

2007 Cases- Probable Exposures• 1st central Alberta case likely exposed whilecleaning and moving a dog house with a mousenest underneath. Mice nest underdog house• Second central Alberta case involved cleaning of amice infested home.• Northern Alberta case likely exposed in a storageshed at home, while moving items. Shed had amice infestation• No protective measures or precautions beingfollowed during cleanup in two of these cases.Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionAlberta HPS Case DistributionTotal of 39 confirmed cases of HPS inAlberta Since 1999 (26% Fatality Rate)9 Confirmed cases in AB FN(11% Fatality Rate)(National Fatality Rate is 30%)Closer examination of case distributionindicates that the entire east-centralregion of Alberta has greater incidence ofHPS, not just the FNsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHPS in Alberta First NationsNorthern case (High Level area) representsthe furthest northern case of confirmed HPSMajority of AB FN cases have been in centralAlberta. A number of cases occurred in thisarea (red box) in 2005, including a casecluster (3 individuals)This prompted a detailed study by the PHACNML, special pathogens section onseroprevelance of the hantavirus in arearodents in 2005. Study found that there was ahigh number of infected mice in the area anda large mice population meaning increasedrisk to the public.Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Age Distribution ComparisonPopulation Mean Age Median Age Data Source(Years) (Years)AB FN 32 28 (Health Canada, 2008)AB 39 41 (AHW, 2008)Canada 40 42 (Artsob, 2009)US 38 N/A (US CDC, 2007)Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCumulative HPS by monthHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat do we do with this information?Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Methods of ControlMethods of ControlNotifiable disease (provincially and federally)- SurveillanceNo acceptable vaccine in North AmericaControlling rodent populations and the immediate EnvironmentRemoving excreta and thorough disinfection of affected areasUse of precautions and personal protective equipment (PPE)Education and awarenessHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionPublic Health InterventionsEducation & AwarenessComprehensive Informational BrochureProper cleaning methodsUse of PPE’sTargeted Community Awareness CampaignsCommunity info sessionsRadio messages (particularly in the spring)Targeted training to tradesPublic Health OfficialsRecognize signs and symptoms and potential exposureUnderstanding clinical progression of HPSOngoing SurveillanceHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionPublic Health InterventionsControlling the EnvironmentElimination of Harbourage AreasSealing any entry points into structures anddwellingsKeeping grass mowed surrounding structuresRemoving or making food sources in accessible(garbage, dog food etc.)Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Public Health InterventionsControlling the Agent and VectorControlling mice populationsTrapping (indoors and outdoors)Eliminating food sources in the surrounding areasIntroducing natural predators (Cat)Minimize dust generationDisinfection of areasHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionActions to Minimize Risk of Exposure• Community education and awareness on virus, HPS andprecautions to follow during cleaning• Removal of suitable nesting/breeding areas such as woodpiles, grass piles, eliminating possible entry points andgood housekeeping• Recommendation to remove or demolish abandonedstructures• Prevention and clean-up are the responsibility of theindividual homeowner and not the Band or EPHSHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionInformational Brochure• Explains in detail how toprevent and recognizeinfestations• Explains how to safely cleanand areas with droppingsand dead mice• Available at communityhealth centresHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Signs of Mice• Droppings• Tracks• Chewed items• Burrows/ nests• Grease marks• Rodent sounds• Live or deadRodents• Urine stains• OdoursIf you see one mouse, there are often many morethat you don’t t see !Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionMice DroppingsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat can I do to protect myself?Good HousekeepingRodent ControlProper Cleanup using PrecautionsHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

House Keeping - Outside• Fill all gaps into a house that are larger than ¼ inchUse steel wool and secure with caulk or expandable foam• Store all lumber, firewood and building supplies at least50 ft away from an occupied house• Remove debris from around a dwellingEspecially abandoned vehiclesHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionHousekeeping - Outside• Ensure that openings to the house, such as dryer vents,are screened• Ensure that all doors and windows seal properly• Ensure that garbage is stored in sealed containers• Control vegetation around the houseRoutine yard maintenance includingcutting grassEnsure that pet food isinaccessible to rodentsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionWhat can I do to protect myself?Remove DebrisEliminate possible nesting areasHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

House Keeping - Inside• Practice good housekeeping• Do not leave food out• Store dry goods in sealed containers• Keep floors tidy and free of excess items• Put pet food away at night• Store garbage in a sealed container• Look for signs of rodent infestationHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Rodent ControlHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionRodent Control• Take measures to make an unsuitableenvironment•Use snap traps• glue traps and live traps might cause moreof thevirus to be released through urine andfeces•Read instructions before setting• Not all traps are hard to setHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionRodent Control• Place a pea sized amount of peanut butter onthebait pan• Place the trap so it makes a “T” with thewall• Place traps where there is evidence of miceand inclosed areas (behind fridge and stove)Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Rodent ControlNaturalPredatorsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCleaningHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCleaning Procedures –Areas with Droppings• Ventilate (air out) the area for at least half an hourprior to starting cleanup• Wear rubber or latex gloves and if in an enclosed areawith a heavy infestation wear a N95 (min rating) mask• Note a mask must be properly fitted and does notguarantee protection. It is only one of severalprecautions that need to be followed. Masks can bepurchased at a local hardware store (not supplied byHealth Centre)• Wet down area to be cleaned with a 1:9 bleach solution(1½ cup bleach in 4 Litres of water) and let sit for 10minutesDo not sweep or vacuum !!• Mop up area or wipe with paper towelsHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Cleaning Procedures- ClothingDirty clothing and bedding can be washed by:• Washing clothing and bedding in hot water anddetergent• Dry clothes on the hot setting in the dryer• If needed, wash twiceHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCleaning – Trapped MiceTo clean up a dead mouse in a trap:•Wear rubber gloves• Spray the mouse, trap and area with bleachsolution (1:9 dilution). Use regular householdbleach.• Place the mouse and any nesting material inplastic bag Disinfect the trap if reusing• Seal the bag and place into another bag• Seal that bag too• Throw out in a covered trash can• Wash gloved hands with soap and waterbeforetaking them off• Wash handsHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCleaning Procedures -Solid Objects• Solid objects (don’t soak up water) such astoys, countertops, baseboards, tables, dishesand cabinets can be cleaned by:• Washing or wiping with soap and hot water,then• Disinfecting with a bleach water solution(1:9)Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Items that need to be discarded• Items that have become soiled and absorb moisture,often, cannot be cleaned and should be thrown awayas a precaution. These include:• Papers, boxes, books, magazines• Mattresses, box springs and couches• These items should be sprayed prior to being thrownaway to minimize any dust generation and placed insealed bags where possibleHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionSummary• Not all people exposed to Hantavirus will develop HPS• There is currently no screening method to determine who isat greater risk of contracting the disease• There is currently is no approved vaccine in North America• The disease is not spread from person to person• Dogs and Cats do not carry the virus• Awareness, Education and Prevention are the only ways tocontrol the diseaseHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionSummaryBecause it is a virus antibiotics are not effective.There is no vaccine in Canada.The risks can be reduced by using proper precautionswhen cleaning, effective rodent control andpractising good housekeepingThe occupants of the home have the primaryresponsibility to ensure that they are not creatingfavourable conditions for the mice and to make surethey are doing the cleanup properly and safely.Hantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Summary- Sanitation and Rodent ControlEffective Sanitation & Rodent Control involves• Eliminating nesting areas (grass, garbage, clothing)• Eliminating entry points (sealing holes, proper doorjams)• Removing food sources (storing food in plasticcontainers)• Eliminating Rodents (snap traps, bait stations)• Proper and thorough cleanup (gloves, mask, ventilationprior, limiting dust generation)Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionSummary- Cleanup• Assume all droppings are contaminated• Ventilate Area– at least ½ hour prior tocleaning• Use proper equipment (gloves, mask, boots etc.)• Control Dust – Wet area with bleach watersolution (1:9 dilution, includes trapped mice)• Wipe droppings with paper towel or mop• Spray area again with bleach water• DO NOT Sweep or Vacuum, as this causes dustDO NOT CREATE DUST !!Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionCommonly Asked Questions• My house has mice, is someone going to comeinspect my house and clean-up the droppings?– If you see mice droppings or catch mice, you know there is apotential risk.– Occupants are responsible to ensure they rodent proof theirhomes and to clean and disinfect any areas with droppings.– An informational booklet is available that summarizes how torecognize, clean and disinfect mice droppings and mice isavailable at the Health Centres.• Should we bring in dead mice so they can betested?– No, the testing involves catching live mice and involvescomplex sampling and testing procedures– Discard any caught mice by double bagging and in the normalhousehold garbageHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Commonly Asked Questions• Should I wear a mask?– A mask is only one piece of the overall precautions to usewhen cleaning any mice droppings– If using a mask recommend wearing a mask with a minimumrating of N95.– They can be purchased at a hardware store or safety supplystore– Masks must be properly fit tested to ensure they areeffective– Fit testing can be done through a safety companies.• Can I use other cleaning chemicals?– You can, as long as they are effective for viruses. Checkthe label– Bleach is still the most effective and cheapestHantavirus: What You Need to KnowEPHS, FNIH Alberta RegionReferences• Alberta Health and Wellness, December 2005. Public Health Notifiable DiseaseManagement Guidelines: Hantavirus Pulmonary Syndrome• Heyman 2004. Control of Communicable Disease Manual. 18 th Edition.American Public Health Association. Pages 249-260.• Lindsey et al, June 2005. Hantavirus Surveillance in Communities nearHobbema Alberta May 2005. Draft Report on preliminary Data.Unpublished• Lindsey et al, January 2006. Follow-up in Hanatvirus Surveillance in selectedCommunities near Hobbema Alberta September 2005. Draft Report onpreliminary Data.Unpublished.• Safronetz et al, 2005. A Preliminary Study of Patterns of Sin Nombre ViralInfection and Shedding in Naturally Infected Deer Mice (Peromyscusmaniculatus). Vector Borne Zoonotic Disease 2005; 5(2):127-132Hantavirus: What You Need to KnowEPHS, FNIH Alberta RegionQuestionsFor further information contact your localEnvironmental Health Officer (EHO)orEnvironmental Public Health ServicesHealth Protection DirectorateFirst Nations and Inuit HealthHealth Canada, Alberta Region(780) 495-2712 Edmonton Office(403) 299-3939 Tsuu Tina OfficeHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

QuestionsThank-YouHantavirus: What You Need to KnowEPHS, FNIH Alberta Region

Good Night, Sleep Tight…Bedbug Information for Concerned HomeownersPresented by:Environmental Public Health ServicesHealth Canada, First Nations and Inuit HealthAlberta RegionPresentation Outline• Bedbugs: Background, Description, Life Cycle• Sources of Bedbugs• Public Health Implications• Evidence• Dealing with an Infestation• Control Measures• Prevention Strategies: What YOU can do• Disposal of Furniture• Question PeriodBackground• Prehistorically bedbugs lived in caves and feed off bats.• Bedbugs are found worldwide and transported from oneplace to another by human travel.• Within the last 10 years, reports of bed bugs haveincreased significantly. Factors cited in this increase:• Increased global human travel.• Reduced use of DDT in pesticides.

Background• Infestations have become a problem in many indoorenvironments including: domestic households, hotels,dormitories, and other places of residence.• Bedbug problems are not necessarily related to poor sanitation,tidiness or social status (though crowded housing conditions maycontribute to their spread.)• High end hotels are just as susceptible as cheap ones.Description• Flat, oval-shaped and wingless insects.• They range in size from 3/8” to ¼” long; size of an appleseed• They are light brown/yellowish in color, but become darkred and bloated following a feeding.• Eggs are whitish, pear-shaped and the size of a pinhead.• They have a lifespan of about 1 year.• Female can lay 200 – 400 eggs, depending on adequate food andtemperature.• Eggs take 10 days to hatch.Description• During the day they hide and are rarely seen but come out atnight and actively feed.• Human bites often occur on neck, arm, back, shoulders, legsand ankles.• Clusters of bites are known as breakfast, lunch and dinner, suggestingmultiple feedings.• They are not capable of flying or jumping and rely on crawling,climbing and attaching to surfaces in order to move around.

Description• Can ingest up to 3 times their body weight in a singlefeeding.• They normally feed off of humans but also pets and otherwarm-blooded animals.• Able to find their meals but the carbon dioxide we exhale.• They may live 6-12 months without a feeding.• Thus can survive in infrequently-used hotel rooms or vacantapartment buildings until occupied by an unfortunate victim.Description• People bit by bedbugs while sleeping do not feelthemselves being bitten. Bedbug saliva contains:• An anesthetic to reduce pain,• An anticoagulant to keep blood flowing.Nymph Bedbug, Feeding

NymphsAdult Bedbug (unfed)Adult Bedbugs (unfed, fed)

Bedbug EggsBedbug Life CycleBedbug Life Cycle• Eggs hatch in about 6 – 10 days.• Immature nymphs molt (shed outer exoskeleton) 5 timesbefore reaching adulthood, taking a blood meal eachtime.• Once fully mature, females take repeated blood mealsand continuously lays 5 eggs per day.• There may be three or more generations of bedbugs peryear.

Sources of Bedbugs• Bedbugs do not just spontaneously appear; if you have aproblem, its because they came from somewhere else.• Infestations can start by:• Travelers who stay in affected hotels and pick them up onclothing.• Bringing home infested used furniture.• Family members who live away from home e.g. college, military,group homes.• Moving into an apartment or building that has a bedbuginfestation.Public Health Implications• Although extremely unpleasant, bedbugs are not knownvectors of any infectious disease.• However, their saliva can cause allergic reactions, itching,sensitivity or inflammation in certain people.• Scratching can lead to infection.• People living in infested homes are subject topsychological trauma, mental stress, anxiety andinsomnia.Evidence of an Infestation• Unexplained bites on body.• Itchiness (lasting hours or days)• Redness• Swelling

Evidence of an Infestation• Physical Evidence• Blood spots on bed linen and pillow cases.• Fecal stains.• Egg casings, dead insects and shed skins.• They shed their skin numerous before becoming anadult.• A strong musty or sweet odour where infestations aresevere.• Seams, creases, tuftsand folds of mattressesand box springs• Cracks in the bed frameand head board• Under chairs, couches,beds, dust covers• Between the cushions ofcouches and chairs• In telephones, radios,and clocksHiding Places• Under area rugs and theedges of carpets• Between the folds ofcurtains• In drawers• Behind baseboards, andaround window anddoor casings• Behind electrical platesand under loosewallpaper, paintings andpostersBedbug Control and Prevention

Bedbug Control and Prevention• Once a bedbug problem has been identified, it is vital thathomeowners act quickly to limit they’re spread within the home.• The Integrated Pest Management Approach (IPM) should beemployed, involving:• Good sanitation• Preventative measures• Targeted use of chemicals where necessary• Thoroughness is essential in addressing bedbug problems.Before Do Anything: Tidy-up• Removing everything from dressers, drawers, closets,shelves, cupboards and counter tops.• Keep floor clear, and move all the furniture 2 feet fromthe wall.• Get all items off the floor.• Items that cannot be moved should be placed into sealedplastic bags.• Remove all unnecessary clutter.Control Measures - Vacuuming• Thoroughly vacuum affected rooms with a nozzleattachment to capture the bedbugs and their eggs.• Areas to focus your vacuum:• All crevices on your mattress, bed frame, box spring, baseboardsand any objects close to the bed.• Furniture interiors• Dresser drawers• Under chairs• Behind pictures• On curtains

Control Measures - Vacuuming• Ensure vacuum is emptied and disposed of in sealedgarbage bag immediately.• Vacuuming alone will not resolve the issue but isvital step in reducing their population.The inside of your bag might look like this!Control Measures – Laundering• Wash all your linens in the hottest water possible andplace them in a hot dryer for at least 20 minutes.• Cold water does not kill bedbugs.• Once laundered, consider covering your pillows andmattress with a plastic cover.Control Measures – Mattress Covering

Control Measures – Exposure to the Elements• Bedbugs are temperature sensitive; exposure to heat(between 45 o C - 50 o C) or cold (less than 0 o C) will killthem.• Infested garments or bed furniture can be wrapped inplastic and left outside in hot and cold weather.• In order for these methods to be effective mattressesshould be left out for at least 2 weeks.Control Measures – Steam• Hot steam is very effective in penetrating beddingsurfaces and killing bedbugs and their eggs.• Conventional steam cleaners produce enough heat todestroy them.• Follow up with vacuuming to removedead insects.• Be cautious when dealing with steam.Control Measures – Steam

Control Measures – Maintenance• Prevent future bed bug problems by sealing cracks andcrevices between baseboards, on wood bed frames,floors and walls with caulking.• Repair or remove peeling wallpaper, tighten loose lightswitch covers, and seal any openings where pipes, wiresor other utilities come into your home (pay specialattention to walls that are shared between apartments).Control Measures – Monitor• Monitor daily by setting out glue boards or sticky tape(carpet tape works well) to catch the bed bugs.• Examine closely any items that you are bringing into yourhome. Furniture put out by someone else for garbagepick-up could be infested with bed bugs. Use caution.Control Measures – Commercial Products• Commercially available products are available to assistwith bedbug eradication, such as diatomaceous earth(DE) and pyrethroids.• May come in liquid, powder or aerosol forms.• Care must be taken in using them especially where infants andyoung children can be affected.• Look for products that state their safety for humans and pets.• Read manufacturers instructions carefully.• Multiple treatments may be necessary.

Control Measures• It is normal to see some living bed bugs for up to ten daysafter treating your home through IPM and/or pesticides.If you continue to see a large number of bed bugs aftertwo weeks, contact a professional pest control service.Control Measures – Professional Services• Homeowners may not be thorough enough wheninspecting for bedbugs.• The knowledge of a well-trained and experience PCOmay be required, especially when it comes to applicationof pesticides.• It is recommended that only certified pest controloperators apply insecticides.Is Disposal Necessary?• Generally speaking discarding beds, bedding, andfurniture is NOT a sound approach to bed bug controland not recommended• Without a thorough approach they can be easily re-infested.• However, for large scale infestations disposal would be areasonable and effective measure in eliminating bedbugsfrom a home.• As the majority of bugs will be associated with the mattress andbox spring and removing these will eliminate a significantpopulation of bedbugs and their eggs.

Disposal of Furniture• It may make even more sense to discard the bed if• The infestation was very severe,• It was old/damaged and in need of replacement or• You or your family cannot emotionally deal with leaving theinfested bed in the home.Infested MattressDisposal of Furniture• Furniture that is infested with bedbugs that cannot besalvaged needs to be disposed of in a manner that willprevent the further spread of bedbugs.• In the process of removing a piece of furniture, bedbugscan escape into hallways and make their way into newapartments spreading the problem to new areas.

Disposal of Furniture• Take apart, deface or damage the piece of furniture toensure it cannot be reused.• Mattresses should be slashed or otherwise damaged to make itunusable and wrapped.• Wrap the furniture in plastic so bed bugs cannot escape-thisshould be done in the unit before the mattress is removed.• Do not store in the home while awaiting pick-up.• Put in trash as soon as possible.Careful DisposalPrevention Strategies –Things YOU can doAt home:• Practice regular cleaning in your home.• Including vacuuming your mattress.• Clean up clutter to help reduce the number of places bed bugscan hide.• Launder bedding between out-of-town house guests.• Be wary when buying used furniture or clothing.• Make sure to inspect the used item, and feel free to ask theretailer if the items were checked for bed bugs.• Use caution when bringing home used furniture or clothes fromthe curb side. These items may be infested with bed bugs.

Prevention Strategies –Things YOU can doWhile Traveling• Inspect the room, furniture and bedding.• Inspect all cracks and crevices of the mattress and box spring,and look for blood spots or live insects.• Request a different room if you find evidence of bed bugs.• Protect your luggage.• Keep all belongings in your luggage and wrap your luggage inplastic to help prevent bed bugs from entering your luggage.• Keep luggage on a shelf, off the floor and away from bed.Prevention Strategies• Protect the bed• Move the bed away from the wall.• Tuck in all bed sheets and keep blankets from touching the floor.• Upon returning home• Inspect the luggage and clothing; if you have any doubt leave yourluggage in the garage.• Wash all your clothes in the hottest water possible and put them in ahot dryer for at least 20 minutes.• Do some research• Internet sites such as bedbugregistry.com allows people to postinformation on bedbug infested hotels.Summary• Bedbugs are becoming a more common problem everywhere.• They move from one place to another by attaching to clothing,luggage and bedding.• They are often difficult to observe until the problem becomessevere.• There are not known to carry any infectious disease.

Summary• Control of bedbugs can be achieved with some knowledgeand resources right in your home.• In some cases where basic control measures have failed, aPCO is recommended.• It is not necessary to dispose of infested bedding andfurniture.• Knowing prevention strategies can keep them out!Good Night…SLEEP TIGHT???References/Resources• http://www.toronto.ca/health/bedbugs/infoforpublic.htm• http://pestcontrolcanada.com/INSECTS/get_rid_of_bed_bugs.htm• http://www.hc-sc.gc.ca/cpsspc/pubs/pest/_pnotes/bedbugs-punaises-lits/indexeng.php• http://bedbugbullies.com/bed_bugs• http://www.bed-bugs-handbook.com/• http://www.doctorbedbug.com/

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