This is a case of a bed bug infestation. Bed bugs have recently made a resurgence in the modern day world that has placed them in the spotlight of many newspaper articles and news casts ready to sensationalize. But they are hardly new to mankind.
Bed bugs have been infesting man since early mankind when cavemen shared caves with Bats. Bats are thought to have been originally the blood source for bed bugs but later adapted to the blood of humans living in caves.
Though there are various species of bed bugs, there are really only two that are adapted to feeding on the blood of humans (Cimex lecularius and Cimex hemipterus). Cimex lecularius is the species we are most familiar with in the United States and other temperature regions while Cimex hemipterus is more common in the Tropics.
The bed bugs are a reclusive group of bugs and are therefore normally difficult to find, hiding in the cracks of furniture and walls. They generally are nocturnal and live relatively close to their blood meal source. Bed bugs tend to reside relatively close to the sleeping space of humans giving them close proximity to their food source. They are attracted to the heat and carbon monoxide given off by the unsuspecting host. Bed bugs feed for a relatively short time and then retreat back to their resting space after they have fed. Therefore, they are much different than ticks or lice which require a relatively long period of attachment to the host in order to get a full meal. Their bites are relatively painless as they have a natural pain killer in their saliva and thus are able to obtain their blood meal while not disturbing the host. However the salivary proteins do produce an allergic reaction to the bite area that in some individuals can cause intense irritation and/or lead to secondary infections. They are not known to be vectors of any parasitic, viral, or bacterial diseases.
Unlike the ticks and lice, they are relatively fast. Also, their flattened body is advantageous. It allows them to be able to secure resting spaces that are small, secure, and difficult to access. This makes bed bugs difficult to locate and eradicate. Infestations of areas can require multiple attempts at eradication before a complete eradication is achieved. Bed bugs can be without a meal for months at a time. For this reason the rapid detection/identification of bed bugs by the microbiologist/parasitologist is crucial in institutions such as hospitals, rest homes, hotels, apartment complexes, etc. before an extensive infestation is established. Prompt application of insecticides, the use of dogs to detect hidden colonies, the removal of infested material, and/or in last resorts the use of heat needs to be initiated as soon as possible. Once an infestation has been established in a location, and depending on the size of the area, thousands of dollars can be spent in attempting to fully eradicate an area of bed bugs. In addition as in the case of hotels, thousands of dollars of loss revenue can occur. http://www.bedbugregistry.com/ is a site that I have used when traveling to make sure that the hotel I am planning to stay at is free of bed bugs.
What was unusual about the identification of this bed bug was the stage that was submitted. Rarely are you going to get a bed bug submitted at this early stage. Simply because its small size would make it easy to overlook. There are 7 developmental stages to the Bed Bug including the egg stage. At a mere 2mm this is an example of an early nymph stage. There are 5 nymph stages. Adult Bed Bugs which are what we normally see being submitted for identification are approximately 5-7mm long (see the image below). They have a flattened highly segmented dark brown body, six legs, and mouthparts made for piercing.
The nurse was most certainly astute in both detecting and submitting it for identification. Once it was identified by us we made the call immediately to the area so that the nurse could request a terminal cleaning of the area and an application of insecticide by our facilities management personnel be ordered.
When the bedbug has had a blood meal it can take a shape that many times can make the identification difficult for the inexperienced Microbiologist or Parasitologist. The image below is that of a well fed bedbug. Notice that the body is elongated in comparison to the flattened oval shape that is most commonly encountered as seen in the above photo.
Any comments or additional information are welcomed!