A new Canadian Medical Association Journal article reports on a patient who was ultimately hospitalized with severe anemia “almost certainly caused by ongoing blood loss from multiple bedbug bites.”
Pritchard, M.J. & Hwang, S.W., 2009. Severe anemia from bedbugs. CMAJ, 181(5), 287-288. doi:10.1503/cmaj.090482
The patient, 60 years old, initially presented with fatigue and lethargy for a two-month period that coincided with the bed bug infestation in his apartment.
After his second hospitalization for anemia (his hemoglobin had dropped to 52 g/L), his doctor visited him at home and discovered the true extent of his infestation (thousands of bed bugs, some observed crawling on the patient).
The patient had other medical problems, including a substance abuse problem that “may have increased his risk of extreme bedbug infestation by rendering him apathetic and inattentive to conditions in his home.”
Because he was unable to prepare his apartment for treatment, he was put up temporarily in a shelter while his apartment was treated.
His hemoglobin rose to 132 g/L (the authors reference the normal range as 135–180 g/L) four weeks after he received bed bug treatment.
Dr. Pritchard and Dr. Hwang write that bed bug bites:
should be considered a possible cause of chronic blood loss and iron-deficiency anemia in people who have signs of bedbug infestation. The anemia in the patient we have described was almost certainly caused by ongoing blood loss from multiple bedbug bites. The attribution of his anemia to bedbug bites is supported by the absence of other identifiable causes of anemia and the return to normal of his hemoglobin level after treatment of the severe infestation in his apartment. The patient’s poor eating habits may have contributed to the severity of his anemia.
Sadly, six months later, his anemia is still gone but the bed bugs, in lesser numbers, are still in his apartment, though it seems he is not suffering as before:
He has reported seeing and killing a few bedbugs in his apartment on a daily basis, but he has not experienced new bedbug bites.
(Because he lives alone, I think he must be experiencing continued bed bug bites, but perhaps we may conjecture that the current level of his infestation is not producing the previous reactions or, indeed, the severe anemia.)
This is the most disturbing aspect of this case. Here is someone who cannot cope with bed bugs and who is at medical risk from a severe bed bug infestation.
And he still has bed bugs.
The authors note the higher risk of developing severe bed bug infestations for people with certain medical and substance abuse conditions who also may require significant health care and social services intervention for bed bug treatment and control.
Dr. M. Jane Pritchard practices at Leaside Health Centre in Toronto and Dr. Stephen W. Hwang is a homelessness and health research scientist whom you will recall from the 2005 Toronto bed bug study: Hwang SW, Svoboda TJ, De Jong IJ, Kabasele KJ, Gogosis E. Bed bug infestations in an urban environment. 2005. Emerging Infectious Diseases 11(4), 533-538. http://www.cdc.gov/ncidod/EID/vol11no04/04-1126.htm