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| Bugs without Borders |
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by Bob Blumm, MA, PA-C, DFAAPA - June 24, 2011
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Doctors Without Borders/Médecins Sans Frontières (MSF) is an international medical humanitarian organization created by doctors and journalists in France in 1971.
Today, MSF provides aid in nearly 60 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters. MSF provides independent, impartial assistance to those most in need. MSF reserves the right to speak out to bring attention to neglected crises, to challenge inadequacies or abuses of the aid system, and to advocate for improved medical treatments and protocols. Whereas these physicians and nurses perform legendary feats of medical volunteerism which have actually cost a number to lose their lives while performing a service for mankind, I wish they would include NPs (they may) and PAs. In any case I thought it to be a good lead in message to introduce my subject today: Bugs Without Borders.
Bugs without borders have had an amazing effect of the world over the past decade, creating fear, financial loss; they have lowered the number of participants in conferences for fear of contamination and have introduced new customs to travelers such as myself. We immediately, upon going into a hotel room, strip the bed of its luxurious bedspread, pull back the sheets and meticulously search the corners of the sheet as well as the sheets themselves for the presence of these small uninvited guests. On the brighter side, they have helped our struggling economy by providing new jobs for “dogs who sniff bed bugs” and their masters or owners. Why all the hype and pomp and circumstance?
As I read an article in Nursing 2011, I discovered that the history of bedbugs scans the same history as that of civilization. They are mentioned in the medical literature as far back as Aristotle and have been the subject of poetic inspiration such as “Goodnight, sleep tight, and don’t let the bedbugs bite.” The Romans named them cximex lectularis, which means bug and bed or couch. The vector was the human being who decided that they would recline for a glass of wine, to read a book or to find sleep for the night. Bed bugs have proven that they appreciate “hitching rides” and join us as travel companions in our luggage without paying a customs fee. They travel by ship, plane and automobile as well as by taxi, bus, trains such as Amtrak and even bother to achieve first class status. Regardless of our age or place in society, they have proven that they can travel efficiently and quietly with the best of us and resurface on our own bed linen and in our snug homes and apartments. No, this is not an issue of socioeconomic status. They flourish even more on those who have the ability to travel .
These bugs were common during the early 20th century until we devised a chemical called DDT which almost totally destroyed their presence in the USA. They still flourished in other countries and continents, making the USA once again prey to this new and more improved species that has developed immunity to many OTC sprays and countermeasures. Yes, burning down your dwelling still works, but is considered an extreme by most of us normal folk. Much like vampires, bed bugs go out in search of human blood in the predawn hours. They are stealthy and can grow to the size of an apple seed after a thanksgiving dinner consisting of your body. Much like a surgical team, they have the ability to anesthetize your skin prior to stabbing and sucking. They favor parts such as the peniculous that many people have developed in the 21st century; they enjoy the cleft of pendulous breasts and love buttocks. This is not to say that they avoid other parts of the body that are calling out for a bite which is why it remains a good idea to sleep with bedclothes rather than go “commando” while residing in a hotel.
The signs and symptoms are really simple: you go to bed without lesions and awaken the next day with clusters of erythematous bites that itch or burn. Treatment may just be simple soap and water, an antihistamine and low strength steroid. People have been encouraged not to purchase furniture such as mattresses and other comfortable acquisitions such as chairs and couches because they may be bring into their homes thousands of these critters and their extended families. This problem is also prevalent in our health care institutions and some patients need a full “body check” such as they should be getting annually from the health care personnel.
If you wish to discover much more than this simple appetizer on the subject, I would suggest reading this article written by Kathy Miller Wilson, RN, a clinical instructor at the University Of Maryland School Of Nursing in Baltimore, Md. As I have mentioned before there are great articles in every journal, not just those in our profession.
Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 150 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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