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Question: Discuss about the Bed Bug Bites Or Cimex Lectularius. Answer: Introduction: Bed bugs or Cimex lectularius is a type of parasitic insect that feeds on blood of other animals, and is commonly found in third world countries where there is unsanitary hygiene conditions and congested population. Contradictorily, after the latter half of the twentieth century, spread of bed bugs was observed even in developed countries like Europe, United States and Canada. The aim of this brochure is to provide a brief idea regarding the Cimex bug which would help research scholars develop ways to control its spread and for health organizations to make the general population aware of the bed bug infection and its harmful effects. The brochure is important to draw attention about bed bugs, because according to an article provided by Centers for Disease Control and Prevention, bed bugs can occur anywhere regardless of cleanliness and every clinical symptom is different for each affected person (CDC - Bed Bugs - Frequently Asked Questions (FAQs), 2018), which makes it difficult to t reat. Article 1 by Susser (2013) According to a journal article published in International Journal of Molecular Sciences, it was addressed that sleep deprivation over a prolonged period of time may lead to different health problems, physical as well as mental. Any hindrances or nocturnal pruritus can lead to malfunction in the restorative process of sleep (Lavery, Stull, Kinney Yosipovitch, 2016). The constant irritant stimulus and compulsion to perform nocturnal pruritus can lead to both infection and mental health declination. The research paper is dedicated to correlate the occurrence of Cimex infestation and its impact on the sleep disturbance which leads to anxiety and depression. There are no epidemiological study data that would support the hypothesis of the paper, but it is most likely to be observed that recurrent infestations of Cimex will eventually hamper sleep of the person affected and thereby will most likely to become irritable, anxious and will eventually suffer from temporary mental illness. The s cientists performed a secondary research based on a survey conducted by Montreal Public Health department in 2010. A total of 91 participants who lived in unhealthy living conditions were questioned and was noted that half of the sample participants suffered from sleep deprivation and most of those people suffered depression and preferred isolation. The patients physical as well as mental health should be clinically diagnosed by doctors to ensure an all rounded therapy. The doctors are also advised to make the patient and their family aware to be careful regarding the infection. Article 2 by Salazar et al. (2015) The parasite Trypanosoma cruzi, causing a disease known as Chagas disease is rampant in the Latin America, where low sanitation is seen. According to an estimate provided by CDC shows that, nearly eight million people are affected by Chagas dieases in Latin American populated areas (Chagas disease, 2018). The problem with this disease is that it can remain undetected for years and prolonged exposure leads to enlargement of heart ventricles, esophagus and colon. Recent research has shown that Cimex has similar features like the Triatomine class of insects like that of T. cruzi (Benoit et al., 2016) Scientists are trying to find out the relation between these similar features and whether or not Cimex can serve as a vector for Chagas disease. In their experiment they infected a group of healthy mice with T. cruzi and those mice were exposed to Cimex. The results showed that the Cimex that fed on the infected mice acquired the Chagas disease effectively. The Cimex were then observed to t ransmit the T.cruzi into normal mice when they were subjected to cohabitation with normal mice. Another method of disease transmission was through contact with T. cruzi contaminated fecal matter in healthy mice. Data analysis has shown that the more probable cause of Chagas disease transmission was due exposure to fecal matter of the infected mice into the normal mice via Cimex. This can pose a threat to entomologists in considering Cimex as a potential vector to T.cruzi and awareness should be created in areas where Chagas disease is potent. Article 3 by Olson et al. (2013) Olson et al. (2013) worked on cold tolerance of bed bugs. It is a known fact that the performance of animals as well as insects is controlled by the temperature of the surrounding environment, geographical locations where temperate and polar conditions prevail; the majority of the insect population faces a set back and is challenged to survive in under low nutritious conditions. This is natures own pest controlling method to inhibit excessive spreading of insects directly or indirectly by impacting physiological responses, biological function and reproductive ability (Sinclair, Alvarado Ferguson, 2015). An article of Journal of Economic Entomology, states that Cimex has high tolerance to even cold temperatures and can feed in those extreme freezing conditions. This suggests that Cimex infestation can also occur in cold climatic conditions in which generally all other insects are unable to thrive. The scientists exposed the Cimex to extreme freezing temperatures with variable time of exposure and determined the bugs tolerance towards cold and how the mortality is affected by harsh temperatures. They studied the different life cycle stages of the Cimex and determined the optimum tolerance to manage pest control. The mean temperature ranged from -21.3C to -30.3C, with the egg phase having the lowest tolerance. Only when the bugs were exposed to a lethal freezing temperature of about -31.2C, all the bugs were reported to be dead, meaning these bugs could not survive a temperature lower than body freezing. Health organizations should create awareness in colder countries and observe the low hygienic areas to find the presence Cimex bugs and way to control them. Article 4 by Zhu et al. (2013) Zhu et al. (2013) worked on resistance to pyrethroid insecticides. Chemical insecticides are mostly used to control disease causing vectors that affect the human population and spread diseases and rampant infection. The first choice of insecticide is the pyrethoid class of chemicals which is highly efficient to destroy most of the vectors (Nkya, Akhouayri, Kisinza David, 2013). The recent advancement in the genomic mapping of Cimex, have been able to analyze of the whole genome of the species. The analysis has showed that, as of late, the species has developed a resistance towards pyrethroid group of insecticides. Fourteen molecular markers have been identified to be associated with the insecticide resistance by transcriptome analysis. The article shows that the genes responsible for the insecticide resistance have different mechanism to inhibit the pesticide action by slowing down the toxin effect before it is targeted to the nervous tissues. The variety in the different strategies is dependent on the physiological, morphological and metabolic construct of the Cimex, which is only unique to this insect. Scientists should try to find chemicals that would directly destroy the genetic structure of the bugs that are structurally dissimilar to pyrethriods. Article 5 by Rahim et al. (2016) The dependence of the Cimex on humans for its blood meal leads to the direct exposure of human contact with the bug. Due to this reason, many adverse physiological and mental reactions are observed in patients who undergo Cimex infestation. The discomfort caused to the patient are mainly, irritability, nocturnal pruritus which may lead to the development of chronic inflammation, transmission to other domestic mammals and people, adverse allergic reactions and skin rashes (Minocha et al., 2017) The common clinical symptoms from Cimex bite include inflammation, swelling, redness, bullous eruptions, itchiness and development of rash and lesions. Affected individual develop compulsive pruritis (adverse itching sensation) and lesions after they have been bitten by Cimex. The severity of the skin reactions manifested from the bed bug bites varies between individuals and the bite from female Cimex were observed to take longer time to heal than male bug bites. Health practitioners are reques ted to clinically treat their mental health if necessary along with physical treatment and advise the affected people not enhance their infection by mistreatment and scratching. Conclusion: The sudden uprise of the Cimex or bed bugs is a growing concern and is clinically neglected in most developed countries. The United States are recorded to have the highest number of Cimex infested population in the world. The past decade, Canada has been susceptible to spread of bed bugs and mainly the homeless population seems to suffer from the recurrent manifestations of the bug. The clinical manifestations of the bug bite are not only restricted to physical infections but also impact the overall mental health of the individual. The more alarming issue that needs to be addresses is that the Cimex has developed resistance against the widely used insecticide, pyrethroids. Health organizations should be focusing to find out ways to control the widespread growth of these blood sucking parasites before it becomes a major worldwide threat. References: Benoit, J. B., Adelman, Z. N., Reinhardt, K., Dolan, A., Poelchau, M., Jennings, E. C., ... Zhu, F. (2016). Unique features of a global human ectoparasite identified through sequencing of the bed bug genome.Nature communications,7, ncomms10165. Chagas disease. (2018).World Health Organization. Retrieved 26 February 2018, from https://www.who.int/mediacentre/factsheets/fs340/en/ Lavery, M., Stull, C., Kinney, M., Yosipovitch, G. (2016). Nocturnal Pruritus: The Battle for a Peaceful Nights Sleep.International Journal Of Molecular Sciences,17(12), 425. https://dx.doi.org/10.3390/ijms17030425. Minocha, R., Wang, C., Dang, K., Webb, C. E., Fernndez?Peas, P., Doggett, S. L. (2017). Systemic and erythrodermic reactions following repeated exposure to bites from the Common bed bug Cimex lectularius (Hemiptera: Cimicidae).Austral Entomology,56(3), 345-347. Nkya, T. E., Akhouayri, I., Kisinza, W., David, J. P. (2013). Impact of environment on mosquito response to pyrethroid insecticides: facts, evidences and prospects.Insect biochemistry and molecular biology,43(4), 407-416. Olson, J., Eaton, M., Kells, S., Morin, V., Wang, C. (2013). Cold Tolerance of Bed Bugs and Practical Recommendations for Control.Journal Of Economic Entomology,106(6), 2433-2441. https://dx.doi.org/10.1603/ec13032. Quarles, W. (2015). New IPM methods for bed bugs.IPM Pract,34(7/8), 1-9. Rahim, A. H. A., Zahran, Z., Ab Majid, A. H. (2016). Human skin reactions towards bites of tropical bed bug, Cimex hemipterus F.(Hemiptera: Cimicidae): A preliminary case study.Asian Pacific Journal of Tropical Disease,6(5), 366-371. Salazar, R., Borrini-Mayor, K., Tustin, A., Levy, M., Nquira, C., Castillo-Neyra, R. (2015). Bed Bugs (Cimex lectularius) as Vectors of Trypanosoma cruzi.The American Journal Of Tropical Medicine And Hygiene,92(2), 331-335. https://dx.doi.org/10.4269/ajtmh.14-0483. Sinclair, B. J., Alvarado, L. E. C., Ferguson, L. V. (2015). An invitation to measure insect cold tolerance: methods, approaches, and workflow.Journal of thermal biology,53, 180-197. Susser, S. R. (2013). Good night, sleep tight, dont let the bed bugs bite: exploring the mental health fallout of urban bed bug infestation in Montral, Qubec. Zhu, F., Gujar, H., Gordon, J. R., Haynes, K. F., Potter, M. F., Palli, S. R. (2013). Bed bugs evolved unique adaptive strategy to resist pyrethroid insecticides.Scientific reports,3, 1456.