Bedbugs and Healthcare-associated Dermatitis, France

To the Editor: Bedbugs (Cimex lectularius) are hematophagous insects. Adults are 4–6 mm long, flattened, oval and wingless, and brown to brownish-red (Figure, panel A) (1). They may feed in the wild on birds or bats (2), but they are mainly associated with human dwellings and can be found on furniture and clothing (3). Because bedbugs are nocturnal and feed painlessly only in the dark, while humans sleep, initial bedbug proliferation usually goes unnoticed until several weeks later when the patient discovers a pruritic cutaneous eruption of unknown origin (4). Decades ago, bedbugs were frequently found worldwide, but reports of cases in industrialized countries have progressively declined, probably the result of improved living conditions (3). They nonetheless remain a pest in less-developed countries and in the wild (5). The past 10 years have seen the revival of this insect in industrialized countries (3,6,7). Increasing reports describe isolated cases or bedbugs spreading throughout a single building (8). We report an outbreak of healthcare-associated dermatitis caused by bedbugs in a hospital nursing home in Cannes, French Riviera.