QUESTION:

I have a client who, along with his wife and child, have been feeling they were being bitten, causing severe itching for about a week now. They have no visible signs of bites and the itching is not localized to any particular portion of their bodies. On inspection of the apartment I found no fleas or bed bugs. They have recently started using the heat so I wondered about this. I'm leaning toward scabies mites or an over-sensitive client. What else could cause this? Any ideas would be appreciated.

ANSWER:

Well, if I use my handy fingers I can list the possibilities here. First, there could be nothing present that is related to bugs that could "bite" them or cause some other skin annoyance, and this might well be their imagination (also known as Delusory Parasitosis). Second, there could be some small arthopod such as mites that could be either biting them or causing skin sensitization. Third, there could be some non-arthropod cause to all of this, such as an allergic response to something in the home. However, your role in this needs to remain confined to #2, and your license for pest management permits you only to identify the presence (or lack of presence) of some arthropod pest that you then can deal with as needed. While Scabies is a skin condition caused by mites, YOU have nothing to do with either verifying the presence of scabies or even treating the home in any way if a doctor has properly identified scabies. (Unfortunately I personally believe doctors too often mis-diagnose scabies on people).

You should continue to place monitoring traps throughout the home to capture any arthropods that could possibly be present - rat or bird mites, springtails, psocids, fleas, dust mites, etc. - and have those monitors inspected under high magnification by someone who can properly identify any arthropods captured. You might be surprised and find that there are some tiny mites capable of biting wandering in the home. You might find other non-biting mites or insects that could simply be causing allergic responses, perhaps on one person and the others start "feeling" the crawling and prickling too. However, try to avoid becoming a psychologist by suggesting that it may be their imagination, and definitely don't tell them they are crazy. If your best efforts at capturing any kind of arthropod that might be causing skin problems fails to turn up anything you could suggest to them they hire an industrial hygienist to sample the air. Certainly a change in the environment around them, such as suddenly beginning to use heaters again, could discharge materials into the air that might cause skin sensitivities.

The process is to begin with the easiest solutions and work through the list, and the easiest and probably least expensive for them is for you to rule out (or confirm) the presence of any kinds of "bugs". Perhaps it is only allergic responses due to the presence of dust mites, lady bugs, or other insects and arthropods that are within the home, and now that the home is more closed and confined with cold weather these allergens could be causing the problems. However, you should not assume there might be bugs and just go ahead and "spray something" and hope for the best. Instead, avoid applying any kinds of pesticides if you have not confirmed a reason to do so.

The mind can do amazing things. Since all family members seem to be experiencing the same sensations it would suggest that something is present that is affecting them all. But, it's not unusual for one person in a home or an office to feel that something is biting them or crawling on them and pretty soon everyone else is itching and scratching too, purely because they think something must be there. On the other hand, maybe they all are exposed to some new household product or cosmetic or soap, and are feeling the effects of it. So, stick with your role, which is pest management and the identification of any pests that are truly there. If there are none suggest other options for sampling the home environment or visiting a dermatologist to see if non-arthropod causes can be found.

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