[Bed Bugs] A Bed Bug State Of Mind

If you have a pulse and work in the pest control industry, you know that bed bugs are back­­­­­ — big-time. Seemingly arising from nowhere, this scourge from the past is wreaking havoc on a new generation of PCOs and their customers. Especially common in hotels and apartments, bed bugs are also appearing in single-family residences, health care and assisted living centers, college dormitories, churches, hostels, laundries and various modes of transport.

Excellent information on bed bugs is provided in the latest edition of the Mallis Handbook of Pest Control and recent articles in industry trade magazines (see references at the end of the article). The intent of this article is to keep the information flowing, and examine some emerging issues in bed bug management.

THE PERFECT STORM. Today’s bed bug infestations are like the “perfect storm” of pest control. People of this generation are not accustomed to being bitten by bloodsucking parasites while they are sleeping. Infestations occur in the most intimate places like bedrooms, beds, couches and closets, where the pest control industry seldom has needed to spray or service. Our arsenal of effective bed bug products is dangerously depleted — and of the insecticides we do have (mainly pyrethroids) — the forecast for the bugs developing resistance is worrisome. Another big concern is the specter of litigation. When you were bitten by bed bugs years ago, it was just another of life’s annoyances. People’s tolerance for bed bug bites today is zero and they just might decide to sue you.

WHY THE RESURGENCE? Theories abound as to why bed bugs have made such a sudden comeback in the United States. International travel is often mentioned and surely is a contributing factor. Yet people have been traveling to and from this country for years, and this alone does not explain the rapid increase in such a brief time. Along with business and recreational travel, immigration from Asia, Africa, Europe, and Central America/Mexico has been hugely important in the spread of bed bugs to this country (the Hispanic population in Kentucky, for example, has increased three-fold in the last decade). Bed bugs have long been common in other areas of the world, and populations presumably have been increasing since the loss of DDT and other highly effective insecticides. Immigrants to new lands also tend to congregate and share the necessities of life, including mattresses and other furnishings.

Changes in pest control practices may be another factor contributing to the resurgence. Traditional baseboard spraying probably made it harder for bed bugs to become established in places like apartments, which often were serviced in this manner. This does not explain the upsurge in hotels, motels and college dormitories, where rooms seldom were preventively treated. Whatever the reason(s) for the resurgence, it’s worth remembering that bed bugs never completely vanished from this country. Surveys of pest control firms indicate that limited infestations were encountered over the years in a hostel here and a hotel there.
 
THE BUG NOBODY KNOWS. Bed bugs were once called “the bug that nobody knows” because they were an embarrassment. The same is true today and most clients simply do not want to talk about them. Understandably, the hospitality and housing industries are apprehensive, fearing adverse publicity and reprisal. Would you stay in a hotel or lease an apartment if you knew it had bed bugs? Suppose your child’s college dorm was infested and they were coming home for the holidays. Today’s bed bug infestations raise complex questions about the public’s “right to know” of potentially harmful conditions. “You mean your establishment had bed bugs and you didn’t bother to tell me?” For businesses, these are not such easy decisions.

The hesitancy to report bed bugs­­­­­ — and a lack of public awareness­­­­­ — are further helping to spread infestations. Like cockroaches, bed bugs travel freely between living units and can be transported building-wide by human activity. Accessing all rooms, especially near those that are infested, is crucial. In doing so, PCOs should be sensitive to the challenges this presents to management. Notifying tenants or guests of a bed bug infestation can be a property manager’s worst nightmare.

PROPER DIAGNOSIS. Correct diagnosis of a bed bug problem is crucial. Older established infestations are rather easy to confirm, but in the early stages can be much more subtle. Many things other than bed bugs can produce itchy welts on a person’s body. Confirmation requires finding a bug, shed skin, fecal spotting, etc. Knowing where to look is essential, but a bright flashlight and good quality hand lens will help you distinguish tiny eggs, nymphs and shed skins from other bits of debris.

Do not rely on the client to show you the bed bugs­­­­­ — oftentimes, people are bitten repeatedly for months but because the bugs are mainly nocturnal never see an insect. Glueboards and sticky traps are also unreliable indicators of infestation. Poor capture efficiency may be related to the bug’s flattened body and tendency to crawl under rather than over the edge of the trap. Since warmth attracts bed bugs, some companies are experimenting with heating pads with or without glueboards placed beside the bed at floor level. Bed bug odor is another characteristic that should not be relied upon. While heavy infestations are sometimes accompanied by a “buggy” or sweetish odor, such smells are often not apparent.

Another hindrance to early detection is that medical personnel are not in a “bed bug state of mind.” Bed bugs are not yet on the “radar screen” of most health care providers, including some dermatologists. Recently, for example, a young child was sent home because the school nurse said she had chicken pox. Two different dermatologists subsequently examined her. One thought she had fleabites even though no pet was involved and the welts were all over her body (fleas tend to bite legs and ankles). The other dermatologist’s diagnosis was scabies and despite a negative skin scraping, put the entire family on scabies medication. Neither of the doctors bothered to ask if the family had been traveling, or had acquired a used bed, couch, etc. They had, in fact, received two beds donated by their church just before the welts started appearing­­­­­ — both infested with bed bugs. Similar errors by medical personnel have been related by other pest management professionals.

Obviously, there is work to be done educating health care providers, schools, etc., about the resurgence of bed bugs. Since it is difficult to diagnose any type of “bug bite” by merely examining the patient, pest management professionals will play a key role in confirming infestations. When interviewing clients, remember to ask if they have been traveling or acquired used beds or furnishings before symptoms started to appear. Bed bugs are also suspect if they woke up with bites they did not have when they went to sleep. As people become more aware of this pest, all manner of welts, itches and irritations will be attributed to bed bugs when often it will be other factors. This will require us to be better diagnosticians.

CLIENT EDUCATION/PREPARATION. No pest has a greater need for client education than bed bugs. Many questions will be asked of sales inspectors and technicians, so it’s useful to have materials available for clients to read. Your Guide to Bed Bugs: Understanding and Control (PCT, August 2004), was created for this purpose, and other excellent materials are available through the National Pest Management Association and various suppliers.
Some companies also provide printed instructions in English and Spanish for client preparation. Typical instructions include laundering of bed linens and leaving mattresses uncovered, removing clothing and clutter from floors (including under beds), and moving furnishings 2 to 3 feet away from walls. Clutter is a particular problem in homes and apartments, obstructing treatment and affording additional places for bed bugs to hide. While some companies want beds disassembled or disposed of before they arrive for treatment, others prefer to do this themselves to minimize disturbance and possible spread of infestations.

It is often impractical to expect customers to launder all of their belongings — not to mention bagging them in plastic for several days or weeks. Items in drawers and closets might be harboring bed bugs, but bedding and clothing piled on floors should be a priority. Another option, especially with items that cannot be laundered (e.g., children’s stuffed animals), is to heat them in a clothes dryer for several minutes. Targeted vacuuming by pest control firms can be useful in bed bug management. Vacuuming by clients is generally less effective since most of the bugs will be hidden.

TREATMENT CONSIDERATIONS. Bed bug treatments must be thorough to be effective. The manner of being thorough can vary with the company. Some firms spend a great deal of time inspecting and treating where bed bugs are found. Beds are stripped, furniture is flipped, dressers are emptied, and household articles are closely examined in an effort to find and treat every bed bug. Other companies inspect less and treat more, rationalize that the bugs can be hiding almost anywhere. Gradations of both approaches are also being utilized depending on the type of account, job price, etc. What seems to be important — especially with today’s insecticides — is to treat all areas where bed bugs are likely to crawl or hide.

During inspections, it is important to “think like a bed bug.” Bed bugs are efficient blood feeders and are most likely to be found near their next meal­­­­­ — a sleeping human. Begin with the bed (mattress, box spring, frame, headboard) and other nearby locations such as items stored underneath, along and beneath the carpet edge, night stands, curtains and wall hangings. Like cockroaches, bed bugs prefer cracks, crevices, seams, tufts and edges. They also prefer wood, fabric and paper to cooler, less porous substrates like metal and plastic.

Nonetheless, aggregations of bed bugs can be found almost anywhere and with time, often extend beyond bedrooms. Living room sofas and chairs, for example, can be major bed bug hotspots, especially when used for sleeping. Missing these areas can result in further callbacks. Because bed bugs are so mobile, it is also important to inspect and oftentimes treat adjoining rooms.

When doing bed bug work, it’s often better to work in teams. If this is not possible, there should at least be someone available onsite to help dismantle beds and move heavy furniture. Disposable gloves are prudent when handling soiled bedding, and technicians should be mindful when reaching under cushions and into dark places where hypodermic needles and other hazards may be lurking. Workers also have legitimate concerns about bringing bed bugs home with them or to the office. Bed bugs will not jump on a person like fleas, and during the daytime, tend to be immobile. They will however become more active when treated with insecticides. Be careful when moving mattresses and box springs. Rubbing against these can dislodge bed bugs onto your uniform. For added peace of mind, some companies provide washing machines and clean uniforms before employees head home. During inspection and treatment, it is also prudent to keep jackets and other equipment elevated off floors.

Bed bug work is not for everyone. It is tedious, communication-intensive, and for some employees unnerving. Some companies have dedicated bed bug technicians while others train all their people but have certain ones who are leaders.

WHAT ABOUT BEDS? A common issue in bed bug management is what to do with the bed. Beds offer perfect harborage in the immediate vicinity of the host. While frames and headboards are rather easy to service, mattresses and box springs are not and are often main reservoirs of infestation. If there are holes and tears in the fabric, bugs and eggs may be inside as well as outside.

This is especially true of box springs, which have plenty of places for bed bugs to enter and hide. Some companies insist that all infested beds be discarded or fumigated, whereas others advise against getting rid of beds, rationalizing that a new one will also become infested if the infestation has not yet been eliminated. Oftentimes such decisions are based on the condition of the bed, severity of infestation and nature of the client. Hotels, for example, may want to discard anything that is potentially infested whereas renters on a budget may not.

Whether the bed stays or goes, encasing both the mattress and box spring is helpful if bugs are still present. Zippered encasements­­­­­ — available at bedding and allergy supply stores­­­­­ — deny bed bugs access to inner, hidden areas and entrap any bed bugs already inside.

Years ago, companies routinely treated both sides of the mattress, pillows, box spring and bed frame with all manner of insecticides. Treatment of the bed was deemed essential, and DDT was so effective that other areas of rooms were sometimes left untreated. The rationale was that bed bugs coming to the bed for a blood meal were killed when they contacted the long-lasting, non-repellent DDT residues on the fabric. Today’s decision to treat beds with insecticides varies by company. Some firms will not treat beds (especially mattresses) at all, even though application of some products is legal. Toxic tort litigation involving pesticides is an ongoing concern for the industry. On the other hand, companies may be more likely to face trouble if they do not control the bed bugs.

If insecticides are used on beds, it is prudent to use products with clear, permissible wording on the label. Residual insecticides such as Suspend SC and D-Force HPX (deltamethrin), Permacide (permethrin), Drione and Tri-Die (silica gel with pyrethrins), and NIC 325 (limestone) are labeled for treating both mattresses and box springs. Pyrethrum products and Steri-Fab, (a disinfectant-sanitizer-insecticide containing alcohol and d-phenothrin), can likewise be used to treat beds but kill mainly upon contact. Applications would need to be repeated since they afford no residual protection against hatching eggs or bed bugs appearing later. Other products are also labeled for bed bugs, but are less lenient relative to treatment of beds. Demand CS, an effective and widely used insecticide, can be applied to the box spring and areas around the bed, but not the mattress or furniture surfaces where people will be laying or sitting. Just because a product lists bed bugs on its label does not mean it is particularly useful or effective. Further evaluation of all bed bug insecticides is needed so that PCOs know what to expect for their efforts.

When spraying bed seams, tufts and edges, companies may want to use smaller equipment akin to a hand-held plant mister. When it comes to pesticides, perception trumps reality; smaller, less-obtrusive application devices are less likely to trigger client concerns. Dust insecticides may be less suited for mattress application, but can be useful for treating the underside of box springs and couches once the lower cover is pierced or removed. Dusts can also be effective behind electrical plates and beneath carpet edges and baseboards. For routine bed bug work, some firms are finding it efficient to use the same low-pressure electric dusters used for German cockroach control.

Vacuums and steamers are also being used to de-infest mattresses without using insecticides. While some firms find the devices effective, they are tedious and afford no residual protection of the bed or sleeping host. Vacuuming also poses a risk of transporting bed bugs back to the office. These are hardier insects than cockroaches and more difficult to “account for” once pulled into the suction wand. Customers who vacuum may be even more likely to spread bed bugs by forgetting to throw out the vacuum bag.

If beds are to be discarded, it is important to wrap them in plastic before carrying them outdoors. Otherwise, bed bugs may dislodge during transport and spread to other areas. (It’s hard enough to maneuver a mattress through doorways, not to mention down stairs.) Defacing discarded beds and couches makes them less appealing to those who scavenge Dumpsters and helps limit the spread of infestations.

PREVENTING INFESTATIONS. As customers become aware of the growing bed bug problem, many will wonder what can be done to prevent infestation. Clients should be cautioned about acquiring secondhand beds and furnishings. Curbside items should definitely be avoided, and rent-to-own items, especially beds and couches, should be examined closely before being brought into the home. Such establishments are increasingly being implicated in bed bug infestations.

For customers who travel, it would be helpful to show them how to check their bed for signs of bed bugs — a common precaution years ago. If detected, they can at least request another room. Travelers may also want to elevate their luggage off the floor. Recommendations to check luggage upon arriving home are less useful since it is hard to detect bed bugs inside a suitcase. Routine vacuuming and washing of bedding are also unlikely to prevent bed bugs from becoming established. Educating everyday customers about bed bugs is a value-added service that reinforces our role as protectors of public health.

Preventing bed bug infestation is especially challenging in hotels, motels and apartments because occupants and their belongings are constantly changing. Rooms can be free of bed bugs one day but infested the next. Establishments will benefit from having an ongoing surveillance program and a housekeeping staff that knows what to look for (bugs, shed skins, fecal and blood spots, etc.). Since the hospitality industry has tremendous turnover, pest management professionals can offer such training, if not perform the inspections themselves. Clients who previously battled bed bugs may insist upon even more aggressive measures to prevent recurrences — including preventive baseboard spraying. This may pose an ethical dilemma for companies who have been weaning their customers off such treatments for years.

THE FUTURE. Don’t expect bed bugs to subside any time soon. If the past two to three years are any indication, infestations should continue to multiply like mushrooms and spread like spores in the wind. In time, we will become better bed bug killers, yet people’s intolerance of the pest will pose many challenges. So will apprehensions about applying pesticides in the very places in which they are needed. Perhaps the future of bed bug management will be most affected by new “ammo” in the chemical arsenal — as it once was by the availability of DDT. A 21st century version may be just what the doctor ordered…

All photos are courtesy of M.F. Potter

The author is a professor and urban extension entomologist at the University of Kentucky. He can be reached at mpotter@giemedia.com.

References
Cooper, R., and H. Harlan. 2004. Bed bugs & Kissing Bugs. pp. 494-529. In: Handbook of Pest Control 9th ed. GIE Media Inc., Cleveland, Ohio.
Gooch, H., 2005. Hidden profits: there’s money to be made from bed bugs – if you know where to look. Pest Control. 73(3): 26-32.
Kramer, R.D. 2004. Closing in on bed bugs. Pest Control Technology. 32(11) 62-64, 66-68.
Potter, M.F. 2004. Your guide to bed bugs: understanding and control. Pest Control Technology. 32(8). 6 pp.