Hotels, hospitals, universities, public housing, the military. All are stakeholders in the current bed bug epidemic. And facilities in all these sectors say they are being hit hard.
Meanwhile the professional pest management industry has a singular interest in working to make a difference in the course of this epidemic. But getting a handle on the problem has proven to be more complicated than it appears. A multitude of interrelated factors are at play, and, one expert argues, industry professionals may not know all they need to know to get at the root of this perplexing problem.
Rick Cooper, technical director of Cooper Pest Solutions, Lawrenceville, N.J., shared his five key observations about bed bugs during the opening session of the sold-out BedBug University: North American Summit 2010, held just outside of Chicago in September. More than 360 participants, including entomologists, bed bug experts, pest management professionals, industry suppliers and key stakeholders were in attendance.
Cooper pointed out that while bed bugs don’t transmit disease, they can have a tremendous impact physically, emotionally and financially on those involved. In the last 16 months, for example, he has served as an expert in 24 lawsuits and insurance claims, including cases involving pest management companies for their failure to resolve problems effectively and provide proper advice. Considering these situations and what Cooper has learned over the years, he suggests there are five major factors pest management professionals need to keep in mind, if they’re not already.
1. Infestations are not reported quickly enough.
Bed bug biology and behavior make them difficult to detect, so infestations may go undetected for several months or more. But, said Cooper, early detection is key to keeping control costs low. When undetected, bed bugs have the opportunity to become well established and spread to other environments.
Consider hotels and motels. Bed bugs are secretive, inhabiting areas of least disruption. Typically, they infest the headboard first. And once the headboard is mounted in a hotel room, it’s rarely removed.
"There could be an infestation in the headboard without a single shred of evidence anywhere else," Cooper explained. "Considering that bed linens usually are stripped and changed daily, visible evidence on the mattress is usually an indicator that it’s a well-established infestation."
Bed bugs go undetected for other reasons as well, Cooper said. In early stages of infestations, bed bugs are active at night and their bites are often painless. Victims
and/or medical professionals may not make the connection between bite symptoms and bed bugs. In addition, not everyone reacts to bites, or the reaction may be delayed.
For example, a study by researchers at the University of Sheffield in the United Kingdom showed that 54 percent of the participants did not experience a reaction the first time they were bitten. Almost half — 46 percent — of the participants exhibited delayed reactions of one week or more. Researchers also found that delayed response decreases with repeated exposures to bed bug bites. And in a University of Kentucky study with 474 participants living in known bed bug-infested residences, 30 percent of the occupants reported no bite symptoms.
"When you add it all up — you’re not seeing the bugs, you’re not feeling the bite, you may be having a delayed reaction and bites are often misdiagnosed — you can easily see how this problem can go on for three or four months, or even longer, before you realize you are dealing with a bed bug infestation," Cooper said.
That’s unfortunate, he said, because if detected within the first few weeks — when infestations tend to be localized — PMPs are able to treat bed bugs easily and relatively inexpensively. "When allowed to go undetected, populations will disperse away from sleeping areas and they can be found virtually anywhere — behind pictures hanging, in books, on stuffed animals," said Cooper. "Nothing is off limits."
Cooper said the eggs are the single-most complicating part of the bed bug life cycle when it comes to control. "Females deposit two to five eggs per day that are only about 1 mm in length, so they are tiny and very hard to see unless on a dark surface." Further, said Cooper, the eggs stick to surfaces and can be difficult to remove. Seven to 10 days later, they hatch. "An entire reproducing population can fit into the head of an adjustable wrench," he said.
2. Bed bugs move efficiently between units.
While it’s critical to detect bed bugs early on to prevent their distribution in a dwelling, early detection is even more important in multi-unit settings. "Bed bugs are very efficient at moving between one unit to another — whether it’s an apartment building, a hotel, a hospital or a college dorm," Cooper explained.
Cooper shared a series of slides, courtesy of Stephen Doggett, a well-respected bed bug expert in Australia, that he described as "a classic example in a multi-unit setting of what can happen when you don’t take a proactive approach." Over time, one infestation became four infested units, which then became 12, which then became 38. Finally, experts conducted a facility-wide search, and found 30 more infested rooms.
"This is a great illustration that shows just how efficient bed bugs can be and how effective they are at moving between units," Cooper said. Perhaps even more important is how often infestations went unreported. "Nearly 50 percent of these were not reported by the occupants, and this is university housing for medical staff that should very well be able to report infestations."
Cooper said in his experience with other multi-unit settings, adjacent units are infested as often as 25 percent of the time. Occupants are either unaware that they have a problem or a reported infestation is next to a clearly obvious, yet unreported, infestation. Cooper shared an example of a one such unreported yet severe infestation. "Bed bug eggs were caked an inch deep on the bottom of the box spring," said Cooper. "The pillow they were sleeping on was covered with blood splatter."
Cooper has found that in some cases, occupants are not willing to report the problem because they are engaging in some type of deviant behavior. Perhaps there are unauthorized occupants in the unit or illegal activities are taking place.
In other cases the individuals might have a mental or social handicap and are not capable of recognizing or reporting the problem, Cooper said. "Regardless of the reasons, if you have a severe infestation, it’s going to have huge financial implications, huge legal implications and it’s going to affect a number of residents around you."
3. Reliable detection methods are lacking.
As important as early detection is, says Cooper, there still is no single tool or method that is 100 percent reliable for detecting bed bugs. Visual inspection is limited and is not a reliable method for detecting low-level infestations, Cooper said.
Meanwhile, canine scent detection, when done correctly, said Cooper, can be a tremendous tool that helps offset visual inspection, especially for large-scale inspections such as entire office buildings, hotels, retail locations or college dorms. "There’s no better way," Cooper observed.
However the method also comes with its own caveats, Cooper noted. "Anyone who knows me knows I am a huge advocate of canine scent detection," said Cooper, "but I am really concerned with what I am seeing in this industry." He argued that some canine scent programs may not be well run, turning out canines that create false alerts when there are no bed bugs or don’t confirm the infestation when there is one.
Cooper also discussed the development of new early detection tools — active and passive monitors. Active monitors use lures such as carbon dioxide, heat or chemicals to attract bed bugs, while passive monitors use the human host as the lure to attract and trap bed bugs seeking a blood meal.
"The bottom line is that none of these methods is 100 percent effective, and all too often we see people coming in and clearing a structure as bed bug-free," he said. But, "you can’t do it. You can only say that based on your monitoring and inspection that you were unable to detect them at that time. Low-level infestations can easily go undetected."
4. There’s no silver bullet.
A study conducted by the University of Kentucky demonstrated that 88 percent of 110 field populations tested were resistant to commonly used pesticides. "One thing we know for sure is that resistance exists, it occurs at high levels and it’s very widespread," Cooper said. "Experts would agree that relying on pesticides as the sole method of control is a very dangerous thing to do. We really need to take a multi-faceted approach."
Regardless of methods employed to treat the infestation, short of a structural fumigation where the entire structure is tented and fumigated, it is unlikely that 100 percent of a well-established infestation will be controlled in one visit, Cooper said.
"Follow-up programs are a must," he said. "You should have follow-up programs in place that are based on the biology, the life cycle and the behavior of the bed bugs." Cooper said the follow-ups should occur no more than 10 to 14 days apart initially. "Plus, you can’t just be coming in and doing the same treatments over and over. You need to gear yourself toward eliminating every last bug and every last egg."
5. Cooperation required.
Effective bed bug management requires a high level of cooperation among everyone that is involved. "If it’s a leasing situation like an office or multi-family housing dwelling, the property manager, occupants and a high-quality vendor will all need to work together," he said. "Cooperation will be paramount, especially if the infestation is spread out, and it will help expedite control."
Education should be at the core of any treatment program so all stakeholders understand that bed bugs exist, how to avoid them, how to recognize signs of an infestation and what to do if an infestation is suspected.
An excellent communications system is also essential. Without it, bed bug elimination efforts often break down.
Finally, be sure to keep comprehensive documentation, which Cooper says is the best defense in court. "You need to document that you educated your clients. Even if they don’t follow your recommendations, you have to prove that you educated them about what they should do and they declined to do it," explained Cooper.
Promising Developments. Despite the challenges that bed bug control poses, Cooper said the industry has made significant progress in the last four years.
"The research community is making huge contributions and getting a much better understanding, and that is helping shape management decisions and product development efforts. We’ve seen a tremendous amount of new tools and methods. Plus the pest management industry has gained much needed field experience," Cooper said.
But, he adds, this progress needs to continue, on multiple levels. Along with the development of tools and techniques that are affordable and less labor intensive for the pest management industry, the country needs cost-effective, community-wide approaches. Government assistance will be needed for the poverty-stricken, and consumers will require self-help methods that are both effective and safe.
"We need to stop just reacting to bed bug problems as they are reported and get ahead of the problem," said Cooper. "We need long-term, community-wide, sustainable bed bug management." Cooper said there also needs to be an increased emphasis on basic and applied research. "Thankfully the research community stepped in around 2006, and in the last four years we’ve seen a lot of really good work, but we need to see a lot more."
Finally, Cooper appealed to the participating stakeholders and media outlets to embark on a national bed bug public awareness campaign aimed at prevention and early detection. "If we would have had a massive awareness campaign back in 2003, we would not be facing these problems today," he said. "The situation in New York is the writing on the wall about what is going to take place in city after city after city across the country if we don’t do something about it."
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How the Bed Bug Epidemic Started
A pest that was thought to be eradicated toward the end of World War II through the widespread use of chemicals, bed bugs began creeping back into the United States in the late 1990s with isolated incidents mostly limited to the hospitality industry and typically blamed on the increase in international travel.
Today, bed bugs make daily headlines due to their spread onto university campuses, apartment buildings, single family residences, movie theaters and even retail stores such as New York City’s Niketown, Victoria’s Secret and Abercrombie and Fitch.
"For the last 10 years, we’ve seen an enormous lack of public awareness that’s allowed bed bugs to spread throughout our society," said Rick Cooper, technical director of Cooper Pest Solutions, based Lawrenceville, N.J. "Kids are bringing them into the schools. Parents are bringing them into the workplace. This has become a very widespread and well-established problem," said Cooper. "At Cooper Pest Solutions, we treat two to three office buildings per week in New Jersey alone — and that’s just the ones we service."