Let’s talk about bed bugs. Although once considered an issue of the past, today we find bed bugs thriving throughout the United States and the world. As many as one in five Americans have either had a bed bug infestation or know someone who has (NPMA 2022). In fact, pest management companies receive so many calls for bed bug services that Orkin compiles an annual “Top 50 Bed Bug Cities Report” that ranks cities based on the number of bed bug treatments Orkin technicians performed in a 12-month period.
Large metro areas regularly find their way onto Orkin’s report — which makes sense. The more people there are, the more potential there is for a bed bug infestation to occur, and thus, the more need for bed bug control. However, just because metropolitan areas tend to dominate the list does not mean that smaller, rural communities are exempt from bed bug issues. The truth is, wherever people are, bed bugs can find them.
Perhaps more unsettling than learning the cities with the most bed bugs is finding out the environments where bed bugs truly flourish. The 2018 Professional Pest Management Alliance Bugs Without Borders survey revealed that pest management professionals (PMPs) find bed bugs most frequently in single-family homes, apartments/condos and hotels/motels, respectively (PPMA 2018). In other words, folks discover bed bugs in the places where they would normally go for personal respite, comfort and safety. However, despite what their name might imply, bed bugs infest more environments than just those with beds. Commercial buildings such as schools, libraries, emergency departments and office buildings also are susceptible to attack.
The fact that bed bugs live where humans are most comfortable and feed on unsuspecting people at rest may cause a person unfamiliar with bed bugs to feel like there is no safe place to hide from this pest. Many individuals also may feel like they are powerless to eradicate bed bugs once they have invaded. For these reasons and more, bed bug infestations can negatively impact individuals, communities and organizations.
The ramifications of an infestation may have physical, mental, social, financial, unintentional and/or legal impacts. However, when working with bed bugs every day, a professional can easily forget how deeply and profoundly this bug affects so many people. As a refresher, this article is one in a two-part series (editor’s note: part two will be in the December 2022 issue) that will outline the many different impacts of bed bugs on humans and will reinforce the importance of managing this pest to protect public health. To begin, this article will outline the direct negative impacts bed bugs may have on an individual person.
PHYSICAL IMPACTS. Bed bugs physically impact people when they bite a person to drink blood. The bite alone punctures the skin and, in some instances, feels uncomfortable. However, the bites also can result in a variety of additional physical reactions. One survey of people living in a building with a known bed bug infestation found that 70 percent of respondents had some kind of skin reaction (Potter, F., et al. 2010). Skin reactions can vary from small red marks to large, very itchy bumps. These reactions also can cause people to scratch, which can lead to the introduction of bacteria and subsequent secondary skin infections (EPA 2022).
The physical impacts can extend beyond skin reactions too. Some people can have systemic reactions such as asthma, welts and (more rarely) anaphylaxis (Goddard, J. and R. deShazo. 2009). Additionally, people living in environments with large infestations can experience anemia caused by blood loss from the massive amount of bed bugs taking bloodmeals. Health care- associated infections (also known as nosocomial infections) can occur when a person contracts an infection after exposure to bed bugs during medical treatment. Loss of sleep and stress also can take a toll on a person’s physical well-being. Finally, even though bed bugs are not known to spread any pathogens, research has shown they do have the potential to do so.
Mental Health Impacts. People can suffer from mental health impacts during and after a bed bug infestation as well. Humans build shelters to protect against many outside threats, including other arthropods such as flies, ticks, mosquitoes and fleas. And while these critters do make their way into buildings meant for our protection sometimes, bed bugs (unlike many other pests) depend on humans for their survival. They stay in our homes, live in our beds and drink our blood without our consent. This reality can leave a person feeling violated by this pest.
Has a customer ever expressed feeling queasy or itchy when discussing bed bugs? That physical feeling when thinking about bed bugs illustrates something powerful: Simply thinking about bed bugs can cause an emotional stress reaction. That emotional reaction is just one very small mental health impact that bed bugs have on people. Unfortunately, persons encountering bed bug infestations can develop several, very severe mental health consequences. Researchers have documented people experiencing stress, anxiety, depression, worsening of pre-existing conditions, thoughts or attempts of suicide and suicide related to bed bugs (Ashcroft, R., et al. 2015).
Worse yet, long after the physical symptoms of a bed bug infestation have subsided, the mental health impacts can remain. The Mayo Clinic describes post-traumatic stress disorder (PTSD) as a mental health condition characterized by intense negative emotions and trouble coping months to years after a traumatic incident (TMC 2018). So by definition, PTSD caused from a bed bug encounter is a long-term, negative health outcome. Environments where a person has experienced bed bugs in the past can trigger sudden, intense emotions that leave the person disoriented and anxious. Even in environments where a person has no previous association with bed bugs, individuals with a history of bed bug exposure have reported experiencing insomnia and anxiety.
Social Impacts. Human beings live in complex social environments made up of family, friends, acquaintances and strangers. When a person does not get enough of/or the right kind of socialization, they can experience loneliness and social isolation, which the Centers for Disease Control and Prevention (CDC) recognizes as a serious public health risk (CDC 2021). Isolation and loneliness can make a person feel sad, depressed and/or shameful. Additionally, those experiencing loneliness and social isolation have increased risk of premature death, dementia, heart disease, stroke and other mental health consequences (CDC 2021).
The impacts a customer experiences living with a bed bug infestation on a daily basis can feel overwhelming and exhausting. The EPA has officially declared bed bugs a public health issue.
Unfortunately, those dealing with a bed bug infestation may experience loneliness, stigma and social isolation (Ashcroft, R., et al. 2015). Elderly people living alone or in nursing homes with a history of bed bugs may have family and friends that are unwilling to visit them. People of all ages may feel shame from having bed bugs and experience stigma from those within their communities. Bullies may tease and torment children living with an infestation. All of these effects can result in individuals feeling isolated and lacking the love and support they need, which can result in detrimental effects on mental and physical health.
Final Thoughts. Some may view bed bugs as just another urban pest — a creepy crawly that has invaded a home and requires eradication. However, the impacts a customer experiences living with an infestation on a daily basis can feel overwhelming and exhausting. The EPA has officially declared bed bugs a public health issue (EPA 2022), and the agency released a joint statement with the CDC emphasizing some of the consequences associated with Cimex lectularius (bed bugs) (CDC, EPA. 2010). Given this reality, killing bed bugs is more than just pest control, it is a service that protects public health.
Because bed bugs have such a multifaceted effect on people, communities and organizations, a single article could not adequately cover every complex issue. However, the effects of infestations listed previously highlight some of the intense and personal consequences bed bugs have on individual people. Thus, the discussion here is not meant to be exhaustive. However, one thing is abundantly clear from the research and personal experiences cited: Bed bug control protects people and public health, and it alleviates human suffering. Without the hard work and dedication from PMPs, even more people would feel the grossly negative impacts resulting from this pest.