Dear Pennypacker Resident:

After reading the Crimson opinion piece from October 22, 2007, “I’ve
Got an Itch”, it seems worthwhile to review where things stand after
the incidents of skin complaints two weekends ago at Pennypacker.

At that time, three individuals came to university health services
(UHS) with similar symptoms. After being evaluated by a physician at
After Hours Urgent Care, the possibility of scabies was considered.
Discussion with proctors at Pennypacker revealed that there were at
least 5 or 6 students at Pennypacker with itching skin and rash, though
only three of them wished to be examined.

Given the symptoms, also under consideration was the possibility of bed
bugs, though the skin findings were not classic for this diagnosis. A
scraping from the skin of one student was done to look for mites, but
these were not seen. It’s important to note the presence of mites on a
skin scraping absolutely confirms the diagnosis of scabies; if they are
absent, though, the diagnosis is not excluded. Frequently, the
diagnosis of scabies is difficult to make, and it takes several
examinations of a patient over time before other possibilities are
excluded. This is because the rash associated with scabies can be
fairly non-specific, and the “burrows” are often not seen.

But the three students’ rashes had cleared up within three days, leading an entomologist to speculate that scabies was not to blame:

Four days later, Dr. Michael Alpert, an entomologist from the Harvard School of
Public Health came to Pennypacker and talked to three symptomatic
individuals and concluded that scabies was unlikely, given the rapid
clearing. He speculated that the causative bug could have been
mosquitoes, though he never saw the bites when they were present. The
physician who did see the bites, said that the appearance of the bites
was not consistent with mosquitoes, and that their locations on the skin
was more consistent with scabies. As is frequently the case with rashes,
the simple symptoms can lead to a variety of diagnosis, and it
is often difficult to tell, in the absence of definitive testing, which
one is correct.

This memo above to students was from Doctors Sohayla Gharib and Gregory Johnson of the Harvard University Health Service, who also had this to say,

If the diagnosis was not scabies, it is
possible that there was another insect involved, though it does not
appear to be bedbugs (because there are no ongoing symptoms and there
was no evidence for bed bugs when the pest control team evaluated the
dormitory), nor appear to be mosquitoes. Whatever the ultimate source,
it is now eradicated from Pennypacker thanks to your response and
cooperation.

Let’s all hope that Pennypacker is itch-free for some time to come.

Get the full story from IvyGate.

Also, here’s a Columbia University gossip blog, BWOG (put out by writers from the student magazine) alleging bed bugs are in Schapiro 12 (student housing at Columbia University):

According to Bwog,

Now that a few students have been bitten severely, Housing has finally admitted that there are bedbugs. Two rooms have been fumigated, one of them twice. Unfortunately, Housing still refuses to clean the hallway and carpet even though bedbugs can easily travel from one room to another. Housing, you’ve really let yourself go on this one…

• Johns Hopkins suggests SCRATCH method for diagnosing insect bites in kids
• Bed bugs at the College of New Jersey
• teaching doctors to diagnose bed bug bites
• FAQ: What are bed bugs? Do I have them? What else could be causing this?

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Although you may feel the bites begin to itch any time during your day, and even days after you are bitten, you probably don’t feel them when they actually occur. So if you feel you are being bitten, don’t assume there are bed bugs in that space.

The feeling of bugs crawling on your skin is technically called formication, and we don’t fully understand it, but it may be caused by your allergy to bed bugs, or by bites already received (which often don’t itch until hours or even days after you’re bitten). It can sometimes be caused by delusional parasitosis (and this can even happen to people who have suffered from bed bugs in the past.)

As our FAQ (”What else could be causing this?”) states,

This American Entomologist article by Nancy C. Hinkle is entitled “Delusory Parasitosis” (click here to load a PDF), and it outlines how very real environmental, physical, and other conditions can cause similar symptoms to a bed bug infestation, including itching, crawling sensations (formication), skin conditions and rashes.

But in most cases, where bed bugs are still living in your environment, I believe formication is felt by Bedbuggers because we are reacting to something real. However, it was important for me to realize that this creepy crawly itchy feeling does not mean there is anything actually crawling on me at that moment (at least there wasn’t the 100 or so times i looked.)

To ensure that you truly are not being bitten all day long, even outside of your home, you might want to keep your washed clothes in sealed bags, and shower and change into clean clothes from a sealed bag when you go out (to avoid spreading bugs). Keep shoes and bags in a sealed place too. Frequent showers and/or hot showers can dry your skin and make itching worse. Use a moisturizer like Cetaphil or Aveeno or another that does not contain perfumes or dyes, to make sure your skin isn’t dry, which can make things worse.

Bed bugs excrete a substance that makes you NOT notice being bitten, and they’re also lightweight, adept travelers, and so you should not feel them crawling or biting. the itching might come soon after or much later. It may be worse in the hours after a shower, or if you’re in a warm room. S did some bite tests and reported feeling the crawling feeling as the bed bug walked away after its meal (and only after). However, most people glance at their skin when they feel formication, as I did, and see nothing. Most people check tens or hundreds of times. So I feel pretty safe saying most people don’t feel a bed bug biting them or waddling away. In fact, S is the first person I have heard this from, and she only reported this when she was purposefully being bitten and in full knowledge of when it occurred.

And try very hard not to scratch bed bug bites. This can take a huge act of will, but if you do it, you will itch less. A scratched bed bug bite itches more and longer.

• Itchy and scratchy? This might help.
• FAQ: What are bed bugs? Do I have them? What else could be causing this?
• FAQ: Are bedbugs a health issue?
• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 2)

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We have some news. It’s not earth-shattering, and it’s not bad, but it’s pretty interesting.

Saturday night, we looked at George’s arms and found bumps. There were two bumps in the spot where he was bitten by the adult. He said, “Oh yeah, I think it stopped and restarted biting at one point.” One bite was a little larger than the other.

Then we checked the arm with the nymph, and there was a bump there too.

His bites do not itch. He thinks they might have shown up a couple days ago, but he barely noticed them because they don’t itch at all. They look like pimples. Non-itchy pimples.

Throughout our bedbug ordeal, I remembered noticing pimples on his back. But nothing ever itched him, and I always assumed he just had some pimples on his back. Now, of course, I am wondering if they were bites. Non-itchy bites.

Interestingly, George’s two adult bites are of different sizes. The adult started biting him, for about ten seconds, before he moved his arm slightly and the bug stopped biting (it actually flipped onto its back, it was so weird - I have heard of bedbugs “playing dead” and perhaps that was this response). Anyway, then it righted itself, and went back to biting, in what we thought was the same spot. I guess it was actually half an inch over.

Today, if we look at his smaller adult bite, and his nymph bite on the other arm, they look pretty much identical in terms of size and color. His larger adult bite was where the bug spent the majority of its time. This leads me to believe that the length of time the bug spends is as important, if not more important, than the size of the bug itself.

—

Meanwhile, the flaming skin around my adult bite is taking up much more space on my arm, than the skin around my nymph bite. The centers of the bites look the same - a little hard whitish-clear bump - but the itchy skin around them is definitely different for nymph versus adult.

S’s bites on day 5

My overall finding is that while my two bites started out the same, and looked & felt exactly the same for about two days, the adult bite remained swelled over a larger surface area than the nymph bite, for the following three days. So I do believe there is a difference, though in my case, it appeared over time.

• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 3)
• Lou Sorkin: bitten on the hand by 30 bed bug nymphs and 2 adult bed bugs
• World exclusive: Bedbuggers experiment with being bitten, on purpose!
• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 2)

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————————————————————————

By 3 pm on the second day, the two bites were fully swelled and majorly itchy.

Waaaaaay itchier than the “bites” I’ve been feeling for the past two months. This is definitely making me doubt myself, in the weirdest way - was it all a joke? It’s hard to pin down exactly when my “really itchy” bites stopped and my “less itchy” bites began, but it was probably at least two months ago. Were the past two months all “phantom bites?”

I don’t know the answer to this. For example, there was one time back in January when I saw a nymph run across my hand. I looked down because I felt a hot itch on my knuckle, and then I saw the bug. So I’d say that was a “confirmed bite.” That bite itched, for sure, but not like these. It swelled up for about two days, and then it faded to a small pink non-itchy bump on my knuckle.

Perhaps that bug was interrupted halfway through its bite, and that’s why the bite never got huge. Or perhaps different locations on the body elicit different bite responses. Last year, when we first had bedbugs (for about two weeks in April 06) I had bites all up the inside of my arm, in similar locations to these new test bites. And those were just as big and itchy as these. So maybe the inside of your forearm is just a particularly sensitive, reactive location, and your knuckle, not so much.

Either way, these bites are raging. They itch all day and night. There is definitely a difference. I know you guys know. It’s the kind of itch where you want to chew your own arm off.

By 11 am on the third day, I’d say the adult bite is slightly larger.

But the nymph bite is still far larger than any of my recent “bites.” All the skin around the adult bite is pink, in like a 2-inch circle. They are both swelled like crazy, and they both itch like mad. It makes me wonder, does the bites’ proximity to each other make a difference? I am not about to go back for another Bite Fest, but the new questions I’d love to answer are:

1. Does the length of time the bug takes, make a difference? What if it only feeds for say, 5 or 10 seconds?

2. Does the location on the body make a difference?

3. Does bites’ proximity to each other make a difference?

I know this sounds like a long shot, but the only way I could see that I’m still getting actual, new bites, is if bedbugs (adult or nymph) are biting me for like five seconds, on “tough” parts of my body, and not near each other. I guess they could be biting me for five seconds while I sit on the couch, but I don’t feel like my face and neck are “tougher” than my inner arm.

And still, zero reaction to the cast skin. I’m continuing to monitor that arm as well as the rest of my body. So far, incidentally, nothing on the rest of my body either.

So my initial conclusion is that while I’m NOT hypersensitive to chitin, I’m also NOT currently being bit by bedbugs. What is my skin doing? I have no freaking idea. But hey. As long as it’s not new bedbugs, I’m fine.

Last night, for the first time in four months, I experienced a brief moment - maybe ten seconds - where I actually accepted that this might be over. I was putting my bag into a ziploc as I came in the door, and I pictured not doing that. The feeling went away, sadly, almost right away! But this feeling rushed over me that for the first time, I actually believed that this might indeed be over.

Baby steps.

These are the marks S has gotten on her skin for the last 2-3 months before Bitefest began. She now thinks they were “bites” (in our parlance here at bedbugger.com, “bites” are marks someone is not sure are actual bites from a bed bug).

Editor’s note from Nobugsonme:

I actually started composing S a long email on Wednesday, posing just some of those questions she notes above. And I did not send it–deciding to wait and comment after the last installment. While I hope very much that S is bed bug-free, I do want us to be skeptical about the conclusions that can be drawn from this limited experiment.

What I think S and G proved was this:

(a) G can be bitten and not react (at least for three days), and

(b) S reacts the same to nymph and adult bites (at least on her arm), and

(c) Nymph bites and adult bites, at least sometimes, look the same.

I know my conclusions will seem stingy to many, but if we want solid information, we need more research to be done.

Remember, S said a few weeks ago she wants to keep people from getting caught up in “groupthink,” the sharing of incorrect information among members of a group until everyone believes it? One fact that was becoming gospel among many bed bug sufferers around the internet was that nymph bites are small and adult bites are large. I was always skeptical of this idea, since we just did not have any proof. I am immensely grateful that S tested and shattered that belief. Doesn’t mean they can’t be different sizes in different circumstances, mind you, but on S’s arm, this week, they were not. That’s quite a nugget of information.

As S says above, “…perhaps different locations on the body elicit different bite responses.” In my own experience, I know this to be true. I have not undergone testing, but I am fairly certain. Bites on my face always looked the same: less swollen, looking like pimples but with a distinct bedbuggy itchiness that set them apart. Nevertheless, they never itched like bites on my back, shoulders, or elsewhere. They often faded quickly. Those on my toes were always tiny, but again, charactertistically itchy.

It’s possible that length of time you were bitten may matter, that distance between bites may matter (both possibilities S also posits), that even variables such as your own immune system, the degree of histamine reaction at that time or to that bug’s saliva, even how dry your skin is, or how much water you drank in the day, all of this may be a variable. I am sure there are other factors that are possible. My point is, we don’t know: this is the tip of the iceberg.

I think S is probably bed bug free as she suggests. I just don’t think she can rule out that the other marks in the composite photo were from bed bugs. Both possibilities can co-exist at the same time, in the form of bugs who just hadn’t crossed the poison yet when they bit her–they could now be dead, though they bit her. That’s my hypothesis, but we won’t get to test it. Let’s hope all S’s and G’s only future bed bug bites, if any, are by choice– “from a can,” if you will.

Thanks again to S. and G for sharing this amazing experience, and for the nugget of wisdom we’ve gotten from it.
Thanks also to our readers, for coming back to parts two and three!

• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 4)
• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 2)
• World exclusive: Bedbuggers experiment with being bitten, on purpose!
• FAQ: Bed bugs are crawling on me all the time. I am being bitten all day long, no matter where I go!

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I must confess, I thought S and G were mad when they decided to beg their PCO/entomologist friend to let them be bitten by bed bugs. He must have too: he made them sign a waiver, but he let them experiment.

I am really amazed at the story you’re about to read, and while I think it’s a bit crazy, it also provides a certain kind of scientific evidence that has been lacking. Look, this is not a controlled research study, and research needs to be done in order to draw any major conclusions. If we know one thing about bed bugs, it’s that we don’t all react the same to bites, which can look different, feel different, and take longer to appear (or, in fact, never appear) depending on who is bitten.

S and G each wanted to know if they would react differently to adults vs. nymphs, whether G would react at all, since he assumed he wasn’t being bitten at home, and whether S would react to having a dead bed bug on her skin. What I do think is safe to say is that S and G learned something very interesting about they way they react to bed bugs. It may or may not correspond to your experience, but it probably does mirror lots of peoples’ experiences.

For some background on bed bug bites, here’s an article from last October about doctors (not) diagnosing them, which links to a number of photos of bed bug bites that do, and don’t, look typical. You may also be interested in S’s two photos from our “bite photos” page, which is a reminder that bites do not always look the same on the same person.

One final disclaimer: please do NOT try this at home. While bed bugs are not known to spread disease, that can always change, and it probably isn’t a good idea to get bitten on purpose or to share bed bugs with others.

So without further ado, here’s the first of two installments (the second is coming on Thursday morning). Thanks to S and G for taking it on the arm, in the name of research! And my super-special thanks to S for writing the article below.

Bite Fest 2007

By S.

I decided to get bitten because I really need to know if my bedbugs are gone. The infestation began in early December 06 and after 4 months, we really, really, really think they are gone. Our PCO does too. There’s been no evidence in months. But I am still waking up with little, mildly itchy bumps on my skin, maybe 3-4 a week, and nobody has been able to give me a satisfying explanation.

Are my bumps a reaction to the chemical? I don’t think so. I spoke with the makers of Demand, and no, it would not cause single, itchy bumps. Are they pimples? Well, a lot are on my face, but they look and feel different to pimples. Are they a skin hypersensitivity? Maybe. But could that account for ALL of them? The ones on my face look different than the ones on my chest, which look different than the ones on my arms or back. And what would I be having a hypersensitivity TO? Are they old bites flaring back up? Maybe, but some of them, I’m fairly certain, are in new places. Are they nymph bites? Maybe, although by now, wouldn’t the nymphs have grown up, and the bites gotten bigger? Are nymph bites smaller than adult bites? Finally, might these be regular bedbug bites, but I’m not reacting as much as I used to? Can you become immune?

All these questions have been plaguing me for months. I felt that at this point, after consulting two dermatologists, many PCOs online and in person, and gleaning everything I could from other peoples’ stories, I just had to try it out for myself. The only way to know if these are new bedbug bites, is to see what actual, confirmed bedbug bites look like. Not four months ago, but now. And not photos of other people’s bites, but my bites, on my skin.

So my PCO raises colonies of bedbugs because, well, he is crazy. But also brilliant. He feeds them on himself and keeps them in vials. He has adults, nymphs of every instar, including first instars. There was fecal matter, cast skins and a crumpled-up piece of paper in the vials - just a little jar of goodies! Ugh, it was SO GROSS. And something else, that I knew but was still gross to see for myself, was basically how LAZY they are. In the vial, they don’t crawl around. They just sit there, in the folds of the paper.

My lovely boyfriend (we’ll call him G) said he’d do this with me, because he wasn’t scared, and he knew it would help me to be braver. I am not brave. I had nightmares about this for weeks - mostly that the bug would somehow run up my arm and into my shirt. Also, in my nightmares they were humongous. The one dead one, that we found on a glue mat when our infestation began, had grown larger in my memory. So while my boyfriend was like “THEY’RE HUGE!” I was like “Oh, they’re actually not as big as I remember.”

The other reason for G to do this, was that he’s never found a single bite. So we hoped to answer the question “Do they just prefer me? Or do they bite him, and he doesn’t react?” We knew that if G DID react, then they have actually been choosing me over him all this time.

Andy (the PCO) was well-prepared when we arrived at his office, on the south side of Chicago. He had us sign waivers saying that we wouldn’t blame him or his company for any damages. Sure, no problem. Then, here’s what he did. He’d take the bug we wanted to test out of the main vial, with tweezers. He’d place it in a clean, empty vial. Then, he’d tip the vial sideways, until it was pressing against my arm. Then he’d turn it over, and just hold it down. This way, the bug had about a one-inch circle of skin, and couldn’t run away. We’d press the vial down firmly the entire time. When the bug was done biting, I’d gently tip my arm until the bug fell back into the vial, and then Andy would cover it with a lid. It was all very controlled.

BUT STILL REALLY GROSS!

So, here’s how it went. First, G did a first instar nymph.

This is the nymph on G:

This is G’s immediate reaction to the first instar nymph:

As you can see, his reaction was basically nothing. No itch, no red dot, no evidence that a bug was ever there. (We made a circle where the vial was, and a smaller circle where the actual bite took place).

While he was doing that, I did a cast skin. (We just placed it on my skin). I have read from multiple sources that chitin hypersensitivity could possibly elicit a bite-like skin response from a dead bug, or even a skin. (Their skin contains chitin).

This is the cast skin on S:

And S. right after the cast skin:

The skin sat on my arm for about 5 minutes. It fell off once, so we put it back in a different place (hence the two circles). No immediate reaction to the skin.

Meanwhile, the nymph was biting G, but he couldn’t feel a thing. They are really tiny. We watched it go from clear to red.

Then, G did an adult, while I did a first instar nymph. His adult was oh so gross. It landed on its back, then turned itself over, stood there, and started biting. It was really quick. Again, he didn’t feel a thing.

This is the adult after it fed on G:

As you can see, it’s huge. The adult grew fatter as well as longer, during the 5 minutes it was feeding.

I had the teeniest little first instar nymph that latched onto me quickly, and when I saw the little red spot form, I looked away. It was done after maybe 2 or 3 minutes. We took it off and circled the spot with pen.

This is S’s arm after the nymph:

There was the tiniest whitish flat swelling on my skin by the nymph bite, and that was all. G was showing no reaction to either bite. It seemed like we weren’t gonna learn anything from him about the difference between nymph and adult bites.

So he said, “I think you should do an adult.” I was not mentally prepared for this. They are just so much bigger, and grosser, to me. But I knew he was right, that would be a true experiment, and we’d learn so much more this way.

Adult biting S.

Andy brought it over in a vial, and I covered my face with my hands. He pressed that vial down so hard, and during the entire time, I kept telling him to press it harder! I did not feel the adult biting me. But I did start to feel an itch, about halfway through! And that freaking bug sat there for ten minutes. It felt like ten hours. I never looked. G held my hand and we tried to talk about other things. Finally, it was done and I knew it was done because right away, I felt it walk. I practically screamed, and Andy came over and took it away. It clung to my skin at first, it didn’t want to fall off and into the vial, he apparently had to move the vial a little, and I was trying hard not to cry. I never looked. And then it was off, and it was done.

S’s skin immediately after the adult bed bug bit her:

Editor’s note:
What happened the next day?

Did G develop a reaction to the bites? Did S?
If so, did the nymph and adult bites look different?
Did S develop a reaction to the cast shell?
And what does it all mean?

Tomorrow (Thursday) @ 9am EST, come back for Part 2 of S’s story.

• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 2)
• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 4)
• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 3)
• recent bites from bed bugs (photo)

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Please do not adjust your set– the site is not hosted by a 1970’s Leonard Nimoy and I will not be blogging about the Loch Ness Monster tomorrow. We want rational, researched, peer-reviewed information on the after effects of bed bug bites, and causes of sensations we’re experiencing. However, until we get that (remember, bed bug entomologists have their hands and brains tied up right now with the whole killing-the-monsters business), we have to share information amonst ourselves. Entomologists and doctors are encouraged to share their input and I’d love sources on this. But be warned, non-sufferers may just not get this one.

On another thread, Hopelessnomo’ raised the question of whether it’s possible to feel bites, sense bugs crawling on the skin, and even see “bites” in the absence of bed bugs (I distinguish actual bed bug bites here from “bites” which may or may not have another cause, by use of those quotation marks):

I moved to escape bedbugs. I took extreme precautions. I am fairly certain that I don’t have bedbugs in my new apartment. . . . I moved about 2 months ago. My “bites” (both biting sensations and small nymph-like bites) have only recently begun to fade. I’m sitting here, using the computer at work since I no longer own a computer, and it’s very warm and I feel faint crawling and itching sensations on my arm and back. I’m not sure if this will ever go away. A few weeks ago, I was still feeling what I call the “memory” of bites at different times during the day. . . . [The new bites are] Complete with raised bumps and little red dots and all the old manifestations, except that there was a difference in the quality of these sensations that I cannot articulate that allowed me . . . to believe that they were not new bites.

I did a bit of snipping for space, but you get the idea. What could be causing this?

1. Bed bugs. Yeah, we know. It’s improbable in this case, though it is worth taking seriously as the most likely cause in most cases.

2. Old bites that won’t stop itching plus lingering allergies. (Nomo’, are the new bite marks in the same places, or are you breaking out in new “bites”?)

3. Sensitivity to insect by-products touched or ingested. (Eh?) Seriously. This came up on the yahoo Bedbugger group (which is not affiliated with this site, but which you can join by clicking the links in the sidebar under “information and help”). American Museum of Natural History entomologist Lou Sorkin said (9/25/06, message 1358: I can’t link to these but you can join the group and view it),

I know it has been reported for mites [that] shed skins of the mites on a patient’s skin sometime after having been bitten will elicit a similar or indistiguishable “bite” from an early bite.

Though bed bugs are true bugs, and not “mites,” Lou is speculating over whether the same thing may happen with bed bugs as happens with mites. Lou continues:

A researcher who raises bed bugs told me that a person had been bitten and had “typical bites” (bites had been witnessed by the researcher) and later when the patient ate a . . . preparation vitamin D (later found out to have been mixed with crustacean shell derivative called chitin . . . . The patient broke out in “bites” indistinguishable from real bites.

Perhaps chitin–made from shells of unidentified origin (usually it’s shellfish) used in the vitamins caused an allergic reaction in someone who had become very sensitive to chitin in bed bug shells? However, Lou noted in another message that chitin is not supposed to cause reactions, and he speculated that perhaps something else was in the vitamin.

4. On the Leonard Lopate show on NPR (2/3/06), Richard Pollack, Harvard entomologist, and Richard Cooper of Cooper Pest Solutions in NJ (a PCO), discussed how sometimes people who are no longer getting bitten get new “bites” (that is, lesions appear, even in the absence of bed bugs) after bed bugs are gone. A caller to the show reports occasional isolated “bites” three and six months after an infestation. (Possibly, but not likely to be a reinfestation if they wait 3 months to feed.)

Richard Pollack gives as another example of this: a grad student he knows who was exposed to bed bugs in a hotel room, months later experienced “bites,” identical lesions, though she was not exposed to bed bugs in the interim. Granted, how you can be sure you were not exposed to bed bugs–especially if you’re a student living in Boston– is a tricky question! Nevertheless, these “phantom bites” seem to be a phenomenon bed bug researchers are aware of.

Is it an allergy to debris left behind after the infestation? Is it a lingering skin problem caused by months of allergic reactions to bites? Is it your imagination? A reaction to pesticides (which can also cause allergies and reactions)?

5. Some other non-bed-bug-related cause:

There is at least one person who was on the yahoo group who had bites but could find no bed bugs (or other mites). After months of treatment, she finally found out the cause: folliculitis. She never had bed bugs. (I found this out offlist.) It’s just a reminder to rule out everything. However, it’s unlikely that bites which continued after an infestation and a careful move (like Nomo’s) would be caused by something else. Possible, not likely, but I want to throw it out there for others.

Warning: I strongly discourage anyone from assuming their bed bugs are gone and that the bites are just “phantom” bites unless they have really good evidence this is the case. Bed bugs are really hard to get rid of and they can linger a long time; don’t ignore bites unless you have very good reason to think they are gone. Nomo’ didn’t “just move,” Nomo’ went to extreme lengths while moving; “just moving” on its own, and even parting with lots of stuff, is not reason enough to assume you have phantom bites.

Also, don’t panic if you are fighting bed bugs and worry this will never end. This reaction is not experienced by everyone.

That said, does one of these theories explain what’s happening to Nomo’? I’m going to ask Lou to pop in and see this thread if he has time. Perhaps he will have further insight. I welcome your thoughts and any relevant leads. This should probably become a FAQ, but it needs some whittling down.

And let me give another plug for the Leonard Lopate show on NPR, which mentions how hard the bugs are to find, how people can go for months without seeing any bed bugs, as well as how bites do not look the same on every person, or on the same person at different times. NJ PCO Richard Cooper also says they’re seeing infested laundromats. That is so, so something I had in mind: most people in NYC go to laundromats; many leave their laundry (unsealed! unattended! for days! side-by-side with others’ dirty laundry! Arrrggghhh!)

• FAQ: What are bed bugs? Do I have them? What else could be causing this?
• World exclusive: Bedbuggers experiment with being bitten, on purpose! (Part 2)
• recent bites from bed bugs (photo)
• Bed bugs also causing havoc in England & Northern Ireland: university residence, hospital staff residence, possibly a school, infested

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