“Yes, Tiny, Evil–and in My Bed” is the first, and provides yet another first-person account from a journalist who had bed bugs (here are a bunch more journalists who had bed bugs). Daniela Deane was lucky to get rid of her bed bugs quickly:

I probably caught my infestation early, the experts tell me, meaning it hadn’t yet spread beyond the confines of my bed.

I caught it early because I was lucky enough to be one of the people who show an allergic reaction to the bites. Michael Potter, an entomologist at the University of Kentucky and a leading expert on bedbugs, said that between 20 and 50 percent of people don’t, meaning the problem can go undetected for a long period of time.

“If an infestation goes undetected, the bedbugs are much more entrenched into the bed structure and even adjoining structures,” [bed bug expert Richard] Cooper [of Cooper Pest in New Jersey] said. “Then it gets very, very difficult to get rid of them.”

Incidentally, Deane suspected she got bed bugs from a favorite pillow she took to a hotel on a vacation. That’s the second such report today, since the woman from Charlotte featured in the video about Mr. K the bed bug dog told the same story. They could have brought bed bugs home anyway, but a pillow from home makes it so easy.

Nevertheless, the Washington Post felt the need to accompany this story with a second story arguing that the “media frenzy” around bed bugs is just hype. “Hmm. Tiny, Evil–and Everywhere?” makes one valid point: that there’s no need for everyone to panic. While I do think the word “epidemic” is appropriate, I agree that “plague” is probably an overstatement.

Yes — bed bugs are not every single place you go everyday, and the thing that makes you itch might not be bed bugs, and often isn’t. We at Bedbugger acknowledge that every day, and we are constantly pointing out to visitors that they need to rule out other possibilities — and strive to get an actual bed bug sample for verification.

That said, it’s no surprise that Bedbuggers, including myself, don’t appreciate it so much when articles deny how widespread the problem appears to be, or when journalists discount the true difficulties that a bed bug infestation can bring. Daniela Deane was very lucky–by her own account. Yes, bed bugs are treatable, and no, they are not known to spread any disease (yet). But they do wreak havoc on one’s home and, dare I say it, one’s mental health.

And no, I don’t mean “mental health” as in delusional parasitosis, though experts are often quick to mention people exhibiting “the matchbox sign” when they talk about how bed bugs are not as widespread as people think. The “matchbox sign” is what doctors call it when patients turn up with a matchbox (envelope, paper bag) full of lint and particles, claiming they have a sample of what’s biting them. No doubt PCOs get a lot of this too.

“We had a lady come in here with a garbage bag she said was filled with bugs that were biting her,” says Matt Nixon of American Pest Management in Takoma Park. “She handed it to my dad and she said, ‘If you open that and you get bit, it’s your problem.’ And there was nothing in there except lint, hair and dry skin. We deal with people like that every week.”

Delusional parasitosis is a real — not imaginary — medical condition, in which people feel the sensation of insects crawling on them and biting them, when there are no bugs present.

It’s also a nice, distracting concept to throw into a story about how the bed bug panic is all hype. The thing is that bed bugs can be hard to detect.

I grant that the woman with a garbage bag of scraps likely has another condition.

On the other hand, while a customer or patient with an envelope of scraps may have delusional parasitosis, she may also have some other problem or condition, or she may be experiencing real bed bug bites but nevertheless have had trouble finding bed bugs or signs of them. She may even have had a Pest Control Operator inspect who did not find signs. Bed bugs do leave visible evidence, but everyone does not know how to find it. And if the infestation is very new, there may not be a lot of it yet.

So, in response to Matt Nixon’s story, let me tell you, dear readers, about the kinds of people we at Bedbugger “deal with every week”:

• Readers who are told by qualified PCOs that they do not have bed bugs, after a cursory flip of the mattress yields no black marks or bed bugs;
• Pest Control Operators who tell us that –since we brought them a sample of a spider beetle we found in a bed, that we don’t have bed bugs (even though the most rudimentary understanding of the scientific method tells us that the presence of a spider beetle does not rule out the presence of bed bugs, and an inspection might be in order). In one such incident, the PCO actually told the Bedbugger in question, who was covered in itchy bite marks — without ever entering the home — that the spider beetles were probably biting her and that they could treat for that (and oh yeah — they just treated another woman for the same problem) — even though a cursory glance at university fact sheets tells us spider beetles are a grain pest and do not bite humans.
• Well-known and well-respected PCOs who tell us that there’s no point in inspecting since bed bugs are so hard to detect, so why don’t they treat anyway?
• PCOs who tell us that we don’t have bed bugs because we do not have bite marks;
• Doctors who tell us — simply by looking at our suspected bite marks — that we have scabies / that we have bed bugs / that we don’t have bed bugs — when it is known that visual inspection is not enough to diagnose either condition definitively;
• Landlords who self-treat, hire PCOs who don’t know what they’re doing, or hire good PCOs and don’t pay them to inspect and treat thoroughly;
• Landlords who refuse to have neighboring units professionally inspected (since neighbors claim not to have any bite marks), and therefore cause bed bug problems to continue much longer than they need to, and spread to others.

I would venture many of these occurrences are as common to me as customers with bags of lint are to pest management professionals, and probably even moreso.

Many people do feel or think they have bed bugs when they don’t. But quite often, people with bed bugs have trouble verifying their presence, and it takes a very long time for them to address the problem because they can’t get the proper assistance to detect and get rid of the problem.

About the health problems bed bugs are known to cause?

• Not sleeping enough;
• Allergic reactions (most who react experience itchy bites, but in some cases, extreme life-threatening reactions do occur);
• Stress (which can lead to a host of medical problems);
• In rare cases, reactions to pesticides, expecially if treatment goes on for a long time;
• In some cases, anxiety and depression.

These are usually not life-threatening, but nevertheless are (or can cause) medical problems.

Add this to the other stress-inducing experiences bed bugs cause:

• Spending a lot of time washing clothes, decluttering and otherwise prepping for bed bug treatment;
• Spending thousands on treatment and supplies; and
• Undergoing treatment for months and months, since your neighbors may insist they have no bed bugs, or may believe they have no bed bugs, when they are actually continually exporting them to you, or since your landlord may hire someone who does not know what they’re doing to treat for bed bugs, since — as Deane cites Michael Potter as saying — 20-50% of people don’t react to bed bugs–and you may be one of them, and have no idea until they are very far along indeed, and you see them cavorting in daylight.

Bed bugs may rob you of money, sleep, and time, and cause a great amount of stress. They can cause real mental health concerns for many.

And saying there’s no reason for everyone to panic does not mean that bed bugs are not a possibility, since you can indeed encounter them anywhere or bring them home at any time. Saying there’s no reason to panic does not mean that governments, businesses, institutions, and individuals should not try and prevent a bed bug infestation, nor that they should not seriously spring into action should one occur.

More, not less, needs to be done by the government to track bed bug infestations and help homeowners, landlords, tenants, and others prevent and deal with them.

The statistics this Washington Post article cites for the incidence of NYC bed bug cases are way off. The Post claims

In New York, the city housing authority has fielded and checked out more than 2,500 bedbug complaints in the past three years; fewer than 500 turned out to be actual infestations.

These statistics are incorrect according to all other accounts I’ve seen. In NYC public housing, The Daily News reported, in December 2007, there were:

. . . 1,708 verified bedbug cases in 277 public housing projects this year, the city Housing Authority says. The Department of Education has documented another 74 cases, spread across 50 schools.

That’s 1708 cases in NYC Housing Authority public housing projects in 2007, not 500 in three years. And that’s only in public housing projects.

Other news sources had much higher figures for infestations in non-NYCHA apartments which were reported to the Housing Preservation Dept. via 311 and verified by the city in fiscal years 2006 and 2007.

The Village Voice reported that

Carmen Boon, the spokesperson for New York City’s Department of Housing Preservation and Development, reports that of 4,638 calls about bedbugs in fiscal year 2006, about a quarter—only 1,195—of those, upon inspection, were actual infestations. That’s up from two complaints in 2002. That’s an increase of 231,800 percent (not to mention a 25,000 percent increase in bedbug articles in newspapers and magazines).

So HPD got 1195 actual complaints in FY 2006 (July 2005-June 2006). In December 2007, The Daily News said Fiscal Year 2007 (July 2006-June 2007) brought significantly more bed bug violations:

In the fiscal year that ended in June, 6,889 infestation complaints were logged and 2,008 building owners were hit with summonses.

And, as I keep insisting on this here blog, the HPD stats only track bed bug cases of people who complained to 311 and then had a housing inspector verify their bed bug case. Comparing fiscal year 2006 with fiscal year 2007, according to the stats above, the percentage of 311 complaints which are actual infestations went up (from 25% in FY 2006 to 29% in FY 2007) — which may mean there were fewer false alarms in 2007 than 2006 (and/or, possibly, that there were more experienced inspectors, who were able to detect more infestations in 2007 than 2006).

These statistics understate the problem of bed bugs in New York. Very, very few New Yorkers call 311 to report their problems. The vast majority will not call to file a complaint with the Housing and Preservation Department, when simply calling your landlord to ask them to fix the problem is the normal first step in getting help for a problem in your apartment.

Almost everyone reports bed bugs to their landlords first. (So all those cases which are then treated by landlords do not get included in the statistics journalists cite.)

Of those whose landlords are uncooperative, or who do not fully solve the problem, some will call 311. But many also fear filing housing complaints because they fear (rightly or wrongly) that doing so may mean they will have trouble getting a reference when its time to move (and boy, do some folks with bed bugs and unhelpful landlords want to move).

And let’s not forget that homeowners would never call 311 about bed bugs in their co-op, condo, or house. Bed bugs infest those homes too.

So even though the Post grossly understates the true level of bed bug violations the city has tracked, it also misses the point — as every other article stating these statistics so far has done — that 311 reports of bed bugs are the tip of the iceberg in terms of actual bed bug infestations that occur in New York City.

Of the hundreds of New Yorkers with suspected or confirmed bed bug cases who pass through the Bedbugger forums, few have reported calling 311 and getting the housing inspectors in. Another confirmation that these statistics understate the problem is that if you read the statistics cited by pest control operators on how many confirmed bed bug cases they treat, they themselves show how much more widespread the problem is. I have previously quoted statistics from Jeff Eisenberg of Pest Away, who told the Village Voice in December 2006 how many bed bug cases he encountered each day:

Out of Eisenberg’s 100 calls a day, at least 15 percent are wrongly self-diagnosed rashes or lint balls.

But as many as 85 calls per day to this single PCO [in late 2006] pertained to actual bed bug infestations!?! If this happened five days a week, 52 weeks a year, that would be 22,100 actual bed bug cases a year. And that’s assuming the number does not keep growing (though other data suggests it has). Yes, it’s anecdotal (we don’t have data from this company, though I am sure PCOs are keeping track of how many bed bug cases they see).

The city must implement a method of tracking actual bed bug cases in rental units that is not tied to filing a housing complaint. It is important to know how many people actually have bed bugs in this city. If the numbers truly are small, then I’d be happy to hear it. But I am weary of Housing Authority bed bug complaints or HPD (311) reports of bed bug violations being offered as evidence of how few New Yorkers have bed bugs, when it does not take a genius to see they can’t possibly represent the true scope of the problem.

Last but not least, the third Post article on bed bugs today, “Know Your Bedfellows” offers “just the facts” but nevertheless is not without inaccuracies, for example:

Life span: Adults live for about a year. They can survive for several months at a stretch without feeding.

Many reputable sources (including the Harvard site the Washington Post links to in the same article), point out more than a year is possible. Some say as long as 18 months. Harvard says:

Under ideal conditions, adult bed bugs can survive for more than one year between meals.

The following, also from the Post, is not inaccurate, but tells only part of the story:

Favored hiding sites: Mattresses and box springs, as well as cracks and crevices in furniture and walls.

Bed bugs are commonly found outside the bedroom, especially in sofas and upholstered furniture, but also desk chairs, in addition to other furniture and walls. Pointing this out can be helpful.

Unlike the Washington Post, I think bed bugs are underreported. Every article that comes out, no matter how inaccurate, misleading, or downright insulting to my intelligence (and this is by far not the worst we’ve seen) is positive in that it makes more people think about bed bugs.

That said, I’m not terribly impressed with the contribution to bed bug journalism that the second and third articles represent.

How about you?

• Washington Post prints correction thanks to bed bug activist
• Columbia Spectator on bed bugs, again with the HPD statistic soup
• Roger Smith Hotel on Lexington in NYC: latest bed bug lawsuit
• Lexington, KY vs. New York, NY: a tale of two bedbugged cities

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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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You may notice that I am beginning to remove the comment function from the FAQs, since people are overwhelmingly using them to post tales of bed bug woe and questions and answers, rather than comments related to the FAQs. This would be okay, except it means people “lose” where they leave their questions, and they don’t always find their way back.

Instead, if you have a suggestion for a FAQ, you can email me, nobugsonme at yahoo dot com.

Thanks!

• FAQ: I am not in the US. Can you tell me where to buy XL ziplocs, or what mattress covers are called in my country?
• Ask your bed bug questions / share your tales of bed bug woe here
• Hints from Bed Bug Helloise!
• Welcome Bedbuggers!

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They also hide well. They can be very thin (like a piece of paper) and can slip into cracks. They may be hiding in places you do not think anything can get into. Though they prefer to feed late at night (around 3-5 am seems to be ideal), they may bite you without your knowledge, during the night or day, in bed or while you sit in a chair or on a sofa. You can be bitten for months and months without seeing an actual bug dead or alive. And the bites can be hard to identify, and can look like several other conditions–and they don’t look the same on everyone. Our bed bug bites photos page gives you some idea of the variations. (More on some of the other conditions you might have instead are below.)

Here is a photo from Stephen L. Doggett, Senior Hospital Scientist in the Department of Medical Entomology at the University of Sydney and Westmead Hospital. This is their bed bug site. He’s also the principle author or the Code of Practice for the Control of Bed Bug Infestations in Australia, which can be downloaded from the same site. We thank Stephen L. Doggett for giving us permission to post this helpful photo!

Where can I learn more?

This is a highly informative PowerPoint presentation by Harold Harlan, a well-known bed bug researcher. You will be able to gain a lot from it even though it is obviously meant to accompany a presentation. Warning, if you click the following link, a PPT presentation will be downloaded. You need PowerPoint, or a compatible program, to view it. Harold Harlan’s PowerPoint.
These are some links to Bed Bug Fact Sheets from university extension services and entomology departments:

University of Sydney (warning: link will open PDF )

Harvard University Public Health site on Bed bugs and Harvard’s environmental services department’s Bed Bugs page (for photos of eggs, bugs and so on).

Armed Forces Pest Management Guide to Bed Bugs (written by Harold Harlan)

Here are some photos from Lou Sorkin–the set includes first instars, youngest hatched bed bugs, about 1 mm in size, feeding.

Other things that might be bothering you

Bed bugs are rapidly spreading right now, but these other closely related species may also be the source of your woes:
Bat Bugs (Wikipedia entry with photo). More bat, bird, rat bug information to come when we find it.

Less closely related are bird mites (U of Sydney page on bird mites) and scabies mites. Many of us are erroneously treated for scabies in the first instance; doctors can test for scabies and you should get them to do this before treatment if at all possible. You’ll be praying it’s scabies anyway, and hey, if you’re lucky, you’ll be right. (I wasn’t.)

This PDF from the University of Kentucky outlines a number of insect and non-insect causes for unexplained itching. Click to load PDF.

Non-insect causes include: allergies to cosmetics, animals, chemicals of all kinds may cause similar symptoms. There will, obviously, be no bed bug feces, bugs, or cast of shells in this case. See dermatologist and/or allergist.

Hot-tub folliculitis: apparently time in a hot tub can lead to a special bacterial infection that also looks a bit like these other conditions. Again, see your doctor.

Delusional Parasitosis is a condition in which people think that insects are crawling on them and biting them, when they are not. Although this American Entomologist article by Nancy C. Hinkle is entitled “Delusory Parasitosis” (click here to load a PDF), it also 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. While it is true that people are occasionally mistakenly diagnosed with Delusory Parasitosis (and later discover their symptoms to have been caused by bed bugs or another cause), it is a common condition.

If you think you have bed bugs but have not got a bed bug specimen, you should take steps to verify whether you do have bed bugs or another medical, pharmaceutical, or environmental cause. Enlist the help of PCOs and entomologists in identifying any insects or cast-off shells you find. You should at the very least see some bed bug feces (which can appear as small black specks or sometimes stains on the bed). Experienced PCOs can often identify the presence of bed bugs by such evidence. In the absence of any bed bug evidence, be persistent about seeing your physician and preferably a dermatologist as well, until someone is able to help you.

You will probably find these FAQs useful in trying to figure out if you have bed bugs:

What do bed bugs and signs of bed bugs look like? Where can I see photos of bed bugs, bed bug eggs, cast skins, and fecal specks?

What do bed bug bites look like? Where can I see pictures of bed bug bites?

Readers: Please ONLY post comments below which are about adding information to this FAQ. If you have questions or concerns about your experiences with bed bugs you can post your questions here in our forums.

If you wish to suggest additional information or links to other resources, please email me at nobugsonme at yahoo dot com and I will incorporate them if appropriate. Thanks!

• What are bedbugs, how do I know if I have them, other possible causes
• FAQ: Bed bugs are crawling on me all the time. I am being bitten all day long, no matter where I go!
• Harvard dorm treated for scabies–but what was it really? Also, bed bugs at Columbia?
• bite photos

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