I received an email earlier this evening–my cousin living in New York, in a beautiful old building. Apparently, his building is experiencing an infestation of bed bugs. Here’s his email:

I’m sorry to “bug” you about this, but i have some entomology related questions and i really need the help of an expert. there has been a huge bed bug problem in brooklyn and everyone i know is getting them. there is a lot of hysteria and misinformation, which is why i thought i would ask an expert. bed bugs is like the new AIDS in nyc.

here’s the deal: my apartment seems fine, but i have close friends in the adjacent building (which is owned by same landlord) who have bed bugs. we live in 100-year-old tenement style buildings that are cheap and beautiful but very poorly maintained. there is a lot of back and forth traffic between the two buildings. their apt has been exterminated twice, but the problem persists. other tenants in their building also have had them for quite a while. worse, mutual friends who live outside of our buildings have recently discovered bed bugs. and nobody knows if it has been spread around from visiting. i’m really worried that i’m going to have them soon, since i constantly hang out with the same people. i really don’t want to move or see my neighbors move since this would mean moving somewhere really ghetto or taking on a huge increase in rent.

Now, what good is having an entomologist in the family if she can’t help with insect infestations? So I spent several hours writing up a comprehensive inspection and treatment plant for him, then thought “hey, this would be perfect for my blog!” So here it is. Enjoy!

At the moment, bed bugs have made a huge come back in the US. They are extremely common in big cities (such as New York, SF, Chicago and LA) and have infested many upscale hotels and apartment complexes, which, as you might imagine, has caused no end of media coverage.

The good news is bed bugs have not been linked to the spread of any disease at all, and are therefore less dangerous than more common things like fleas. The even better news is that if you have an infestation it can be managed relatively easily so you won’t have to move or get rid of all your stuff.

The bad news is the management can be time consuming, and bed bugs can be really annoying. You can develop allergies to bed bug bites pretty easily, so prevention and treatment are important.

Basic Bed Bug Information

Bed bugs are extremely small (about 1/16th inch), blood-feeding insects that live in very tiny places and tend to emerge at night. (To give you an idea about the size, fully grown adult bugs have been found in picture frames between the glass and the frame itself). The females need a blood meal to produce eggs, and lay those eggs in small, protected areas such as crevices in beds, behind loose wallpaper, or cracks in the base boards. The eggs are laid in a sticky substance that allows the eggs to stick tightly wherever they are placed. Adults lay a stand of eggs every 15 days or so. Once the eggs hatch, the larval or baby bed bug needs a blood meal to grow. Bed bugs can live for around a year without a blood meal, which is one reason they are so tough to get rid of. They thrive in areas that are climate controlled, which is why they are so prevalent inside apartments and hotels.

Bed bugs can be easily spread. Since they are so small, they can crawl into clothing, luggage, animals, etc. and happily move to new places whenever they can. Most infestations start when someone travels to an area with an infestation and the bugs infest their luggage, or when an infested piece of furniture is brought into the home.

If you have a reaction to the bed bugs (most commonly a welt and itching around the bite) you can treat it with topical cortisone to reduce the itching and Benadryl or other oral antihistamine to control the reaction.
Now onto the good stuff: treatment. First step is making sure you’re infested by bed bugs. You don’t want to treat for them if you don’t actually have them. Bed bugs are found in small areas, and while they are commonly in the bedroom (since that’s where people are sleeping and easy meals) they can also be found everywhere else. You need to do a thorough inspection of the apartment to both identify if you have an infestation and where the bugs are. You don’t want to miss a group of bugs, since just a few adults can spark a full blown infestation within 2 weeks.

Step 1: Inspection

Inspection tools:

• A quality flashlight
• Thin blade spatula for looking behind wallpaper and under carpets
• Screwdrivers and wrenches for dismantling bed frames, removing switch plates, etc.
• 10x magnifying glass, just to make sure the bugs are alive when you find them
• Garbage bags (for containing infested items as soon as you find them)
• Packing tape (to seal garbage bags)
• Vacuum cleaner
• Steam machine (recommended but not necessary)
• Carpet adhesive (available at any hardware store)

Start your inspection where you’ve seen the bugs or where you think the infestation started. Look along all edges, crack, seams, and fold. Screw holes are very important and can house huge populations. The bed itself should be carefully inspected, and the frame taken apart. Favored areas for the insects are where the head and shoulders of people rest. However, fully and carefully inspect the entire bed and frame.

As soon as a bed bug is discovered, stop your inspection and treat the insect. Bed bugs are easily disturbed, and may scatter once discovered. Don’t give them the chance to find new hiding places. Once those bugs are taken care of, continue your inspection where you left off.

Mattress

1. Remove any mattress pads. Start with the edging/piping of the mattress, and look along all stitching lines.
2. Check along the sides and edges of the mattress first, then continue to the top and bottom, following the stitching lines as a guide.
3. Finish by giving special attention to labels, tags, air screens or buttons that may be present. Also closely inspect any holes or tears in the mattress, as these will allow easy access to the center of the mattress and could indicate a fully infested mattress.

Box spring

1. Start with the edging and piping on the box spring.
2. As you lift the box spring from the bed frame, pay special attention to the frame itself. Bugs on the frame will scatter seconds after being exposed to light, so check the frame immediately after lifting the box spring.
3. Look under any plastic guards, if present. If there is a bad infestation, remove the plastic guards to check for bugs, then reattach with a staple gun.
4. Double check any folds and attachments, and remove if necessary. (If there is no evidence of infestation in the box spring–i.e. fecal matter, bugs themselves or blood spots, then don’t rip it apart just to check thoroughly. I’ll give you some treatment advice in a bit).
5. Check any countersunk screws, depressions, cracks, or dings.
6. Finally, check the joints and corners of the spring itself.

Bed Frame

1. Remove mattress and box spring and start with the rails, paying special attention to joints, welds, end caps, cracks, holes, seams, countersunk areas, damage, and dents. Bed bugs will hide in both metal and wood frames.
2. Inspect all cross bracing, paying attention to areas listed above.
3. Inspect the legs, wheels, and casters (if present).
4. Remove head and foot boards, and pay special attention to features mentioned in #1.
5. If bugs were present on mattress or box spring, you need to take the bed frame apart for an adequate inspection. If bugs were not found during your other inspections, you can adequately inspect the frame without dismantling. However, if you don’t dismantle it, be very careful during your inspection to not overlook possible cracks and seams.

Bed Area

1. Move the bed frame and inspect area where the bed met the floor, paying special attention to dents or depressions in the carpet or floor.
2. Inspect the baseboards, checking in cracks, depressions, peeling paint, peeling wallpaper, under plugs and phone jacks, and under carpets.
3. If carpeting butts up against the baseboards, or is affixed to the wall, carefully peel it back a few inches to check for bugs. Carpet can be replaced using carpet adhesive. Use carpet adhesive sparingly.
4. Remove any area rugs that were near the bed and inspect the area beneath the rug, and the underside/edges of the rug itself. If bedroom has wall-to-wall carpeting, peel back several inches starting from the baseboards and inspect the floor beneath, tack strip, and the underside of the carpet. Replace carpet with carpet adhesive.
5. Use spatula to scrape or scoop the underside of the baseboard. Angle spatula so leading edge rests on floor and trailing edge scrapes the bottom portion of the board. Inspect debris. This may crush any insects present, so pay attention to blood spots or fecal matter present.

Once you finish the bed area inspection, move to the next piece of furniture and inspect using the same guidelines. Don’t gloss over any area, especially if there is a known infestation, since these bugs are so tenacious.

For small electrical appliances or toys, hold item over a plastic sheet and briskly shake or tap the item. Inspect any debris that falls from the item for insects.

Step 2: Control

As soon as you find a bed bug, or evidence of bed bugs, start control measures to treat present bugs before moving on to next inspection area. Work efficiently and quickly–you only want to move objects once if possible to discourage insect scatter.

Set up a “clean” area. Inspect and treat a single area of the apartment, and once this is finished, you can put each inspected and treated item in that area. This will open up other areas for inspection and allow you to keep track of what you have inspected and treated. Make sure you don’t introduce any untreated/inspected items to this area, especially if a confirmed infestation is present.

Treatments

1. Vacuum. As soon as you see a bug, vacuum it up. Once you have finished your inspection and treatments of the whole apartment, or the vacuum is full, empty it outside, preferably far from the building. Make sure you don’t let the contents touch your clothing or person, or you may carry bed bugs back into your home. If the vacuum has bags, seal the bag with packing tape and place it in the freezer for 24 hours. This will kill all the bugs in the bag. You can then dispose of the bag in the dumpster.

2. Steam machine. Steam is very effective as a treatment, and kills all stages of the insect. Once you have vacuumed the bugs up, thoroughly steam the area where the bugs were found. Make sure the area can dry completely, though, or you risk introducing mold and dust mites into the area (which are more dangerous than bed bugs in terms of allergies). For large items such as mattresses, put the item in front of a large fan. Steam kills the bugs instantly, but once the steam is removed the object is subject to re-infestation, so make sure to place the item in the clean area immediately.

3. Washing/drying. Clothing, bedding, and other washable items can be treated using the washer and dryer. Wash items at the hottest setting possible. The insects all die at approximately 120º F (48º C), so wash them on the “hot” setting, and dry them for at least 45 minutes on the highest heat setting. Any items that are near an infestation should be washed and dried (several times if it makes you feel better, although once should be enough). Items in other rooms or in dressers/closets away from the infestation may be ok, but to be safe wash everything in the apartment.

Items that cannot go through the washer (or you don’t want to wash) but can tolerate the dryer may be placed in the dryer for at least 45 minutes on the highest heat setting (at least 1200 F).

4. Freezing. Items that cannot be easily washed may be frozen. Cushions, pillows, stuffed animals, etc. should experience a core temperature of at least 230 F (-50 C) for 5 days to ensure total insect control. If you have access to a super freezer, instant death occurs at -150 F (-260 C). The lower the temperature, the shorter you have to leave the item in the cold.

5. Dry Cleaning. For items that cannot be washed, dried or frozen, you can take to the dry cleaner. However, the cleaner must be informed of the possibility of bed bugs so the owners can take proper precautions. This gives them the opportunity to charge you a lot more, so use this as a last resort (and for your very best clothing).

6. Mattress Covers. If there are holes or tears in the mattress, or you suspect for any reason there may be bugs inside the mattress or box spring itself, cover the mattress and box spring with a plastic, bug-proof cover. These can be found online at the Bed and Bath Store, the Natural Allergy Store, or Allergy Solution.

If you suspect living insects inside the mattress, make sure you use the vinyl covers. If you are simply preventing a possible infestation, you can use the cotton-feel covers. Seal the covers with packing tape along the sipper and seams, and leave in place for at least one year. (Remember that adult bugs can survive for at least a year without a blood meal, so a minimum of 12 months is recommended to starve any living adults). Use this same technique to cover the box spring.

7. Washing. Use a stiff-bristled brush and soap and water to thoroughly scrub any areas where bugs are found. The eggs can be hard to dislodge, so hard scrubbing is necessary. Wash several inches around the infested area, and use a stiff toothbrush to get into nooks and crannies. Use the hottest water you can stand, and scrub for several minutes.

8. Insecticides. Certain insecticides can be used to control bed bugs. However, only a few are rated to put on mattresses. Make sure you carefully read the label on any chemical you buy.

Recommended insecticides:

Diatomaceous earth: this is a natural, dusty substance that wears away the waxy cuticle on the outside of insect bodies. This causes the insects to dehydrate and die (imagine crawling through a bunch of razor blades–that’s what happens to the bugs). However, it’s safe for human exposure and consumption, so can be used on mattress, clothing, etc. Dust any areas you find bugs. Reapply as necessary. Incidentally, diatomaceous earth is effective for killing most insects, including cockroaches, ants, aphids, and fleas, so it’s really a useful substance to have around the house.

Raid, Hot Shot: This stuff is nasty, but contains several different chemicals rated to kill bed bugs. This is not at all safe for humans, though, so you need to keep it away from anything that will come in contact with you or your family. Use the spray stuff to spot treat infested areas, and get a full house or room bomb to treat an entire room. Remove any food and clothing before treating the room, and do not use on the bed. Wash all dishes after you treat the kitchen. You should be able to get either of these products at hardware stores.

9. Seal cracks and holes. As you inspect each room, seal up any cracks, crevices, holes, or dings that you may find. Bugs can move from apartment to apartment in a building along wiring and pipes, so seal everything you can find. Also tighten down plugs, phone jacks, and light switch plates.

10. Professional Pest Control. Many pest control companies have specialists certified to treat bed bug infestations. This can be costly, however, and will introduce hard core chemicals into your house (which you may not want). If you have a bad infestation, this may be your best option. Double check that the company you choose has bed bug expertise, and get references and recommendations. Also make sure the company thoroughly inspects your property and offers follow up inspections.

11. Surveillance. Once you have finished all the inspection and treatment steps, spend the next two weeks on the look out for more bugs. Remember that adults lay eggs in 15 day cycles, so you may experience another surge two weeks after your initial treatment. If you see more adults, treat the area as stated above.

Step 3: Prevention

Once you have erradicated the bugs, or if you don’t have an infestation yet, you should take steps to prevent a new infestation.

1.Create a “clean” island out of your bed
. Move the frame away from the wall (to prevent access to the bed from the wall) and keep all bedding off the floor. Wrap your mattress and box spring in a mattress cover (if your just trying to prevent an infestation, you don’t have to use the vinyl ones, which may be uncomfortable. Try Natural Allergy mattress covers. They are made to feel like cotton and move with you) to keep bugs from getting in there. Place the legs of your bed in small bowls of mineral oil to prevent access via the legs. Wash your sheets and blankets in hot water and dry in a hot dryer at least weekly.

2.Vacuum frequently
–at least every other day if you fear an infestation. A few times a week is fine if there are no bugs in the building. Incidentally, frequent vacuuming also controls fleas.

3.If you have visitors that may have been exposed to bed bugs, have them wash their clothes and luggage
(remember you can freeze luggage or put it in the dryer instead of washing it. You can also dust it with diatomaceous earth). Have them keep the luggage in their room, preferably away from the bed, and wash their bedding daily. Vacuum their room daily as well. Once they leave, do a general cleaning of the room, including a thorough vacuum of the floor, mattress, and drapes. Wash all fabrics, and dust base boards and any cracks with diatomaceous earth. If you happen to find adult bugs, treat it as a full blown infestation and follow the steps outlined above.

Sources

• Control of bedbugs in residences
• Pests of Homes, Structures, People, and Pets
• Ohio State University: Bed Bugs
• Bed bugs are back! An IPM answer