The public health question

We want to review the pest management challenges posed by bed bugs, and give you a clear idea of where we stand on possible policy approaches and solutions, but there is yet one more thing to get out of the way: the question of whether bed bugs, which are not known to be vectors of disease as of this writing, nevertheless warrant a public health interest.

Everyone unfortunate enough to have intimate knowledge of this pest—to the degree necessary to motivate late-night internet searches of fact sheets and reference sources—quickly learns two things: a) bed bugs do not transmit disease, and b) they are everywhere in the literature called “nuisance” pests.

It may be interesting or sad that the bed bug’s apparent innocence in the matter of disease transmission sometimes causes mixed feelings in bed bug sufferers. And we can spend a lot of time considering whether “nuisance” even begins to describe the impact of this pest.

But let’s just move ahead to the policy issue.

We believe very strongly that a finding of disease transmission is unnecessary, in the case of bed bugs, to a determination of public health interest. Yes, we are aware that this is controversial.

Before you interject “bed bugs are not X!” with X standing for any of the modern terrors in epidemiology and vector-borne diseases, yes, okay, bed bugs are not X.

Conceded. Can we move on?

Bed bugs affect the health and environment of city residents in several ways. A bed bug infestation may result in the following:

  • significant allergic reactions (and a possible but not yet deeply studied relationship with asthma)
  • chronic sleep deprivation and its impact on worker productivity as well as its contribution to serious medical illnesses (high blood pressure, diabetes and others)
  • stress and anxiety
  • depression
  • the likelihood of desperate and unsafe applications of pesticides and the associated health risks
  • poor quality of life

Crawled asked in a comment whether the New York City Department of Health and Mental Hygiene employed entomologists and pest control specialists.

Yes. The Department likely employs many specialists. But all the specialists in vector surveillance will never spend any time on bed bug issues. Bed bugs don’t spread disease, right?


The Department’s Bureau of Environmental Surveillance and Policy, which employs an entomologist and a pesticide analyst according to the most recent report to the City Council on the implementation of Local Law 37 (PDF) (January 1, 2008), is charged with oversight of the implementation of Local Law 37.

Local Law 37:

set forth a number of requirements related to the use of pesticides on New York City-owned or leased property, with the overall goal of reducing the City’s use of hazardous pesticides and promoting the use of safer and more effective pest control practices, known as Integrated Pest Management (IPM).

There is a section on Bed Bug Protocols in Development in the Bureau’s report:

The re-emergence of bed bugs is a global phenomenon. DOHMH has provided technical assistance around safe responses to bed bug infestations and has produced a fact sheet in response to citizens’ concerns and questions. The fact sheet developed has been widely disseminated through community meetings, the DOHMH Call Center and on-line. DOHMH, the Department of Housing Preservation and Development, the New York City Housing Authority and the Department of Education have all developed and disseminate protocols for the safe handling of bed bugs.

DOHMH also worked with the Cornell University Cooperative Extension to obtain funding from the Northeast IPM Institute to develop a bed bug response protocol for congregate living environments. The project was launched in June 2007 with the NYC Department of Homeless Services. A task force was convened to discuss the appropriate protocols for preventing and responding to bed bug infestations and the inappropriate use of pesticides in response to this. Protocols will be finalized and published in Spring 2008.

So, they’re working on protocols for city-managed properties. We look forward to hearing more about them.

The inappropriate use of pesticides… I guess, given the right approach, the fact that bed bugs don’t spread disease is irrelevant after all?

Other cities have no problem at all in asking their Health Departments to study the bed bug issues and make recommendations. Bed bugs in New York City are properly the purview of various city agencies, starting with the Department of Health and Mental Hygiene.

Let’s get over the disease transmission impediment to bed bug policy-making. There isn’t one.

We want to note the Department’s bed bug fact sheet and a document titled Choosing and Working with a Pest Control Company (PDF).

This last document requires some examination, yes? We’ll do that next as a way to introduce the first challenge to control: inspections.

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