Public health significance of bed bugs: a new tool for action

Bed bugs are literally on the cover of the World Health Organization’s new book, Public Health Significance of Urban Pests.

The aim of this new publication is to present “evidence on which to base policies.” Nothing could be sweeter to us. We now can cite an authoritative source for many of the issues we’re concerned about and we have a new tool to counter the incomprehensible positions of our city government.

This book has been a long time in the making and the bed bug chapter actually does not cite the most recent research. Many of the findings, therefore, may be old hat to those of you who have closely followed the larger bed bug story. It’s still an essential publication. To give you an example, it’s one thing for us to tell you about a possible connection with asthma (and other direct and indirect health problems) and quite another to read—and be able to cite—this:

Besides the effects of direct bites, airborne common bedbug allergens that are always released during infestations may produce bronchial asthma. Within a group of 54 asthmatic Egyptian patients, 37.1% reacted positively to a common bedbug head and thorax extract, and 50.1% reacted positively to an abdominal common bedbug extract (Abou Gamra et al., 1991). Numerous routine bedbug bites can contribute to anaemia and may even make a person more susceptible to common diseases (Usinger, 1966; Snetsinger, 1997). Some people can develop a general malaise from numerous bedbug bites; that, along with the loss of sleep and extreme itching of bug bites, can lower a person’s vitality and make individuals listless and almost constantly uncomfortable.

The bed bug chapter was written by Harold J. Harlan (retired U.S. Army medical entomologist and urban entomology expert—and author of the Armed Forces Pest Management Board’s Technical Guide [PDF]), Michael K. Faulde (Central Institute of the Bundeswehr Armed Forces Medical Service, Department of Medical Entomology/Zoology, Germany) and Gregory J. Baumann (Vice President, National Pest Management Association).

The chapter should be read in full but I want to highlight the items of interest to us:

Large multi-unit buildings common to poor areas can be very hard to rid of bedbugs. Once bedbugs become established, any control effort that does not include checking the whole building at nearly the same time, along with a coordinated occupant education and treatment effort (as needed), will usually fail, because the bugs will frequently move away from any partially treated and potentially repellent active sites into adjacent rooms. Their movements are generally unencumbered, because they readily move through wall voids and along utility lines, heating ducts, elevator shafts, and laundry and mail chutes.

  • recommendations range from the perennial more research is needed to the key recommendation in our view:

Efforts should be undertaken (or at least planned) by appropriate government agencies to address locally evident problems that relate to the difficulties encountered by poor and low-income people in dealing with bedbugs and their control and with housing or building quality. Community-wide or citywide programmes may be needed and possible, if properly supported and well coordinated.

In New York City and elsewhere, of course, bed bugs are not a problem exclusively of the poor and making that connection in framing possible policy solutions poses more questions than answers. Other emphases of the article bear closer examination but I believe the publication of this book is something to celebrate. We’ll investigate this connection between poverty and bed bugs further in another post; it’s a particular interest.

There are various ways to access the book. You can download it for free in PDF format from WHO/Europe or from the National Pest Management Association or you can buy a copy through their websites. In addition, the UK’s Chartered Institute of Environmental Health has prepared a crib sheet of sorts with very nice pictures and bullet point summaries.

For hard-core bed bug news followers, however, nothing but the whole thing will do—here is a direct link to the PDF.

You may also want to check out more interesting WHO reading on the current state of housing and health research.


  1. the eliminator

    I had a problem with bed bugs at my house. I was terrified and called a national pest control company… they sprayed with chemical, they steamed, they recommended that I put my luggage and pillows in cold storage… nothing worked. We were still getting bit. We learned the hard way that it is most important to find the source. We finally found the source by taking apart the bed frame.

  2. nobugs

    Sneaky Simes snagged the cover, nice!

    This is a good development, even if not completely perfect. The WHO is right to recognize the potential (and demonstrated) health problems bed bugs pose or may pose in future.

    The comments about poverty do bring up complex issues.

    It is true, though, that poor people and those on low incomes have a much worse time with bed bugs, on the whole, because they are more likely to lack resources to fight them once they appear, and (seem to be) more likely to live in housing where landlords don’t deal with the problems as swiftly.

    In other words, you don’t get bed bugs because you’re poor or on a low income, but it can be harder to get rid of them once you do.

  3. Renee

    Eliminator – I’m keeping your message above but I deleted the other one, if you know what I mean.

    Nobugs! It was pretty neat to see Ol’ Sneaky’s mug on this one. On the poverty thing, I think it’s a mistake to tie bed bugs to poverty (it’s what’s been done traditionally). I think there’s a way to address the issues (i.e., not ignore the underlying problems) without framing them incorrectly, and so avoid a repeat of some of the consequences that actually make fighting bed bugs difficult, now and in the future: the shame, the persistent idea that bed bugs happen to someone else…

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