This year we saw small signs of what I thought was a new empathetic and knowledgeable grasp of the bed bug issues by NYC public health officials.
But the reality of our problems is as ever complex and good work in building trust is easily undone by careless remarks.
This is what New York City Department of Health and Mental Hygiene spokesperson Jessica Scaperotti told the New York Post Friday about bed bugs in the department’s tuberculosis prevention unit at 346 Broadway:
“It’s fairly common to have a couple of bedbugs brought in by an individual,” said department spokeswoman Jessica Scaperotti. “It’s not an infestation.”
What a way to lose the public’s trust that the department understands the city’s bed bug problems.
Maybe there is a single and spectacularly misguided bed bug PR playbook that Ms. Scaperotti and Jim Grossman from Jay Jay College are both working from.
And yet Ms. Scaperotti’s statements must be distinguished from the statements last week from various officials at John Jay College because while they too earned the mockery they received, John Jay officials in fact communicated fully about the actions they were taking, held an information session for students, faculty and the public to answer questions, and disclosed the extent of the infestation (yes, of course, not their word).
The New York City Department of Health and Mental Hygiene is represented in the recently convened Bed Bug Advisory Board.
I remain hopeful about the work of the advisory board. But what I hope is clear to you is that the board is charged with making policy recommendations.
Decisions about implementation or even whether to implement the recommendations of the board will be up to the Mayor and the City Council. Therefore, it will be up to the public to keep up the pressure for action.
We are not yet where we need to be. As you well know. It’s not like we needed Ms. Scaperotti to remind us.
Please do not lose hope in this process, though. Not yet.
Via City Room.
John Jay College of Criminal Justice has closed the North Hall building and will hold an information session today at 2 p.m., open to the public.
Refusing to call it a bed bug infestation is utterly misguided. They have confirmed the presence of bed bugs on three floors. At what point is this an infestation?
The way to calm fears is to tell the truth. Just tell the truth and give people practical information and tools.
Let’s hope they drop the unhelpful pretense and get down to the practical matters right in front of them.
Holding this meeting is a good step. This is a difficult situation and a big part of what needs to be done is to disseminate clear, rational information. I’m hoping they get this right. The pest control provider will be there to answer questions.
From the president’s update:
Yesterday, we sent a memo to the College Community reporting that a professional inspection by our pest control contractor of certain offices on the first floor of North Hall had confirmed the presence of bedbugs. We undertook this inspection because a number of staff had reported skin rashes and ultimately bedbugs were suspected as the cause of those rashes. Based on the initial results of the inspection of the first floor where those employees worked, we decided to close North Hall over the weekend so that the building could be treated to eliminate these insects. Throughout the day yesterday, the inspection of North Hall continued. At midnight last night, we were informed that the presence of bedbugs had been confirmed in a number of offices on the second and third floors of North Hall. Based on this information, I have decided, after consultation with the University, to close North Hall effective immediately. Classes and other activities will go on as scheduled in all other campus locations. We will move up the treatment schedule from Saturday as a result of these new findings.
I am so sad about what is happening in our city.
UPDATE: The NYT has some details of the meeting. And the Daily News has a photo of the building’s infestation map.
$12,000 worth of destroyed books.
I wonder if people know that this is happening?
What are the chances that this latest sign of the depth of our problems is not even acknowledged, much less understood, by those who do not have a professional interest or are not predisposed to attention by personal experience?
Notice that the library patron was not unaware of the problem.
Nothing but questions, right?
Here’s one more: what are the odds that in all of Denver there will not be a single agency or individual assuming responsibility for the obviously necessary task of eradicating this infestation? I mean, of course, the infestation in the patron’s home, not at the Denver Public Library.
This is someone’s job. Whose?
UPDATE – September 24:
That may well be the Catholic Archdiocese of Denver. The library patron is a retired poet and minister and… Gutenberg Project volunteer.
He kept (keeps?) the books stacked on the floor next to his bed, many of them inter-library loan books.
He is… thinking of suing.
by Renee Corea on September 22, 2009
in Research
The Entomological Society of America holds its annual meeting in December and these are some of the bed bug presentations I could find on their decidedly not very user-friendly online program. Sadly, it’ll take years before anyone tells us anything about some of these findings!
So, a not so random sample (there are many more; also, many still don’t have abstracts):
Effect of feeding and temperature on movement of the bed bug, Cimex lectularius L – Alvaro Romero et al. – University of Kentucky
Characterization and experimental manipulation of endosymbionts in the bed bug – Mark H. Goodman et al. – University of Kentucky
Comparative effectiveness of three bed bug (Cimex lectularius) monitoring devices – Wan-Tien Tsai and Changlu Wang – Rutgers University
Chemical ecology of bed bugs – Mark Feldlaufer – Invasive Insect Biocontrol & Behavior Lab, USDA-ARS, Beltsville, MD
Feeding entrained immune anticipation of mating – Michael T. Siva-Jothy – University of Sheffield
Geographical variation in pyrethroid knockdown resistance allele frequencies in the bed bug, Cimex lectularius, across the United States – Warren Booth et al. – North Carolina State University
Post-feeding behavior of the common bed bug (Cimex lectularius) with regard to harborage choice – Matthew Douglas Reis and Dini M Miller, Virginia Polytechnic Institute and State University
Sensitivity to bed bug (Cimex lectularius) bites in the human population – Michael Potter et al.
Behavioral response of bed bugs, Cimex lectularius, to potential chemical attractants using a Y-tube olfactometer – Eva A. Chin et al. – Dow AgroSciences
Survivorship and growth potential of modern bed bug (Cimex lectularius) populations in the United States – Andrea Polanco et al. – Virginia Polytechnic Institute and State University:
Additional evaluations indicated that field strain bed bugs do not survive the long periods of starvation suggested by Johnson (1935-40). These studies suggest that the modern bed bug populations do not have the same population dynamics as those recorded in the 1930’s literature, and that referring to these older resources for information on modern populations may have limited use.
Bed Bug (Cimex lectularius) Awareness Initiatives In Ohio – Susan Jones et al.
Efficacy of selected insect growth regulators and other insecticides against bed bugs, Cimex lectularius (Heteroptera: Cimicidae) – Ronda L. Hamm et al. – Dow AgroSciences
Walking with grappling hooks: bed bug locomotion on different surfaces – Catherine Loudon and Jessica Boudaie – University of California, Irvine
Evaluation of an inexpensive instrument to detect insects using multiple sound, vibration, and LED sensors – Richard W Mankin, USDA-ARS Center for Medical, Agricultural, and Veterinary Entomology, Gainesville, FL and Ryan Hodges, Electrical and Computer Engineering, North Carolina State University, Raleigh, NC:
Tests were performed in a small arena in which Cimex lectularius, Blattella germanica, Tribolium castaneum, and Sitophilus oryzae were placed individually and allowed to roam freely. The insects could be distinguished readily on the basis of distinctive signal features.
Can we possibly wait to hear about the new bite sensitivity data!?
By the way… I like Johnson, very much actually. He wrote very clearly for one thing, something of a lost art with scientists. He also did not overreach. (There are some articles from this period that are a bit strange.)
The Columbus Apartment Association has been working on bed bug materials for a while. We previously looked, rather warily, at their compliance package.
This new document is being developed in collaboration with the Central Ohio Bed Bug Task Force.
It is a draft training manual for apartment staff (PDF). This version is not yet final but we can take a peek.
It contains a bed bug tutorial from Dr. Susan Jones and checklists for inspecting occupied and unoccupied apartments.
This is more promising, I think.
For example:
Since eradicating bed bugs is costly, prevention and early detection is essential. It is highly recommended that maintenance and apartment staff be properly trained to identify bed bugs and their common hiding places. An inspection of a unit should be conducted prior to occupancy and can be conducted periodically throughout a lease term.
and
Do not consider an infested unit in a building in isolation. Bed bugs move quickly and can easily spread beyond the site of the initial infestation, especially in hotels, dorms, and apartment buildings. Be sure to inspect, and treat if necessary, all units that share a common wall with the infested unit.
and
This problem cannot be overlooked. Ignoring signs of bed bugs will increase the cost of extermination, increase the invasiveness of extermination, and increase potential liability. If bed bugs are discovered, notify your manager immediately.
and
Landlords may want to provide a copy of this manual to select vendors such as carpet installers or painting vendors. Landlord could impose notification requirements on these vendors if bed bugs are discovered.
I’m not so sure about the tenant notices, however. I believe that leaving the schedule of follow-up treatments to the tenant to request, who is after all untrained and unskilled in bed bug inspection and may be non-responsive to bed bug bites, is a common mistake.
What do you think?
Dr. Stephen W. Hwang is a research scientist at the Centre for Research on Inner City Health, the Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, and Associate Professor of Medicine and Director of the Division of General Internal Medicine, University of Toronto. He is lead author of the influential 2005 Toronto bed bug infestations study. Dr. Hwang graciously answered our questions about the recent anemia case report in the Canadian Medical Association Journal which has deepened our understanding of the health effects of bed bugs on vulnerable populations.
New York vs Bed Bugs: Can you tell us about the severity of the patient’s condition and why it was caused by bed bugs? This was a life-threatening condition?
Dr. Stephen W. Hwang: The patient had severe anemia (a very low level of red blood cells) because he had an extensive bed bug infestation in his apartment that had gone untreated for months. This man was losing a substantial amount of blood on a daily basis to the thousands of bed bugs living in his bed and mattress, to the point that he became iron deficient. His blood levels reached a very low level that could be described as potentially life-threatening, although fortunately he did not suffer any permanent damage to his health. As we describe in our report, we are quite certain that the bed bugs were the cause of his anemia because an extensive series of medical investigations did not reveal any other source of blood loss or an alternative explanation for his anemia. In addition, his anemia went away and did not return after his apartment was treated for bed bugs.
New York vs Bed Bugs: The patient’s bed bug infestation has been abated but not eradicated. Presumably he is still at risk should the infestation grow to previous levels. Have you any indications of the prevalence of persistent bed bug infestations in the vulnerable populations which are the subject of your research interests? And what are the implications for the care of individuals who are at higher risk for chronic bed bug infestations? What would you recommend to health care providers?
Dr. Stephen W. Hwang: We have not done a follow-up study to find out if bed bug infestations are more common than before among vulnerable populations such as people living in homeless shelters or residents in low-income housing. In my experience as a physician caring for patients who are homeless, I would say that the problem of bed bugs has become even more prevalent over the last 5 years. Although many people complain about bed bug infestations, and rightly so, I think that the main point of our case study is that we should be keeping our eyes open for those individuals who have bed bugs in their home and are not complaining about it, for whatever reason. I suspect that people who have severe mental illness, addictions, or cognitive impairment (such as dementia) are at highest risk of developing overwhelming bed bug infestations. Health care providers need to familiarize themselves with the symptoms of bed bug bites and infestations, and be prepared to give advice on how to deal with this problem.
New York vs Bed Bugs: Aside from severe allergic reactions, there is little evidence in the medical literature for any of the potential health risks that have been suggested for bed bug infestations. It’s an open question, however, whether there is awareness and capacity to detect effects. In the years since your Toronto survey of bed bug infestations, what has been the interest in and perception of bed bugs in the medical and social services communities?
Dr. Stephen W. Hwang: Over the last 5 years, I think bed bugs have changed from being a new and unfamiliar problem to one that many health care and social service providers are very accustomed to seeing. Since this is a problem that shows no sign of going away, we need to prepare ourselves for a continuous and sustained effort to improve the control of bed bugs, rather than expecting to “defeat” or eliminate them. The risk is that we can’t afford to become either complacent or hopeless in this ongoing struggle. I also believe that we need to devote more resources to ensure that people who don’t have the capacity or resources to deal with bed bug infestations in their home can get the assistance that they need.
Publications:
Pritchard, M.J. & Hwang, S.W., 2009. Severe anemia from bedbugs. CMAJ, 181(5), 287-288. doi:10.1503/cmaj.090482
Hwang SW, Svoboda TJ, De Jong IJ, Kabasele KJ, Gogosis E. Bed bug infestations in an urban environment. 2005. Emerging Infectious Diseases 11(4), 533-538. http://www.cdc.gov/ncidod/EID/vol11no04/04-1126.htm
The members of the Bed Bug Advisory Board have been appointed and will meet this week.
The Mayor appointed Gil Bloom of Standard Pest Management, Richard Cooper of Cooper Pest Solutions, and Jody L. Gangloff-Kaufmann of the NY State IPM Program, Cornell University. The Speaker appointed Ray Lopez of Little Sisters of the Assumption Family Health Service and me.
There are various city agencies that will serve on the board, including the five agencies contemplated by the legislation, the Departments of Health and Mental Hygiene, Housing Preservation and Development, Sanitation, Consumer Affairs, and Information Technology and Telecommunications; and, in addition, the Department of Youth and Community Development and the Human Resources Administration.
I look forward to the opportunity to share in the work that lies ahead to “make specific recommendations to the mayor and council for the prevention and treatment of bed bug infestations throughout the city,” in the words of the bill creating this advisory board (PDF). Please feel free to contact me via email if you have thoughts. I look forward to hearing from you, but I am also always grateful for any comments that you can make publicly as they further the public conversation about bed bugs. We will of course share with you any news of public events in connection with this process.
New York vs Bed Bugs thanks Council Member Gale Brewer and her staff for working so long and so hard for the creation of this board and the Speaker and the Mayor for creating and convening this group to help the city adopt prudent measures to achieve control of the escalating bed bug infestations in our city.
I am overwhelmingly grateful to all of you who wrote letters or made calls or who testified in support of the City Council legislation that created this board. I hope your interest and support will now be repaid with effective policies that benefit the entire city.
A new Canadian Medical Association Journal article reports on a patient who was ultimately hospitalized with severe anemia “almost certainly caused by ongoing blood loss from multiple bedbug bites.”
Pritchard, M.J. & Hwang, S.W., 2009. Severe anemia from bedbugs. CMAJ, 181(5), 287-288. doi:10.1503/cmaj.090482
The patient, 60 years old, initially presented with fatigue and lethargy for a two-month period that coincided with the bed bug infestation in his apartment.
After his second hospitalization for anemia (his hemoglobin had dropped to 52 g/L), his doctor visited him at home and discovered the true extent of his infestation (thousands of bed bugs, some observed crawling on the patient).
The patient had other medical problems, including a substance abuse problem that “may have increased his risk of extreme bedbug infestation by rendering him apathetic and inattentive to conditions in his home.”
Because he was unable to prepare his apartment for treatment, he was put up temporarily in a shelter while his apartment was treated.
His hemoglobin rose to 132 g/L (the authors reference the normal range as 135–180 g/L) four weeks after he received bed bug treatment.
Dr. Pritchard and Dr. Hwang write that bed bug bites:
should be considered a possible cause of chronic blood loss and iron-deficiency anemia in people who have signs of bedbug infestation. The anemia in the patient we have described was almost certainly caused by ongoing blood loss from multiple bedbug bites. The attribution of his anemia to bedbug bites is supported by the absence of other identifiable causes of anemia and the return to normal of his hemoglobin level after treatment of the severe infestation in his apartment. The patient’s poor eating habits may have contributed to the severity of his anemia.
Sadly, six months later, his anemia is still gone but the bed bugs, in lesser numbers, are still in his apartment, though it seems he is not suffering as before:
He has reported seeing and killing a few bedbugs in his apartment on a daily basis, but he has not experienced new bedbug bites.
(Because he lives alone, I think he must be experiencing continued bed bug bites, but perhaps we may conjecture that the current level of his infestation is not producing the previous reactions or, indeed, the severe anemia.)
This is the most disturbing aspect of this case. Here is someone who cannot cope with bed bugs and who is at medical risk from a severe bed bug infestation.
And he still has bed bugs.
The authors note the higher risk of developing severe bed bug infestations for people with certain medical and substance abuse conditions who also may require significant health care and social services intervention for bed bug treatment and control.
Dr. M. Jane Pritchard practices at Leaside Health Centre in Toronto and Dr. Stephen W. Hwang is a homelessness and health research scientist whom you will recall from the 2005 Toronto bed bug study: Hwang SW, Svoboda TJ, De Jong IJ, Kabasele KJ, Gogosis E. Bed bug infestations in an urban environment. 2005. Emerging Infectious Diseases 11(4), 533-538. http://www.cdc.gov/ncidod/EID/vol11no04/04-1126.htm
by Renee Corea on September 8, 2009
in History
One of the landmarks of British documentary film, the short film Housing Problems (1935) depicts the plight of people living in overcrowded and dilapidated housing. It is a slum clearance propaganda film and one worth thinking about. (It was funded by The Gas Light and Coke Company, though no overt gas use propaganda is in the film; but it’s not difficult to see how the filmmakers could interest them in a film about a massive new housing construction scheme.)
The Stepney (London Borough of Tower Hamlets) residents, speaking directly to the camera, recount the stories of their deprivations. Mr. Norwood is “not only overrun with bugs,” but also mice and rats. And Mrs. Hill speaks of the filth and the vermin.
Here is a useful partial transcript of Mrs. Hill’s strangely affecting statement:
We went to see the new houses, and they’re lovely. But here, it gets on your nerves, for everything’s filthy: dirty, filthy walls, and the vermin in the walls is wicked. I’ll tell you, we’re fed up.
Yes, and guess who makes a cameo?
This film is available in a DVD from the BFI; not in the US however.
But a sizeable clip is up on youtube. If you are going to watch it, the bit with Mrs. Hill and old Cimex l. starts around the 3:31 mark.
How exactly were people moved to their new homes? What was the bed bug “disinfestation” process? We’ll consider that next.
by Renee Corea on September 7, 2009
in History
Millard invented a trap, should I have told you about that first?
He named his trap the “Leicester Intercepting Trench Trap”:
It depends for its action upon the habits of the insect as described above, and the principle of it is the placing of an impassable trench, containing sticky stuff, all round the bug-infested room. It consists of a grooved lath of wood cut into the required lengths. Treacle (golden syrup) is poured into the groove or trench, and the trench is left in situ as long as may be necessary. Sufficient time has not yet elapsed to enable me to pronounce a final verdict as to its utility, but in theory it seems excellent, and it certainly “delivers the goods.” I have counted as many as thirty-six bugs in 12 inches of trench after being in position three weeks and thirty-one were counted in a 3-foot length after only three nights.
Millard, C. Killick. 1932. Presidential Address, on An Unsavoury but Important Feature of the Slum Problem. The Journal of the Royal Society for the Promotion of Health 53, no. 7: 365-372. doi:10.1177/146642403205300705
Yes, well.
Stay away from the treacle is my advice.
