The results of the bed bug bite survey we heard so much about are reported in this new article, The Sensitivity Spectrum: Human Reactions to Bed Bug Bites (PCT February 2010, Michael F. Potter, Kenneth F. Haynes, Kevin Connelly, Michael Deutsch, Erich Hardebeck, Don Partin, and Ron Harrison).
This is unprecedented stuff, so let’s take a very close look.
474 respondents, all with confirmed bed bug infestations, in Chicago, New York, Cincinnati, Louisville, Atlanta, LA and Miami. 66% living in apartments and 15% in single-family homes. All ages. 58% female, 42% male.
The breakdown for infestation level:
| Infestation level | Bugs | Respondents |
| Low | ≤10 | 34% |
| Moderate | 11-100 | 47% |
| High | 101-500 | 14% |
| Very high | > 500 | 5% |
“Have you experienced any bites or skin reactions from the bed bugs in your dwelling?”
70% yes, 30% no.
Essentially the reverse of what was previously thought. Though there were also skeptics—see this note about last year’s article by Reinhardt and others.
The female/male differences were not statistically significant. And neither were ethnicity differences. The level of infestation was also not a factor.
Not so with age, however:
Significantly more people over the age of 65 reported no bites or skin reactions than those who were younger. Forty-two percent of the eldest individuals surveyed said they had no bites or reactions from bed bugs in their dwelling, whereas 26 percent of those aged 11 to 65 reportedly did not react.
This corresponds with an earlier survey where 76% of elderly tenants in one “severely infested” building did not react to bites (or reported not reacting). Possible reasons for this mentioned by the authors include reduced responsiveness to allergens in the elderly, medications that suppress the immune response (corticosteroids), and “diminished awareness due to other competing health issues.” For another discussion of a similar case, see the ASHES/Orkin white paper (PDF) from last year.
I think everyone is rightly worried about the elderly. Their infestations may go unreported, grow undetected, and then may be treated incorrectly.
Relationship to mosquito bites
The bed bug bite response reported in this survey corresponded with the level of mosquito bite response in the following way:
- “Barely visible” mosquito bite reactions = 53% reacted to bed bugs
- “Small (dime-size) welts” from mosquito bites = 77% reacted to bed bugs
- “Large (quarter-size)” / “severe (half-dollar size or larger)” mosquito bite reactions = 89% reacted to bed bugs
Characterizing the reactions of the 70%
- 72% had “itchy red welts”
- 50% had “redness or discoloration”
- 28% had “itching in the absence of welts”
- 21% had “a ‘pinprick’ or ‘stinging’ sensation”
Okay, let me pause here. On this last point the authors say: “which may or may not be symptomatic of bed bugs.”
Personally I have to say I can’t count the times people have reported this. Bed bugs!
There’s a lot more about the reported reactions.
The public health question, etc.
This is remarkable:
Other oft-mentioned symptoms from respondents living with bed bugs included nervousness, paranoia, anger, frustration, embarrassment, devastation and depression. Anxiety, stress, sleeplessness and depression are medically important symptoms that can lead to other conditions. Dismissing bed bugs as “not a public health pest” on the grounds that they are unproven disease vectors ignores the pain, suffering and emotional distress inflicted on their victims. When government agencies finally concede this point, additional resources may be allocated to combat the problem, as they were years ago.
I may have to put that on a post-it.
I hope they’re right.
These pages may be of related interest:
- New guidance for bed bugs in health care facilities
- New study of bed bug bites suggests most people do react
- New case report of severe anemia in a patient with an advanced infestation
- Australian medical entomologists on what GPs should know
- Bite sensitivity, ciao Johnson, post-feeding behavior, signals and more: ESA meeting abstracts
{ 5 comments }
Renee,
your point about the public health question is very well put. I see changes in the attitude of Public Health Policy towards bed bugs. I have had my own experiences in this such as speaking to a health unit and having the medical officer of health stop me in mid presentation when i was speaking of the impacts of bed bugs on people while acknowledging the fact that they are not a vector of transmissable diseases. Of course I was a small fish in relation to his power of authority, so I didn’t argue his point though I still spoke to what I knew of impact on people. The Ontario Health Protection and Promotion Act gives this definition of Health Hazard.
health hazard” means,
(a) a condition of a premises,
(b) a substance, thing, plant or animal other than man, or
(c) a solid, liquid, gas or combination of any of them,
that has or that is likely to have an adverse effect on the health of any person; (“risque pour la santé”)
This clearly would include bed bugs beyond any reasonable doubt.
In Toronto, the Health Department has been there from the start and with the formation of the Bed Bug Project has the active lead in this.
I think for some public health authorities this may have been a question of priority in relation to actual impacts… So in the bigger picture, H1N1, SARS, or West Nile Fever can kill a large proportion of victims whereas bed bugs are very unpleasant and stressful and terrible, but if anyone had a choice between gettng a life threatening infectious disease or other life threatening issue such as food poisoning, bed bugs are small fry in this context and the health departments are cautious about commitment of resources.
But I see that this has changed and one would expect all health departments to accept the realityof bed bugs as a Health Hazard by the definition noted.
It is a matter of degree of risk . The impact of bed bugs is horrendous even if the degree of risk is quite different. I am glad that this is clearly changing in terms of some health officials noting the impact on people. I don’t think any would now deem it not a public health hazard.
Well, it’s their point, Potter et al., not mine. I wish I could be as optimistic as they are.
Toronto has of course shown tremendous leadership on this.
I am representing a former tenant who was forced out of apartment due to bedbug infestation. Looking for rules/regulations/codes etc. applicable to the liability of landlord for breach of warranty of habitability etc. since the landlord is claiming the tenant was responsible party and is suing her for damages and loss of rents to his building. I am trying to determine also if there were complaints made to city agencies and am contacting HPD,ECB, Environmental Protection; are there any other agencies who are responsible or who would have issued violations if complaints were made?
I’m not aware of any other agencies. Everything I know about the the laws as they relate to bed bugs is here: http://newyorkvsbedbugs.org/2009/07/13/bed-bugs-and-the-law-in-new-york-city/.
The resources that are nade available here are quite exhaustive. Great as usual Renee.
Not dissimilar to New York in Toronto, there is much responsibilty put on the landlord however it is rare to see a tenant evicted for bed bugs unless there is a lack of reasonable co-operation.
but there is not always justice in the world and so many variables of attitude. I once read a case of a tenant not getting any rebate on rent as the member of the “tenant protection” tribunal considered the landlord’s actions as demonstrating due diligence. Those actions were laughable from a professional pest control perspective as they were very far from what would be expected as a reasonable action of control of bed bugs. The facts are always critical and the way they are presented. If a case involves serious reocvery fora tenant, then hiring a pest control expert to review the history and details of acitons, would be a very wise action. This can indicate whether it is worth litigation or really a waste of your client’s time and money. Either get a Board Certified Entomologist in Urban and INdustrial Entomology or Medical Entomology or an experienced pest control professional.
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