I check the CDC’s website from time to time. The only bed bug-related materials I ever find there are journal articles (the 2003 Toronto study, for example, and the nursing home article we’ve discussed). And they’ve always had these keys (PDF).
So, take a look at the CDC’s (new?) identification sheet at its Division of Parasitic Diseases website. The photos of (unfed) bed bugs are good.
I’m willing to bet this document will be the extent of it.
The cavalry, remember? Detained.
We have to rely on ourselves.
Update – November 2009: Ohio has requested a Section 18 exemption for residential use of propoxur.
Directly as a result of the EPA National Bed Bug Summit, PCT, July 15:
The Environmental Protection Agency (EPA) is considering granting a Section 18 label exemption to older chemistries for bed bug control. Under Section 18 of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) EPA is authorized to allow an unregistered use of a pesticide for a limited time if EPA determines that an emergency condition exists.
The problem:
[NPMA Senior Vice President Bob] Rosenberg said that the current challenge facing the industry is that even though both states and EPA agree on the need, there is no manufacturer at this point that has committed to produce such products. “It could be any number of reasons from economic issues to concerns about liability,” Rosenberg said.
A couple of months ago we looked at just such doubts from PCT columnist Richard Kramer.
However, let’s be optimistic for once, yes?
This is the Section 18 process. And this is the statute.
Public health exemption, looks like, but would it be a crisis exemption? See EPA’s crisis process flow chart. Ah, so many questions, so little information.
How can the public, I wonder, advocate for these solutions?
Is anyone in a position to tell us more?
We’re going to have to research and think about just what the realistic options among those ‘older chemistries’ are. The Australians still have OPs and carbamates, see the Code of Practice. By the way, there is one organophosphate that is “back”—dichlorvos, see this March 2008 PCT article (PDF)—and there are several products registered in New York State according to the Cornell NYS pesticide database but apparently none labeled for bed bugs.
The Greater London Pest Liaison Group’s Beating Bedbugs best practice guides are finally out and you may download them on the group’s new website.
Not since the days of stalking the Cincinnati Board of Health meeting minutes for news of the Cincinnati/Hamilton County Strategic Plan have I waited for any bed bug documents with such impatience, continually checking various websites. And now I can’t devote proper time to discussing them! (Apologies, I hope we can return to this subject and review it in greater depth soon, or better yet, you tell us what you find interesting.) I entreat you, then, to read these documents; they reward the attention.
There are five guides, all PDFs: Information for Residents, Information for Landlords, Information for Healthcare Professionals, Preparing your home for bedbug treatment, and Inspection and treatment guide.
We first noted them here and learned that they were presented at Pestex this year, where the adoption rationale as well as the use of relevant laws for treatment access were explained. Once again, the ever useful Pest showed us where to find what we were looking for.
If you are interested in this subject, the difficult subject of bed bug policy development, you might see in these guides one clear path. There are many different ways of achieving our hoped-for result. One way, the city government way, seems closed to us for now, but why can’t we do this here, exactly? Our system is different, no local authorities here providing pest control services, but the elucidation of what needs to be done, what existing laws can be used to advantage, and, more important, an obvious consensus from within the practicing professionals, an agreement on direction and purpose if not methods. Why can’t we have this here?
If you care to look at our interview with Clive Boase, you will see his discussion of the 1936 Public Health Act and the principles of bed bug treatment and eradication borne out in these documents.
Notice for example, in the Guidance on Inspection and Treatment (PDF):
Confirmation that bedbugs have actually been eradicated from the treated premises, is critical. A surviving and redeveloping infestation will disperse and infest other properties, undoing the work already carried out.
Ha, indeed.
The International Public Health Pesticides Workshop presentations are a good place to learn about the problems of pesticides development and availability. (Disease vectors are the focus here as we’ve already noted but we should nevertheless pay attention to this process. And certainly long-term benefits and ‘new paradigms’ are something to hope for.)
This is IVCC’s presentation (PDF).
While we weren’t looking, bed bugs finally got their own category at the city’s 311 website:
The City accepts reports of bed bugs in private residences, New York City Housing Authority (NYCHA) property, hotels, single room occupancy buildings, day care centers, and subways. To report bed bugs in a private house or apartment, you must be a tenant in the building.
Under Complaints & Problems, Health & Medicine, Environmental Health, if you were wondering: Bed Bug Information or Complaint.
I called 311 to see if anything was new in how the actual calls were handled and a nice guy named Joseph walked me through what they’re doing. Basically, it’s the same but there was a certain efficiency to this call and no more “bed bugs? did you say bed bugs?” It’s still a complaint process that’s routed to HPD or NYCHA, and a call transfer to the Health Department if the caller wants the bed bug fact sheet. Interestingly, they’re now also taking complaints for subways (it’s a script for rats, mice and bed bugs or conditions conducive to the same), and that call gets routed to the MTA.
Good. And definitely not a small thing. A search for bed bugs in a visit to the city’s website in the past netted precious little. This is going to change.
We’d really like to see bed bug calls included in the monthly reports in every district. Or tracked like rodent complaints (PDF), one of the reports available in My Neighborhood Statistics.
At the New York City Council hearing on bed bug legislation in February, I remember that the Speaker thanked Council Member Brewer and specifically her chief of staff, Shula Warren, for 311′s tracking of bed bug calls. At the press conference, Council Member Brewer said that 311 had received 22,218 calls about bed bugs in fiscal year 2008. These calls would have included the private residential complaints tracked by HPD and also information inquiries, and calls about bed bugs in jails, schools, NYCHA properties, etc. It’s nice to see 311 formalizing this bed bug category on their website and specifically stating what bed bug reports they process. Right direction!
Welcome to New York vs Bed Bugs. Did you land here looking for a review of NYC landlord/tenant law? Please see this post: Bed bugs and the law in New York City.
Sharon Heath of the New York City Department of Health and Mental Hygiene will speak at EPA’s National Bed Bug Summit on April 14. It’s a portion of the session titled “How Public Health Agencies View Bed Bug Infestations,” with Mike Herring from CDC, Dr. Camille Jones from the Cincinnati Health Department and Sarah Norman from Baltimore City Health Department.
This is what we have always wanted, for our city and the city’s Health Department to show leadership on the bed bug issues. We have met Ms. Heath (we really like her a lot) and it’s very encouraging that she will participate.
EPA’s Office of Pesticide Programs has made the meeting agenda (PDF) available. Topics include bed bug basics, impact on public and private housing, control methods and challenges and the government response to bed bugs.
This is the page at OPP to access all summit information.
The morning speaker session on Tuesday, April 14, will be broadcast via webinar, instructions here (PDF). No Macs, however.
The work groups in the afternoon session on Tuesday will focus on the following objectives:
Tasks:
Identify most significant factors contributing to the problem
Identify and discuss options and solutions & workgroup recommendation
Major Topics to Consider:
Research
Role of Government
Consumer Education and Communication
PCO Education and Training
Role of Property Owners & Property Managers
The next day’s morning session will report the discussions.
I wonder what this will look like?
We have the highest hopes, but this is surely going to be difficult work.
Consider this summary of the bed bug workshop at last year’s International Conference on Urban Pests (ICUP) in Budapest which recently appeared in Pest, a new UK industry magazine. The article by Clive Boase, Bedbugs fascinate in Budapest (PDF), provides an interesting glimpse into the types of disagreements that may emerge in a discussion about what direction to take to control bed bugs in our society. You should take a look; you will likely find something to strongly agree or disagree with.
In a section on “customer oriented solutions,” Boase writes about the views expressed in discussion on the question of responsibilities:
Clarification of the individual responsibilities of the municipality, landlord, tenant and homeowner to deal with infestation, was also seen as important. If responsibility for identifying, reporting and controlling bedbugs was clarified, then a legal requirement for properties to be certified as free-of-infestation could help address the problem. This was felt to be particularly true for rented properties which can act as reservoirs of infestation.
And on training needs:
In terms of the quality of bedbug control work and the training necessary to carry out effective bedbug control, both manufacturers and academics thought that there had been a decline in the quality of practical bedbug control compared to earlier decades and that standards needed to improve.
Note: We listed the bed bug papers presented at ICUP Budapest here. There’s another bed bug article in this first issue of Pest, by the way, on David Cain and his bed bug survey presentation last year. So, we have one more publication to watch for bed bug stuff, great. There’s a preview of the next issue.
Finally, someone says something intelligent.
Asked by KARE11 about bed bugs, Dr. Stephen Kells said:
“Although they don’t transmit diseases, they could almost be considered like a disease themselves.”
You can tell when someone is compassionate and thoughtful about bed bugs and their absolutely deleterious impact on our society.
Here’s a bit more from the article—see the site for the video:
They’re tough and expensive to get rid of. That’s why Kells worries about outbreaks in low income housing because residents often can’t afford to hire an exterminator.
Here’s more Kells on this subject, from Bed Bugs: A Systemic Pest Within Society (2006, PDF):
When I began discussing the bed bug problem with colleagues in Canada, I heard disturbing news that some administrators in low-income housing were claiming that the elimination of bed bugs was too costly; instead, they began talking about suppressing infestations below threshold levels. Considering the hitchhiking ability of this bug, permitting reservoir sites to exist provides a continual source of bed bugs for temporary sites and a constant risk of dispersion through society.
By the way, there are other free articles from that issue of American Entomologist that are interesting.
And, yeah, of course I have thoughts on the JAMA juggernaut. I’ve now finished reading the paper. Reading. I guess that’s too much to ask from the people who are writing those pesky but harmless headlines. Honestly, who says pesky in the context of bed bugs? And where do they live? How can people still be so oblivious to the suffering this pest causes?
New York vs Bed Bugs recommends community and pest control industry surveys and a city-wide reporting database to track bed bug infestations in our city. Will we get it? Not sure, but I think we’ll be here until we get a comprehensive bed bug control plan, and no such thing will be complete without these tracking tools.
What information might be gleaned from surveys?
Hawai’i leads the way with methodology modeled on the 2003 Toronto study, Hwang et al. (2005).
In this study, Examination of Bed Bug (Cimex lectularius Linnaeus) Infestations on the Island of Oahu, Hawai’i (PDF), the authors collected health department data, surveyed 18 pest control companies and 16 shelters:
Abstract: Bed bug (Cimex lectularius Linnaeus) infestations have been increasing over the past several years in the continental United States. This study identified a similar rise in bed bug infestations on the island of Oahu, Hawai’i and followed up to characterize the local situation. The amount of calls and complaints regarding bed bugs to the Hawai’i State Department of Health, Oahu Vector Control Branch (DOHVCB) and Pest Control Companies (PCCs) increased in 2007 as compared to 2006. Eighteen pest management professionals (PMPs) were interviewed by phone in follow up. The number of sites treated for a company ranged from 2 to 650 in 2007, with a mean of 95.31 sites treated. Residential facilities were most commonly serviced by PMPs, shelters much less often. Eighteen employees from 16 shelters were then also interviewed using a different, in-person survey form. Eleven of these shelters had experienced a bed bug infestation, two of which were still affected at the time of the interview. Sixty-four percent of shelters’ infestations were limited to one incident, 87.50% of these were able to quickly eliminate infestations. To be able to contain an infestation in shelters such as these, training staff on prevention measures is critical. With the overall rise in infestations, updated public information is essential.
Fickle, V.J., Yang, P., Olmsted, G.K. 2008. Examination of Bed Bug (Cimex lectularius Linnaeus) Infestations on the Island of Oahu, Hawai’i. Hawai’i Journal of Public Health. 1:1, 36-39. Full-text PDF available.
Here are some interesting items from this paper:
- The Oahu Department of Health Vector Control Branch recorded 69 bed bug complaints in 2007, up from 30 in 2006, mostly from residential callers.
- PMPs serviced mostly residential locations (74%), hotels (15%), almost no shelters (0.42%), nursing homes (9%), and less commonly, cruise ships, businesses and one fire station.
- One PMP stopped servicing bed bug accounts in 2006 because “demand was too high and profits were unpredictable” and another PMP only treated bed bugs for long-standing accounts.
- Suspend SC (deltamethrin) and sulfuryl fluoride (Vikane, Zythor, true fumigation) seemed to be the tools of choice for the surveyed PMPs.
- In almost all the surveyed shelters (90.9%), mattresses and furniture were thrown out after each infestation.
- Bed bugs spread in 64% of the shelters from the original infested room.
- Most shelters only had a small number of rooms infested, but one shelter had every room and every bed infested:
The spread of the infestation in this shelter may have been due to the short walls separating units. Whereas all other shelters examined had separate rooms for every family, this shelter used cubicles with 4ft walls to separate families.
- 3 shelters had staff taking home an infestation.
- The authors conclude by noting the protocol in one shelter in Hawaii:
One shelter on the Big Island of Hawai’i was given a large walk-in freezer and pre-freezes all items for several days before they enter the facility.
I’m smiling as I write this because the subject is another conference/workshop/meeting.
What can you do? When it rains.
The International Public Health Pesticides Workshop will be held in London on May 19. The organizers are EPA and the Chartered Institute of Environmental Health (UK).
Its purpose:
The purpose of the meeting is to identify new approaches, processes, and implementation strategies that will lead to development and approval of new public health pest control tools. The outputs of the meeting will complement on-going global public health efforts and include a framework for conducting global reviews of new public health pesticide products.
And why it’s necessary:
From a global perspective, public health programs are faced with a depleting arsenal of safe, efficient and cost-effective insecticides.
The focus of this meeting must be public health pesticides for disease vectors and, ordinarily, we would think bed bugs would be left completely out. And I’m not sure how much they might be in, but notice the familiar photograph on the top right.
A global streamlining process to ensure the pipeline of critical pesticides and tools would necessarily benefit bed bug control in the long run whether bed bugs are the initial focus of such a project or not. And it might prevent other pest outbreaks from catching us as unprepared and unequipped as we have been in the case of bed bugs.
The depleting arsenal. I believe that this is the cause of the bed bug resurgence. I know that people have their own theories and favored explanations, but that’s mine: bed bugs are “back” (they never really left) because the methods used to control them started to fail.
No matter what you believe, bed bugs are not likely to significantly decline until we implement an organized response from all sectors in society. But actually accomplishing the feat of making them “disappear” again will require effective and easily deployable control methods.
When we talked to Dr. Jody Gangloff-Kaufmann last fall, we learned of an interesting workshop being planned for the 6th International IPM Symposium.
The program (PDF) is now available and the session, Bed Bugs and Public Health: Establishing the Connections, is extremely interesting:
Because of the long hiatus in bed bug infestations, many people are unaware of them and in many cases IPM strategies have not been adopted. New approaches to raising awareness and managing bed bugs on a community-level are needed. Many sufferers have nowhere to turn for help with bed bugs, such as financial aid, medical attention, and even physical labor needed to begin bed bug control. This workshop seeks to explore and document the links between bed bug infestations and public health, to foster the development of networks and new approaches to their spread, and to illuminate the opportunities for collaboration for a more comprehensive approach to managing bed bugs.
The presentations:
Elizabeth S. Kasameyer, Baltimore City Health Department, Division of Healthy Homes
Bed Bugs in Context: Potential Impacts on the Health of Today’s Vulnerable Populations
This discussion will focus on the clinical implications of infestation for our most vulnerable populations, including: children, the elderly, diabetics, people with compromised immune systems, and cardiovascular disease.
Stephen A. Kells, University of Minnesota
The Societal Connections Used by Bed Bugs: Possible Steps to Consider When Moving from Just Fighting Fires to Systemic Isolation
Complaints from temporary nesting sites are now displaced by problems encountered with multi-family housing, student residences and low income housing. This is now feeding the infestation back to other societal common-points such as hospitals, schools and places of business. With an increase in such habitat complexity, control in commercial housing areas has been costly and largely remains incomplete. The challenge will be to decide on a societal basis what practices and resources will best impact bed bug sources, or their mechanism of transmission, to reduce the societal spread. This presentation will discuss past cases of societal spread and assessment methods to reduce the risk of societal bed bug movement.
Jeremy D. Hessel, Environmental Health Division, Hamilton County Public Health
Community-Level Response to Bed Bug Infestations in Hamilton County, Ohio
This presentation will discuss the uniform response and approach that Hamilton County Public Health and the City of Cincinnati Health Department have taken. We have learned through experience in the field and through education in the community what approaches work. Hamilton County Public Health’s proactive response to bed bugs will hopefully reduce the impact of bedbugs in the community.
Changlu Wang, Rutgers University
Implementing a Bedbug IPM Program in Low Income Housing
The cost and effectiveness of two bed bug integrated pest management (IPM) programs were evaluated in 16 low-income apartments. The apartments were randomly divided into two treatment groups: diatomaceous earth dust based IPM and chlorfenapyr spray-based IPM. Bed bug counts were monitored bi-weekly. Mattress and box spring encasements were installed and hot steam was applied to infested areas. Additionally, bed bug intercepting devices were installed under furniture legs in dust-based IPM group. After 10 weeks, bed bugs were eradicated from 50% of the apartments in each group. Program cost and effectiveness of the bed bug intercepting devices are discussed.
Jody Gangloff-Kaufmann, New York State Integrated Pest Management Program, Cornell University
Examples of Successes in Bed Bug Management and What’s Still Missing
Bed bugs are pests that truly require an integrated pest management approach. Yes, control tools must be integrated. But the most successful bed bug management programs integrate a network of entities, including pest management professionals, health agencies, housing authorities, advocates, and those affected by bed bugs. Education and collaboration are emphasized. Examples of successful collaborations in the United States and elsewhere will be described along with gaps in our ability to aide those affected by bed bugs.
The symposium will be held March 24-26 in Portland, Oregon.
Bed bugs and public health. I think some of us thought we’d never see the day, but it’s been that kind of year so far. I hope this is just the beginning.
Jeremy Hessel very generously talked to us last year about bed bugs in Hamilton County. You may wish to read our Q&A with Dr. Gangloff-Kaufmann about the wonderful Guidelines for Prevention and Management of Bed Bugs in Shelters and Group Living Facilities. And Nobugs recently wrote about the bed bug intercepting device used in Dr. Wang’s study.
