Chicago vs. Bed Bugs

Advocating policy to control the spread of bed bugs in the City of Chicago

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Bed Bugs: A Matter of Public Health

Posted by Jessica on December 21, 2008

Several weeks ago, our adviser, Doug Summers, MS, suggested that I read a relatively new (and really, really long) document published by the World Health Organization.  Well, I finally got around to opening The Public Health Significance of Urban Pests yesterday, and when I read chapter four (page 73), “Bedbugs,” I understood exactly why Doug brought it to my attention.

See, creating and enforcing good bed bug policy is a challenging task. It requires a coordinated effort, and it involves multiple parties of interest– legislators, government agencies, residents, industry professionals, and business owners, to name a few.  And at the heart of this task is one particularly challenging question: Who, exactly, is going to be responsible for all of this?

The Public Health Significance of Urban Pests provides an answer, and it is the best answer I’ve seen so far.  In fact, I’m seeing it in action right now, in other cities and other states and other countries, and it seems to be working quite well.

So who, exactly, is going to be responsible for all of this?  The agency responsible for managing public health and safety, that’s who.  And here are a whole bunch of (really, really creepy) reasons why:

From chapter 4, “Bedbugs,” section 3, “The implications for public health,” The Public Health Significance of Urban Pests, World Health Organization, 2008:

All species of bugs in the family Cimicidae are obligate blood feeders – that is, they survive only by feeding on blood – and many have limited host specificity.  They only consume blood from a host, usually a mammal (such as human beings and bats) or bird.  They must take at least one blood-meal of adequate volume in each active life stage (instar) to develop to the next instar, or to reproduce. There are five immature instars, and each one may feed multiple times if hosts are readily available. Adults of the common bedbug may feed every 3-5 days throughout their estimated typical 6-12-month lifespan. The acts involved in feeding to acquire each blood-meal – that is, biting a host- can cause both physical and psychological discomfort, as well as local allergic skin reactions to the salivary proteins injected.

Yes, this is disgusting.  You’re probably starting to itch, aren’t you?  It’s pretty awful to think about yourself as a host to a parasite that lives with you in your bedroom and feeds on you while you sleep, isn’t it?  It is, but that’s not the part we’re most concerned about.  What’s important here, to the parties involved in creating bed bug policy, anyway, is the very last sentence, because it clearly shows that bed bug bites can cause health issues.  Unless, of course, easily transmittable parasites that cause “physical and psychological discomfort” and “local allergic skin reactions” to human beings don’t quite qualify as health issues in the eyes of public health agencies.

Perhaps these do:

From section 3.3:

Although their bite is often nearly undetectable, the saliva of bedbugs contains biologically and enzymatically active proteins that may cause a progressive immunogenic and allergenic reaction to repeated bitingPeople bitten frequently by these bugs may develop a so-called sensitivity syndrome, which may include nervousness, nearly constant agitation (jumpiness), and sleeplessness.

Medical clinicians… have reported the following significant symptoms as due to common bedbug bites:

  • serious local redness and intense itching, both immediately and after several days delay
  • disseminated bullous eruption with systemic reaction
  • true anaphylaxis, which has been misinterpreted as coronary occlusion

Numerous routine bedbug bites can contribute to anaemia and may even make a person more susceptible to common diseases.  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.

Alright, now we’re beyond the realm of just-plain-creepy.  Now we’re talking about easily transmittable parasites that cause a laundry list of human health problems, ranging from near-constant agitation to true anaphylaxis, which, as you probably know, is nothing to joke about.  And if this isn’t enough to justify the attention of public health agencies, well, brace yourselves, because there’s more.  This is about to get ugly, folks.

From section 3.2:

Common bedbugs have been found to naturally contain 28 human pathogens, but they have never been proven to transmit biologically or mechanically even one human pathogen- specifically hepatitis C and HIV.

No, no, no, that’s not the ugly part.  That’s the good part.  Ready for the rest?

Nevertheless, shedding of viral DNA fragments in faecal matter and transstadial (across life stage) transmission of hepatitis B virus seem to support the possibility of mechanical transmission by contaminated faeces, or when bugs are crushed during feeding onto abraded skin by a susceptible person.

Yes, it means what you think it means.  Bed bugs do, in fact, like to use your sheets as toilets, if you get my drift.  It’s one of their trademark moves.  First they feed on you, then they poo next to you, and then they cohabit with you, sometimes right underneath your pillow.  I told you this was going to get ugly!

And what the World Health Organization is saying here is that bed bugs naturally contain 28 human pathogens; fragments of these pathogens are shed in bed bug feces.  Biological transmission (bug to human through bites) of these pathogens has never been documented, but evidence suggests that it is possible for a person to roll over on a tiny little piece of bed bug crap, get it into an open sore (like one made while scratching relentlessly), and contract a virus– maybe even hepatitis B.  The same goes for rolling over onto a bed bug.  Just imagine the same scenario, only insert “bed bug full of blood” for “piece of bed bug crap”.  I don’t mean to be crass here, really, but there is just no good way to say these things!

I think the laundry list of health problems bed bugs can cause human beings could get a lot longer if the transmission-by-feces suggestion holds any water at all.

So, is it safe to say that bed bugs are a matter of public health?  And is it safe to say that public health agencies are the best-equipped parties to assume responsibility for creating and enforcing bed bug policy everywhere? Well, I certainly think so, but my opinion doesn’t count for much.  What does count for a whole lot is precedence.  And here it is:

“I am writing to ask that you declare ‘bedbugs’ to be a health hazard.  I am including photographs of children who are afraid to go to sleep because their apartment is infested.  Can you imagine the mental anguish of parents who put their children to bed at night knowing that they will wake up with bites all over their bodies…  It has proven to be an impossible situation and will remain so until the Board of Health declares bed bugs to be a health hazard.”  Toronto City Councillor Howard Moscoe, in a letter to the Chair and Members of the Board of Health, Toronto.

“The City and County Health Departments have come together to put a plan to attack the bed bug problem in our community. This plan spells out what citizens can do to protect themselves from this pest.” Hamilton County Commissioner Todd Portune, about the Cincinnati-Hamilton County Joint Bed Bug Task Force.

“Local boards of health would be empowered to conduct exterminations and bill unresponsive landlords. The measure also would require annual inspections of all multi-unit dwellings in the state for bedbug infestations and would require the state Department of Health and Senior Services to create and distribute an informational pamphlet to educate the public about bedbugs.”  From the New Jersey State Assembly Quigley/Spencer/Smith bill news release.

“These Director’s rules and regulations provide guidance for the hotel industry, building owners and managers, tenants, the pest control companies both for the prevention and control of bed bug infestation and for effective compliance with the San Francisco Health Code.  In order to control the spread of bed bugs in the City, it will require an integrated pest control method that encompasses all the stakeholders.”  From the San Francisco Department of Public Health Director’s Rules and Regulations: How to Control Bed Bug Infestation.

“The Toronto Bed Bug Project is comprised of a steering committee and seven workgroups whose membership consists of staff from Public Health, Shelter, Support and Housing Administration, Solid Waste, as well as community agencies, health care organizations, social services, pest management professionals and landlord and tenant representatives.” From the Toronto Medical Officer of Health, in a staff action report update to the Toronto Board of Health.

And there we have it.  Our adviser is on to something, you see.  Perhaps we should consider writing a letter to the Chicago Department of Public Health and asking them to take responsibility for creating and enforcing bed bug policy, with rules and regulations about pest management, financial obligations, sanitation efforts, and public education.  Heck, maybe we should go really big and write a similar letter to the United States Surgeon General.  Talk about killing two birds with one stone!


One Response to “Bed Bugs: A Matter of Public Health”

  1. […] weighs in on the public health question—and gets down to one of the little known miseries of a bed bug infestation: Yes, it means what you think it means. Bed bugs do, in fact, like to use your sheets as toilets, […]

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