I've Got Bugs in My Bed and I Don't Know...How to Get Rid of Them

[SafetyNurse1968, BSN, MSN, PhD]

Though infestations were common at the beginning of the 20th century, bed bugs haven't been on the public health radar for quite a while. In the last ten years, unfortunately, they've experienced renewed popularity. Experts think the recent increase in infestations may be due to increased travel, lack of knowledge about preventing infestations, increased resistance of the bugs to pesticides and ineffective pest control practices. So let's talk about that.

Everything You Didn't Want To Know...

Read on to become a bed bug expert. According to the department of entomology at Virginia Tech, bed bugs are blood-sucking insects in the Cimicidae family. Both the immature bugs (nymphs) and adults feed on sleeping or sedentary humans, mostly at night. The common bed bug, Cimex lectularius, is found in North America, Europe and Central Asia, but there are tropical species as well. Bed bugs can feed on other species of mammals including birds, mice, and rabbits. They lay between 200-500 tiny white eggs during their lifetimes, usually 2-5 eggs per day on rough surfaces such as wood or paper near the hosts' sleeping place. A glue-like material covers the eggs, which hatch in about 10-15 days at room temperature. Bed bugs can go without feeding for 20-400 days (YUP!) depending on temp and humidity. There are five progressively larger nymphal stages, each requires one blood meal before molting to the next stage. The entire life cycle takes between 5 weeks to 4 months. Most people don't know they've been bitten because they're asleep when the bite occurs, and the saliva injected during the bite produces a natural anesthetic. In 2/3rds of those bitten, a bed bug bite looks like a raised welt, that's itchy and swollen, however 1/3rd of those bitten don't have a reaction to the bites. Bed bugs can also leave odors and ugly fecal spots on bed sheets. Luckily, they don't spread or cause disease, but physical and emotional stress make them an unwelcome visitor.¹

Here is a picture from a home I recently helped de-bug:

Myth Busting

The Environmental Protection Agency (EPA) has classified bed bugs as a public health hazard.² They have a great website, with tons of great info. Let's start with a list some of the most common myths about bed bugs. Knowing the truth can set you free (of bed bugs). The most common myth is that bed bugs are a sign of dirt and grime. However, cleanliness has nothing to do with bed bugs. Unlike roaches, rats or flies, which feed on refuse and trash, bed bugs feed on blood. They just need a warm body. Bed bugs have been found in some of the finest hotels in the world, and are no longer seen as pests associated with crowded or dilapidated housing. They are most often found in major metropolitan areas. The top US cities where bedbugs are a problem are Baltimore, Washington DC, Chicago, New York and Columbus, Ohio. Low-income housing units are often sites of infestations due to the use of old bedding and lack of attention to the problem by housing management.³

It's important to know that if you live in an apartment complex, bed bugs can easily move from apartment to apartment, and people may not even know they are infested because not everyone reacts to bed bug bites. If you find you have bed bugs in your bed, and then you move to sleep on the couch, they will follow you, and then your couch will be infested. They tend to only follow you where you sleep. Bed bugs are brought into a home by someone who has travelled outside the home. If you go somewhere with bed bugs, they can crawl into your pillowcase or home health bag or purse. They are good at attaching to things. Experts have seen them on beanie babies, baseball caps and even on the bottoms of shoes. Just remember, you won't typically get them from places where people don't sleep.²

Other myths include that bed bugs won't come out if a room is brightly lit, that you can get rid of them with pesticides alone, and that if you have bed bugs you have to get rid of your bed. Calling an exterminator may seem like the easiest and quickest method of getting rid of bed bugs, however it can be expensive (running in the thousands of dollars for some services) and often relies heavily on chemicals.²

Prevention

To prevent picking up unwanted travellers, inspect the seams of mattresses, pull back sheets, check corners near pillows and the headboard. You are looking for small, black spots. The bugs themselves are flat and can range in size from almost invisible to the eye to ½ cm. Also check for the yellowish skins the bed bugs shed when they grow. And finally, you may see brown spots on linens that indicate a bed bug has had a meal and is excreting blood. Other strategies for preventing home infestations include checking secondhand furniture, using a protective cover to encase mattresses and box springs, reducing clutter, vacuuming frequently and being vigilant. They reproduce quickly, so it's important to catch sight of them early.²

What You Need To Get Rid Of Bed Bugs

The following outline discusses how you can get rid of bed bugs on your own with minimal cost (less than $100) and some hard work. Many of my home health clients don't have access to high cost exterminators, and though public housing is supposed to be responsive to infestations, they often, sadly, are not. So here is some low-cost, effective teaching about how to get 'em out and keep 'em out from the Texas A&M Agrilife Extension and the Minnesota Department of Agriculture.^{4 & 5}

Supplies:

• Trash bags
• Tools for hunting and destroying bugs: flashlight, Old credit card or flat head screwdriver, clear tape, plastic bags, a cloth and hot soapy water
• Vacuum cleaner with lots of bags
• Zippered, bed bug proof covers for all mattresses and box springs
• Bug interceptors (go under legs of bed to catch and kill bugs)⁶
• Diatomaceous earth
• Pesticides

Preparation:

STEP 1: Remove clutter - keep clothing off floor

a. Get rid of cardboard - use plastic boxes

STEP 2: Don't throw your bed away! Make your bed an island

a. Move it 6 inches from the wall

b. Strip and vacuum the mattresses and box springs

c. Remove all bed bugs, larvae and eggs from bed, frame and headboard - sticky tape is useful

d. Place bed-bug proof covers on mattress and boxspring (any bugs left inside will starve)

e. Double bag your bedding and wash in hot water and dry for 30 minutes (discard inner bag after putting bedding into washer)

f. Bed frame: eggs are tough to remove - they won't get vacuumed up, this is where insecticide sprays and diatomaceous earth are useful for every crack and crevice

g. Tuck all bedding under mattress - don't allow it to touch the floor

h. Place bed bug interceptors under each leg of the bed - these are a great way to track progress - notice how many bugs fall into the trap daily.

i. Remove anything under the bed

STEP 3: Clean all items

a. Heat treat clothing - in a dryer on high heat for 30 minutes. Steam can be very effective. Use a 1 gallon (minimum) commercial steamer - the object being treated should be 160-180 F immediately after the steam brush has passed. You can use an infrared thermometer to monitor the temp - use care because steam can burn your skin.

b. Store clean items in a sealed plastic bag to ensure they remain bug free

c. Inspect and clean furniture, baseboards, behind outlet and switch covers - sticky tape is useful for cleaning - be sure to double bag it

d. Use sealed plastic bags to transport items being moved from one area to another

e. Remove and clean drapes and drapery hardware

f. Remove bed bugs from all furniture

g. Vacuum thoroughly, remove and dispose of vacuum bags (vacuuming doesn't remove eggs)

h. Seal the vacuum bag in a plastic bag

i. Place in trash outside

STEP 4: Eliminate bed bug habitats

a. Caulk cracks or crevices around baseboards

b. Repair wallboard damage, ensure wallpaper is not loose

c. Check electrical outlets and wall switches for evidence of bed bugs

STEP 5: Kill the bed bugs (70% of all bed bugs are located on the mattress, box spring and bed frame)

a. Heat treatment using a clothes dryer on high heat, place plastic bags in the sun or a hot, closed car. 7 lbs of items in clear bags in direct sunlight on a 95 degree day will get hot enough to kill all bed bug life stages in one afternoon.

b. Leave items in freezer set to zero degrees for 4 days

c. Use pesticides sparingly.² Only use those specifically labeled for bed bugs AFTER you have done all these other things - they only kill the bugs that are out in the open, not the ones that are hiding (the EPA site lists them all, with pros and cons - you can use a fogger, but only use them after you have tried everything else, and air out the room before going back inside. Be sure to extinguish all pilot lights and cover all food)

d. Plant based sprays like Neem oil, EcoRaider and Bed Bug Patrol have been found to be surprisingly effective.

e. If repeated treatments are needed, consider desiccants like diatomaceous earth (only use food grade, and work it into cracks and crevices, you don't want to inhale it, though it is safe to eat)

STEP 6: Continue to inspect for bed bugs every 7 days

Resources

Several of the references I have provided are PDFs that you can print out and share with clients, patients and community members. The University of California even has one in English and in Spanish.7 If you are looking for local resources, please also consider using 211, which is an information and referral service provided by United Way. Accessible via an easy-to-remember, three-digit number, families and individuals can call to obtain free and confidential information on health and human services and resources within their community. If you have a question, 211 will do their best to answer it.⁸

If you live in public housing, they are supposed to "deal with it". Bed Bug control falls under the Environmental Health Division of your County Health Department. In the town I live in, I called and left a message for the Director of Environmental Health requesting more information on how bed bugs and public housing are handled. The director called me back the next day and was kind enough to share that she had a bed bug problem about one year ago in her own home, and she asked that I talk about the emotional toll it takes on a person. We talked about how ashamed she felt because bed bugs are traditionally seen as something that happens to "dirty people". She spent thousands of dollars to get rid of her bed bugs, and told me how hard it was on her teenage girls because they couldn't have people over to their house during the treatment period. I am so grateful for her courage in sharing.

Pricing

I found the least expensive shopping to be on Amazon: Interceptors (the things that go under the bed legs) are $11 for 4. EcoRaid is about $20 for 16oz, and diatomaceous earth is about $7 for 8 oz. Mattress and box spring covers started at about $20 each. After I calculated the price for garbage bags, tape and extra vacuum cleaner bags - the total for DIY runs about $100 (if you only have one bed). Compared to the cost of a new bed...and the waste of throwing out the old one, or to the cost of hiring an exterminator, $100 is pretty reasonable. I know this can be hard to believe, given all the warnings in social media about throwing away everything you own, however I want to encourage DIY methods, because I have seen them work. Please consider a moderate approach in dealing with bed bugs. Use pesticides sparingly, and consider bed bug biology when you are struggling with a knee-jerk "THAT IS SO GROSS I AM THROWING AWAY EVERYTHING!" approach. Remember, if you don't feed them, they will die. Trap the little boogers in a bed bug proof mattress cover, and they will starve. They don't like heat and they don't like cold. They can't fly and they can't jump. If you move your bed away from the wall, and prevent them from climbing your bed legs, they can't get to you. It's not rocket science, it's regular science, and you can totally handle it. Pest control companies want to make money, just like anyone else, but it doesn't have to be YOUR money. And finally, remember, there is NO SHAME in having bed bugs. They are opportunistic, hitch-hikers - anyone can get them!

References

1. http://www.vdacs.virginia.gov/pdf/bb-biology1.pdf

2. Bed Bugs: Get Them Out and Keep Them Out | US EPA

3. The 5 most bed bug-infested cities in America

4. Bed bugs: Do-it-yourself control options - Insects in the City

5.https://www.bedbugs.umn.edu/sites/bedbugs.umn.edu/files/y2017m04d15_bed_bug_control_in_residences.pdf

6. DIY Bedbug Interceptor Traps: 5 Steps

7. Bed Bug Management Guidelines--UC IPM

8. 2-1-1.org

[3ringnursing, BSN]

OMG! What fantastic article!!! Many thanks for the very best no nonsense, practical and low cost bedbug eradication plan I've ever seen.

I work telephone triage with the largest majority of our patients being very low income (i.e., the working poor). Many call for appointments with providers for bites, but eradicating these virulent pests from the home isn't often addressed in the clinics. Many call for repeat appointments bringing in all family members -- many of our patients and their families don't always have even an extra dollar to spare, so cost efficiency is an absolute must. I made screen shots this article and downloaded the pictures to my work computer because it is superior to what we have in our protocol. Thanks so much!

[sweet sunshine]

Great article! Is the dryer time enough? I read 70 minutes doing research on this.

[Buckeye.nurse]

Thank you for this very helpful article!

[RNrhythm, BSN, RN]

We travel several times a year and my husband is particular about inspecting the room before we put anything down, including inspecting the bed for bedbugs. That always seemed excessive to me. A few years ago he found bedbugs, unmistakably, in a high-end boutique hotel in central California. Live and learn!

[amoLucia]

Just today in the Philadelphia news was a story of a woman contracting bedbugs from the fabric back seams of a SEPTA street bus. They showed picture of a vinyl seat's seams with the buggy critters.

SEPTA reports that it performs quarterly bug sanitation, but that it is also now reupholstering its bus seats with a vinyl-only covering.