Bedbugs: An Especially Disgusting Epidemic, and How to Avoid Catching them at a Hotel

Did you know that the CDC does not consider bedbugs to be a public health threat? Well I’m going to call shenanigans on that one. Bedbugs are parasites, and any parasite that causes this much physical and psychological discomfort to this many people is a public health threat to me. Now is probably the time to issue a Grossness Alert. If you’d prefer not to contemplate insects that live and poop in your bed, emerging at night to suck your blood, this is not the post for you. Perhaps you’d like to pass the time by watching a Tim Minchin video instead. The rest of you, please read on.

Part I. An Especially Disgusting Epidemic

File:Bedbugs.jpg

Source: Wikimedia Commons

Today’s post features, in addition to revolting photos, stories about two of my friends who have real jobs: Leah, a social worker in a major US city and a bedbug infestation survivor (I’ve changed her name at her request to protect the privacy of her clients), and Ada, who works at a Mosquito and Vector Control agency in California. I asked Leah if I could share her story of what it was like to have bedbugs. It turns out the story starts with her job:

I was working in intensive case management for folks who were severely mentally ill and I had a client who had an infestation. The client was an exceedingly sweet man with a diagnosis of schizophrenia, and the last time he had bed bugs he actually tried to kill himself because that’s how terrible they are! So his super told him he had to have his apartment prepped for treatment by such and such a day but he just couldn’t do it. So me and this other case manager went in and got to work. And Jesus Christ, was it sick. They were EVERYWHERE. Every time you moved something, they would scatter. And on the ground were all their gross crispy shed skin. It was seriously traumatic for everyone involved. [Emphasis mine]

Afterward, Leah followed all the anti-bedbug protocols, including throwing out the clothes she had been wearing that day. Then a few weeks later, of all the rotten luck, she wound up with a bedbug infestation introduced by some linens left by an ex-roommate. On the good luck side, she and her roommates had a cooperative landlord who paid for their home to be heat-treated, so now they are bedbug free. But the trauma remains. “It’s really isolating and no one understands except for the people who have been through it,” Leah told me. “For months, you think you see bugs everywhere and spend hours staring at your mattress with a head lamp.”

File:Bedbug004.jpg

Image Source: Wikimedia Commons

So what’s up with bedbugs? The CDC is upbeat in its assurances that bedbugs cannot spread disease–that is, nothing besides themselves. A bedbug infestation is no joke, though. Not only do 70% of people bitten have an itchy reaction like being covered in mosquito bites, but clinical consequences can include severe allergic reactions and exacerbation of asthma symptoms; a very small number of case studies have raised the (disputed) possibility that bedbugs can suck away enough blood to cause anemia. It also has a way of interfering with a good night’s sleep–a topic close to my own heart. But the worst consequences for most people, as Leah’s story suggests, are psychological. Does it reflect our cultural undervaluing of mental health that something that may cause stress, anxiety or depression–a trauma that may have driven Leah’s client to attempt suicide–could be classified as a nuisance rather than a disease?

Everyone seems to agree that infestations are resurging in developed countries in a big way, but it’s surprisingly hard to get estimates of the prevalence of bedbugs (best I can offer is a report of the number of 311 calls about bedbugs in New York City–there’s a chart on page six). Bedbugs may be spread on essentially anything wooden or soft, notably mattresses and second hand furniture, but also on clothing or sheets, or by hitchhiking home from your travels in your luggage. They can crawl from your neighbor’s apartment into yours via electrical cable.

Bedbug infestation is not, as is commonly believed, a sign of squalor; they can turn up in very clean, very fancy places–hospitals, movie theaters, airports, five-star hotels. They do disproportionately affect people living in poverty, however (believe me yet that it’s a public health threat?).  “Obviously it’s a problem for everyone at this point, across socioeconomic lines,” said Leah. “But…it is so over the top in subsidized housing and in shelters. And infestations like that never really get treated, they just get contained. Like our big shelter in [our city] just sprays for them like once a month forever.”

Spraying once a month will definitely not do the trick. Bedbugs are dang near impossible to kill–insecticides exist, but many bedbug populations are now resistant to any insecticide that isn’t also toxic to humans. They can go for months without eating. The best method of extermination is to literally heat your home to 130ºF and cook the bedbugs to death. As you might imagine that is neither easy nor cheap (on average $1,200 per apartment where I live), and must be paid out of pocket. For folks that can’t afford that, the next best option is a housecleaning holy war with scrupulous vaccuming, use of diatomaceous earth, and putting bowls of oil at the foot of the bed to trap bedbugs in a moat before they can climb up. Don’t even get me started on our cultural attitudes toward house cleaning, or the assumption that if you really want to you can magically produce the time required to vacuum every crevice in your home every night.

Part II. How to Avoid Catching them at a Hotel

Now for the second part of this story–avoiding bedbugs when you stay in hotels. A hotel without beds is probably not a viable business plan, and with people coming and going every day, those beds are bug hotspots. I recently had to travel to Baltimore for a business trip, and stay in a nice hotel for four nights. Before leaving, I consulted with my friend Ada, of Mosquito and Vector Control. She has been a font of crazy insect stories over the years (Did you know that following the housing market crash in 2008, the pools standing open in foreclosed homes caused a surge in the mosquito population? Her agency’s website also includes a button for “Report a Dead Bird.”). So Ada has seen a lot of people traumatized by bedbugs over the years, and she is dead serious about preventing infestation of her own home. She has developed the following protocol for travel, compiling prevention tips from various public health and government organizations. She gave me her permission to share it here.

Ada’s Anti-Bedbug Travel Protocol

  1. Luggage type matters.  If you have them, I would recommend using the hard-sided luggage instead of the soft or woven kind.
  2. See if your hotel is on the Bed Bug Registry so you can be hyper-aware.  Sometimes people post the rooms they were in as well.
  3. On the shuttle, keep your luggage with you if possible (between your legs), instead of on the luggage racks.  I lucked out when I traveled last time.  It was raining, so I actually put a garbage back over my suitcase (and cut a slit for the handle) to “shield it from the rain” so I didn’t look as crazy.
  4. Carry on if you can, preferably placing stuff in the end of overhead bins with a jacket or some other item between your bag and the bag next to it.
  5. When you get to the hotel, ask them if they’ve had a history of bedbugs and request a room that has not received bedbug reports/complaints.
  6. When you get to your room, place your luggage and other items on the rack or in the bathroom or any solid/hard surface.
  7. Then pull back the sheets (most especially on the corners) and inspect top and bottom mattress seams and box spring and other crevices for bedbugs or evidence of bedbugs (blood spots, dark pen-like spots [Anna’s note–the black spots are bedbug poop]).
  8. Inspect the headboard by sliding a business card or other cardstock-like item along the edges behind the headboard.
  9. Inspect nightstand including inside drawers.
  10. If you find any evidence of bedbugs, request a new room immediately, and then go through all the steps again.
  11. Once you find a suitable room, I prefer leaving my clothing inside the suitcase, but if you need to take stuff out, you can hang them so they don’t touch the walls and inspect drawers before putting stuff in them.
  12. Do not leave your shoes on the carpet, place them on a rack or in the bathroom.
  13. If you have to put things on the floor, use the laundry bag from the room as a barrier.  I always put my dirty laundry in those and leave that on the floor.
  14. If you find bedbugs in your room during your stay, but don’t want to switch rooms or want to be extra vigilant, you can request the hotel fumigate your stuff when you check out.  They probably use some kind of pyrethrin/roid which is nontoxic to humans.
  15. Traveling home, use the same precautions with your luggage mentioned above.
  16. Once home, keep your suitcase on a hard surface.  Wash everything that is washable and dry on the highest heat setting.  I like to keep my luggage in the spare bathtub for a week or so to see if anything crawls off. Then you can either bag it in a black garbage bag and set it out in the sun for a few days or any place that can get it to 130 degrees for 30 minutes. If its small enough, you may be able to get it in your dryer with the use of a rack insert.
The first time I read this list, my initial response* was, “Christ on a cracker. A ritz cracker stuck between the headboard and the mattress, unearthed with a business card.” Ada responded, “…you already knew I was crazy.” Actually I didn’t. Ada is a quite relaxed and practical person. So I knew if she was implementing this routine (which she says only takes her about five minutes now that she’s used to it), I had to give this a try. It’s not like I was using my business cards for networking anyway. So upon checking into my hotel I did most of those things, as my coworker-roommate stared with ever-widening eyes. I kept my dad’s vintage 1980’s hard suitcase on the desk the whole time, and kept my clean clothes in a drawer and dirty ones in the suitcase. I couldn’t quite bring myself to ask the folks at the desk about it, and I don’t have a spare bathtub, but I’ve been home for two weeks now and so far so good (kenahara).

For those of you who wish to torture yourselves a bit longer, I offer you two flavors of educational bedbug video:

Normal (National Geographic’s Ew Gross! Bed Bugs!)…

…and Completely Bonkers (Isabella Rossellini in the Green Porno series).
*Apologies to my Christian readers.
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