Bed Bugs!

Posted on by John Howard, MD, Naomi Hudson, DrPH, MPH, and Geoffrey Calvert, MD, MPH, FACP

magnified bed bug“Just try to sleep tight. The bed bugs are back,” a New York Times headline proclaimed in 2005. The article reported on a resurgence of reports about infestations of tiny Cimex lectularius in New York City. These “stealthy and fast-moving nocturnal creatures that were all but eradicated by DDT after World War II, have recently been found in hospital maternity wards, private schools and even a plastic surgeon’s waiting room,” the article stated.1

The New York experience is not unique. Around the world, pest control specialists have reported “10-fold, 100-fold, even 1,000-fold increases in bed bug jobs over the past five or ten years,” according to pest control consultants Lawrence J. Pinto, Richard Cooper, and Sandy Kraft.2

Bed bugs have been a nuisance to humans at least as far back as ancient Greece. Although largely eradicated in the Western countries in the 1940s with the aggressive use of pesticides, notably DDT, they began to re-emerge in the mid-1990s. Entomologists and pest control specialists believe that several factors may contribute to this trend. These factors include the continuing decline or elimination of effective vector/pest control programs at state and local public health agencies, increased resistance to various insecticides, and an increase in international travel, which raises the chances that the tiny pests will be unknowingly packed into luggage.3

Bed bugs are not known to transmit disease, but they are a troublesome health nuisance. Their bites can cause mild to severe allergic reactions, and people living in infested homes have reported anxiety, insomnia, and systemic reactions.4 These bites don’t just occur at home. Using workers’ compensation (WC) claims data from California between 2000 and 2011, the California Department of Public Health identified 96 workers who were bitten by bed bugs while traveling for work. The majority of bed bug-related WC claims in California consisted of complaints of bed bug bites or rashes caused from bites; however there were several reports of physical injuries (such as strains) sustained by workers while moving furniture to look for or treat bed bugs. (More information on work-related insecticide exposures is provided below.)

For apartment owners and managers, hotels and motels, and other businesses involving the stewardship of property, a bed bug infestation can be a serious business cost in remediation expenses, public stigma, and lawsuits.5 The annoyance, economic costs, frustration and emotional agony of bed bug infestations may tempt business owners and homeowners to take extreme measures. However, a recent study by NIOSH scientists and their colleagues highlights the need to be informed and strategic in dealing with the problem, so that tackling one problem does not introduce greater health risks of another kind.

Bed bug infestations often are treated with insecticides, but insecticide resistance is a problem, and excessive use of insecticides or improper application can increase the potential for illness in humans. To better understand the problem of illness associated with bed bug-related insecticide, investigators looked for cases using the Sentinel Event Notification System for Occupational Risks (SENSOR) Pesticides program and data from the New York City Department of Health and Mental Hygiene. A total of 110 illnesses and one fatality associated with bed bug-related insecticide were identified in seven states: California, Florida, Michigan, North Carolina, New York, Texas, and Washington.

The most frequently reported health outcomes were neurologic symptoms (40%), including headache and dizziness; respiratory symptoms (40%), including upper respiratory tract pain and irritation and dyspnea; and gastrointestinal symptoms (33%), including nausea and vomiting. Most (81%) symptoms were of low severity. The individual whose death was linked to bed-bug related insecticide had a series of preexisting medical conditions and was exposed to high levels of insecticide through atypical applications.6

The most common factors contributing to illness were excessive insecticide application, failure to wash or change pesticide-treated bedding, and inadequate notification of pesticide application. The majority of insecticide exposures were to pyrethroids and/or pyrethrins, and were in toxicity category III and are considered to be slightly toxic.

Among the cases of illnesses from bed bug-related insecticide, 12% were work-related. Of these, three illnesses involved workers who applied pesticides, including two pest control operators, of whom one was a certified applicator. Four cases involved workers who were unaware of pesticide applications (e.g., two carpet cleaners who cleaned an apartment recently treated with pesticides). Two cases involved hotel workers (a maintenance worker and a manager) who were exposed when they entered a recently treated hotel room, and two cases involved emergency medical technicians who responded to a scene where they found white powder thought to be an organophosphate pesticide.

To prevent future illness from bed bug-related insecticides, NIOSH recommends educating the public about effective bed bug management including:

  • nonchemical methods to control bed bugs such as:
    • heating infested rooms to 118°F (48°C) for 1 hour or cooling rooms to 3°F (-16°C) for 1 hour by professional applicators ;
    • encasing mattresses and box springs with bed bug—excluding covers;
    • vacuuming, steaming, laundering, and disposing of infested items
  • methods to prevent bed bug infestation (e.g., avoiding the purchase of used mattresses and box springs),
  • prudent use of effective insecticides.

Those who choose to treat their bed bug infestation with insecticides should seek the services of a certified exterminator who uses an integrated pest management approach to avoid pesticide misuse. Those applying insecticides should follow product instructions for safe and appropriate use. Insecticide labels that are easy to read and understand also can help prevent illnesses associated with bed bug control.

If individuals develop an illness from exposure to bed-bug related insecticides, they should consult their personal physician or the poison control center (1-800-222-1222) and mention that the insecticide exposure occurred while attempting to eliminate bed bugs.

If bed bugs are a problem where you live or work, be bright in your fight and don’t let the bed bugs bite!

Dr. Howard is the Director of the National Institute for Occupational Safety and Health

Dr. Hudson is an Epidemic Intelligence Service Officer at NIOSH

Dr. Calvert is a Team Leader and Senior Medical Epidemiologist in the NIOSH Division of Surveillance, Hazard Evaluations, and Field Studies


  1. Just Try to Sleep Tight. The Bed Bugs Are Back. New York Times, Nov. 27, 2005, p. A-1.
  2. Pinto et al, Bed Bug Handbook: The Complete Guide to Bed Bugs and Their Control. Mechanicsville, Md.: Pinto & Associates, 2007, p. 2
  3. Pinto et al, pp. 36-41; U.S. Environmental Protection Agency, Bed Bug Information.
  4. Joint Statement on Bed Bug Control in the United States from the U.S. Centers for Disease Control and Prevention [CDC] and the U.S. Environmental Protection Agency [EPA]
  5. The Cost of Bed Bugs, Business Week, Nov. 8, 2007.
  6. Centers for Disease Control and Prevention. Acute Illnesses Associated With Insecticides Used to Control Bed Bugs – Seven States, 2003-2010. Morbidity and Mortality Weekly Report, September 23, 2011 / 60(37);1269-1274.
Posted on by John Howard, MD, Naomi Hudson, DrPH, MPH, and Geoffrey Calvert, MD, MPH, FACP

58 comments on “Bed Bugs!”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    As stated in the blog, controlling bed bugs with extreme heat or cold should be done by a professional. Individuals should not attempt this on their own.

    May be high humidity may help. I remember that the bedbugs vanished in my hometown when there was high humidity and heat.

    We are not aware of any systematic collection of information on the incidence of bedbug infestations. The available information is anecdotal and not peer-reviewed. However, a recent article in Forbes magazine identified the cities and states whose residents were most frequently contacting two of the largest pest exterminators in the US. The cities included New York City, Chicago, Los Angeles and Washington, D.C. The state with the most calls per capita was Ohio.

    What’s the evidence that banning DDT is responsible for re emergence of bed bugs, especially in developed countries?

    Why is this quoted in such an uncritical fashion?

    Thank you for your comment. There are many possible factors contributing to the reemergence of bed bugs in this country. As previously written, the blog may have overstated the role of the discontinuance of DDT. As such, we have edited the third paragraph to better reflect the role of pesticides in the reemergence.

    Thanks for this great information, I am hotelier and working as room division manager. I really need this kind of knowledge.

    Well, I can assure you that we have found bedbugs even in federal buildings. You may have read reports last year that bedbugs were found in the Empire State Building. The problem with bedbugs is that their eggs survive initial attempts to eradicate the adult population. When they hatch, they can breed again.

    I think it is extremely important to keep a clean house. As with any insects like fleas, lice, bedbugs, etc. – they flourish and thrive in dirty houses with crusty or wet floors. Vacuuming every other day and mopping is really not too much to ask for, and it’s a great preventive and also control measure.

    People scream for chemicals that are very harsh and unhealthy to them and their pets, but keeping their place clean in the first place often helps.

    Well, thanks Dr. Howard you gave me a break from my guide on how to study for the mcat.

    I live in senior housing and I am very unhappy with my visitor the bug. I cleaned my apartment section by section they invaded my closets i used mint leaves when they did bite me at nite which helped did not get rid of them but did help. I sprayed with hot shot did help while the exterminator who the manger has here walks around and puts boxes as if the bed bugs are going to climb in and make a new home. This would be a good place to do a study.

    Pest control is now a common and burning topic in this today’s wold. Now a days it should be controlled. If it does not be controlled in time, it may hamper greatly. So we should be aware about his controlling system.I have actually gotten much about this topic in your blog. Thanks for sharing this.

    Sniffer dogs are the nonchemical method to remove the problem of bedbugs. Therefore it is a really effective technique for both an industrial and home-style by that you can kill the bedbugs and their eggs immediately.

    Bed glitches are one of the most aggravating wildlife on the earth. They are little glitches that draw the system vessels of humans for their success. Though the generally recognized is that they are too small to be seen, it’s not entirely real. These glitches often come to life in our residences in the evening, therefore creating it all the more challenging for us to identify a bed bug infestation

    We are seeing that this is by far our best year for bed bugs. We are 1 mile from Gatwick airport and with many Hotels there is a serious problem. We have also found they are becoming resistant to the Insecticides.

    It takes a lot of safety precautions to be able to safely and effectively execute bed bugs insecticides. When you do have to call pest control, I believe it would be best if you will also vacate the area especially if you have kids and elders in the household.

    Im trying to find some help.My sons school has bed bugs an the student who has them comes to school everyday. My son informed me everyday the nurse checks this kid and finds the bed bugs on him every check and she puts them in a little bag. I don’t even want to send him back to the school,he alreay came home with one on him.We searched every thing top to bottom thankfully we haven’t found an since.Still my concern is growing greater iI have five children and I feel that sending my son to school is putting my family at risk of getting bed bugs.The school hasn’t done what needs to be done they told me all they can do is clean everyday.Please help me so I know what I should do.I will be calling into your office in the morning to get more info.

    This issue should be the priority of the Government programs because it will affect our production.

    Nice article, there are cases where in we encounter bed bugs. it may be in our home or school. This is really helpful especially to those having this pest problem.

    when i was a kid, my mother often hang mastress in the sun, so the bed bugs dead.may be that way can be used for households that have more space for drying mastress.because is very annoying when bed bugs bite, can cause dizziness due to overnight lack of sleep.
    Nice artikel.Thanks

    Although bed bugs were largely eradicated in Western countries in the 1940s with the aggressive use of pesticides, notably DDT, bed bugs began to re-emerge in the mid-1990s. Entomologists and pest control specialists believe that several factors may contribute to this trend. These factors include the continuing decline or elimination of effective vector/pest control programs at state and local public health agencies, increased resistance to various insecticides, and an increase in international travel, which raises the chances that the tiny pests will be unknowingly packed into luggage.

    We specialise in Pest Control London and deal with numerous cases of Bedbugs, they are extremely common. The amount of people suffering from health side effects that we deal with have tripled in the last year. Here’s to eradicating them – thanks!

    One of the things I am aware of about bed bugs is that they are not restricted to beds, anything made of wood can make a handy home for them from cracks in bed frames, picture frames to shelves and so on. They are thin little blighters and can hide anywhere and come out at night. They are generally easy to get rid of but whatever you do has to be comprehensive, becuase if you miss one they will breed up again!

    I work assembling furniture in peoples homes and came across this once, when removing an old bed frame, it was horrible to point out. Equally I just wanted to leave ASAP I didn’t want my tools getting tainted! I read up on it that evening just to be sure and left my tools in the car outside overnight. Whilst the overnight cold would ave dne the trick it damaged my drill driver batteries!

    I wrote about it on my blog here:Furniture Assembly News

    Thank you so much for this article on bed bugs, i’m blogging myself about bed bugs symptoms and how to get rid of bed bugs.

    Kind regards,


    Why do certain hotels (like Name Removed) still promote the procedure where you have to ASK to have your bed linens changed everyday? They tout it’s to ‘save the planet’ but it’s rubbish…all it does is increase the bottom line profits for the hotel chain while promoting the spread of bed bugs. It would be good if the CDC issued public statements against this process. Every person paying for a hotel deserves clean bed linens daily and a good vacuuming, which apparently you also have to ask for. Using CNN, MSNBC, and Fox to deliver these important directives would not only inform the public to demand better treatment, but will also serve to notify hotel chain owners of the problem of bed bugs and the need to change this policy. Thanks.

    I have recently started using a chemical spray as bed bugs count has very rapidly increased in my house. Thanks for the part on preventing illness from bed bugs related insecticides. It was helpful.

    Anirudh Bahadur

    Bed Bugs can’t walk on smooth plastic. Encase your mattress. Place a clear plastic sheet between the mattress and box spring. Plastic is on rolls at Osh hardware. The plastic overhang should be about 4 inches all around the boxspring. The Bed Bugs cannot get to you and will starve. Your bed must be a proper bed. No covers touching the walls, etc. Also this treatment works well with Subdued light.
    If, you can kill the eggs at your bed, that is the key. If you determined heat treatment is too dangerous or expensive, now what ? The big picture is you have a ranch, your’re raising Bed Bugs and using your bed as a corral. First, spray your bed or encase the bed to kill the eggs so you won’t be overwhelmed. Second, Make sure there are no problems with your bed. Nothing about your bed can be allowed the touch the wall or floor, but the caster wheels. Third, the new corral for the Bed Bugs is a dim light going 24/7 where the Bed Bugs can be drawn to and removed with masking tape. Fourth, you spray the ceiling-wall line on two of the most distant walls from the dim light to move the Bed Bugs toward the light. Notes: Do not spray near the dim light or any other location, that will create a barrier to keep them from coming to the light. This dim light is most likely for life. As new Bed Bugs arrive at your home they will go to the light. Bed Bugs are drawn to you like Bees, by your Co2. A fan moving air near your bed will mix your Co2 evenly in your bedroom, making it hard for Bed Bugs to find you. Every other day a light spray on your bed caster wheels will protect you. Those in the Bed Bug business won’t be needed anymore. Please beware of baised replies from them.This method seems to be the “Silver Bullet” for Bed Bugs. This lure will provide detection, control for the home and car. The poorest people will be able to handle their infestations. This DIY project can be done for a very small cost of parts. This is a very “Green” method. For all living places and whole house treatment, the hallways will become giant traps. The lights are there, a $5.00 dimmer switch is needed and spray. Lightly place DE on hall traffic areas where people put their foot down. Careful: My new kitten made a mistake, near the light. I moved the litter box there. Later I found a live Bed Bug in it. When the Bed Bugs stop coming to the light, they’re gone, for now. If you have total control, you’ll have complete relief. The Dim lights double for night lights and Bed Bug control. Bed Bugs are not exclusively Nocturnal. When light is used as a lure, this will lead to the downfall of Bed Bugs. Bed Bugs like darkness and subdued light. When you provide subdued light in the darkness they will go there. Search Google… Bed Bugs+ Subdued light. Bedbuggers Bed Bug forum is Overrun with Pest Control Operators who control the site to promote their Bed Bug Businesses. The web site is run by a host who has no knowledge of Bed Bugs and has sold her soul to them for information from them and to give herself credibility.Anybody who has any information to offer, that might interfere with Pest Control Operators ability to promote themselves will be surpressed to keep the information from being made available to the public. All treatments for Bed Bugs must be done by a professional and victims who suffer can do nothing to help themselves,is a lie. The public is being terrorized with false information. Persons making money from Bed Bugs,don’t want, DIY Subdued lighting treatment, to be true. What is it? Has there been a cover-up? How could so many people in the Pest control business not know that Bed Bugs are attracted to light. Don’t they look? Don’t they want to know? How could they let so many people suffer? It’s a scandal. How could reseachers not know? Is this how the World is? It’s disgusting. Insects having negative phototropism show an identical reaction, but only when they are subjected to a rapid increase of light. The bedbug is, as we know, energetically photophobic; it hides in the darkest cracks and leaves only during the night. In the daytime, says Bohn, if an accident has brought it from the shade into the light, it immediately executes a rotation of 180 degrees, which brings it into the shadow. On a sheet of paper it walks away from the luminous rays and turns about immédiately when one holds a candle toward it. “It is very difficult,” adds Bohn, “to make a bedbug which is on black paper pass over upon a piece of white paper. Anytime a Bed Bug is startled with a handheld candle or light of course it’s going to run and hide. A Bed Bug chooses a white paper over other colors when not disturbed. Negative phototropism testing is flawed. Bed Bugs have Positve Phototropism. Vintage – “Bedbugs”, US Dept of Agriculture, 1937
    Leaflet No. 146. Great 8 page, illustrated leaflet stating, “Bedbugs are normally nocturnal. When the lights are out they emerge from their daytime hiding places and seek to feed upon their host. Sometimes, when very hungry, they will feed during the daytime in subdued light. Their normally nocturnal habit is modified necessarily when they infest furniture in rest rooms in stores, theater seats, desks in offices, and similar situations that are not frequented by man throughout the night. In such places bedbugs often bite persons during the day.” Bed Bug Statements:Bed bugs are nocturnal, but may feed during the day in areas with reduced lighting such as theaters when no hosts are present at night. Currently. Cornell University says, “Bed bugs can be enticed to bite during the day if light is subdued and they are hungry.”

    NIOSH posts all responses to the blog that do not violate our comment policy. We have provided safe and effective bed bug control recommendations in our blog. We would like to point out that we do not recommend spraying beds with insecticide because of concerns about skin contact with insecticide residues on the bed.

    I recently heard a news report concerning bed bugs infestations being on the rise, but i didn’t really think it was that bad. To think that they are even showing up in hospitals, which follow stricter sanitation regulations than the general public, is scary to say the least. I like the article gave some do it yourself tips to treat a bed bug problem, because paying a professional can be costly.

    On November 27, 2012 CDC issued a Health Advisory titled Health Concerns about Misuse of Pesticides for Bed Bug Control.

    The Agency for Toxic Substances and Disease Registry (ATSDR) and the Centers for Disease Control and Prevention (CDC) are alerting the public to an emerging national concern regarding misuse of pesticides to treat infestations of bed bugs and other insects indoors. Some pesticides are being applied indoors even though they are approved only for outdoor use. Even pesticides that are approved for indoor use can cause harm if over applied or not used as instructed on the product label. The full advisory can be viewed at:

    We need more education and vigilance in dealing with bed bugs. Their resurgence is becoming very scary. I am working on a video to educate people about the proper ways to get rid of a bed bug infestation. It will be up soon on my youtube channel

    Bed bugs is something we really do care about in hospitals and private clinics. I know some good treatments do exist now, so no excuse for not taking action about this !..

    At my organic mattress store in Berkeley, Ca, I educated consumers about how to care for their mattress with concern to bedbugs. Even something like the zipper is susceptible to bed bugs!

    Working in the pest control industry for the last 6 years, I have seen bed bug calls double or triple in volume year, after year, after year. Successful bed bug control involves both using the right materials and methods as well as thorough and detailed inspection / material application / treatment.

    Thanks for this high quality information, I am hotelier and working as room division manager. I really need this kind of knowledge. Thanks for so much informations about the treatments.

    The American Veterinary Medical Association has some good information on bed bugs and pets. It is available at Bed bugs bite and feed on people and pets, but they don’t live on people and pets. Bed bugs don’t navigate well on fur, so they prefer to feed on animals with limited or no fur. Bed bugs are very efficient hitchhikers and can be transported to your home via luggage, clothing, bedding, furniture, etc.. As such, it is possible that bed bugs could also hitchhike in your pet’s bedding or clothing, if you take that bedding and clothing when you travel.

    Good article. We discuss many different options for bed bug control at our site We prefer heat to the chemical programs as we find it does not spread populations, are far less toxic, and if done correctly are very effective. We are dealing with multi-family housing in NYC so bed bug control is challenging to say the least. When we heat we maintain 140 degrees for a minimum of three hours. This we find ensures penetration to couches and chairs. We have cooked longer to get into wall voids but as time increases we find the possibility of damage increases along with the temp. Use of a FLIR gun has really helped us “see” what is happening within furniture as well as walls.

    Bed bugs is something we really do care about in hospitals and private clinics. I know some good treatments do exist now, so no excuse for not taking action about this !..

    NIGHTMARE! I have helped family with an infestation of these little monsters and LITERALLY burned my clothes afterward. The torment they can cause is so horrible. I have been fortunate enough to have avoided an infestation in my home and would like to keep it that way. I have since purchased a handy dandy container that safely bakes my luggage and its contents, killing the potential bed bug and their eggs within. My sister has the luggage which itself plugs in and bakes its contents. Both her family and myself had not had any problems since adopting this safe traveling policy and I see clear skies ahead. Good luck on the bed bug battle!

    I have many bed bugs as has so many others in this assisted living facility. I have never had them in all my 67 years and am unable to clean after the treatment because my breathing is really bad. I just really need to know how to make sure everything that can be done is being done. this has been very helpfull but I feel like it isnt enough. thank you for the help

    Thank you for your comment. Indeed, getting rid of bedbugs is a tough job, and other medical conditions to which you refer in your comment, may make it more difficult. You might be interested in some additional resources available from CDC at Lastly, you have to check with your physician to make sure the “cure” does make any existing health condition you have worse.

    A bed bug lays up to 300 eggs. It is very difficult to keep killing speed faster than laying egg speed. Only a few of people solved problem immediately by no feeding. U.S. patent 9220254 converts an entire bed into a bed bug trap. Sleepers exhale CO2 and attract bed bugs towards the trap. The last bed bug behind wall must starve in weeks after it detects CO2 and crawls for food in futile without dormant. Approximately 99% bed bug feeding is at night, which is eliminated as sure as you sleep in bathtub. It is also easy to eliminate the remaining 1% daytime feeding because exterminators don’t carry bed bugs home. A person in a tent eliminates mosquito bite. A person in a bed sized trap eliminates bed bug bite. Killing bed bugs by chemical, steam, vacuum, CO2 traps, mattress encasement, and diatomaceous earth is as nonsense as a camping person sleeps outside tent and wakes up for searching and killing mosquitoes everywhere. Without feeding, it is not important how many bed bugs are at home, where they hide, when they starve, or how many bugs are caught. No feeding today confirms no feeding forever because bed bugs have the highest population or feeding chance on day one.

    I am amazed at the lengths some people go to get rid of bedbugs. As a New York City bedbug attorney In the last month, I have had complaints from clients in who stayed in hotels with bedbugs, landlords complaining about tenants with bedbugs, tenants complaining about their landlord because of bed bugs, tenants complaining about their neighbors with bedbugs, and people complaining about getting bed bugs from their jobs and I am going to recommend to them all to visit your page.

    Thanks for your comment. Indeed, bedbugs are small, but create problems for many of us. Thanks for your recommendation!

    I find the importance of pest control like bed bugs; there are so many places where people are facing the bed bugs problem, now this problem can be solved with your services. Thanks for providing such a great kind of services where people will definitely interested to have the equipment and product in their places.

    Bed bugs can also add to the diseases if you are suffering from them. For example if you asthma or any other respiratory problem, bed bugs are like catalyst to it. Bed bugs can make your condition even worse than it already is. The reason for that is the waste material of bed bugs that includes their skin and feces can become airborne when it is dry and inhaling that is very dangerous for patients who have breathing problems especially asthma.

    It’s very useful article, we are impressed about that. And Thanks for sharing this post to all, What you mentioned in the article that was an excellent one. This site very helpful to all

    Wonderful post and such a fantastic information that you gave to us. Thank you so much for it. You made a good site and also you sharing the best information on this topic. I am impressed with your site’s blog. Thank you all

    Here are some tips for bedbug identification: they don’t spread diseases by their bites…however bedbugs’ bites will cause mild to severe itching, irritability, poor sleep (though you won’t wake up). Some people do get tiny red welts or allergies.

    Don’t let the bed bugs bite” might be a light-hearted way to say goodnight, but unfortunately can become a reality. Bed bugs are back, and they are looking to find the best and newest restaurant in town…you!

    During your travels, it is possible to land yourself with some unwanted, blood-sucking, house guests in your hotel or luggage. With numerous people and pieces of luggage coming and going each day, hotels are often a primary contributor to the spread of bed bugs.

    Hey.. this is a good seems the author knows the subject well. It is a good site indeed. Liked good one )).

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