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The Centers for Disease Control and Prevention (CDC) and the U.S. Environmental Protection Agency (EPA) developed this document to highlight emerging public health issues associated with bed bugs (Cimex lectularius) in communities throughout the United States.
Photo 1. Bed Bug. Photo courtesy of Dr. Harold Harlan, Armed Forces Pest Management Board Image Library
Bed bugs (Photo 1) have been common in U.S. history. Although bed bug populations dropped dramatically during the mid-20th century (1), the United States is one of many countries now experiencing an alarming resurgence in the population of bed bugs. Though the exact cause is not known, experts suspect the resurgence is associated with increased resistance of bed bugs to available pesticides, greater international and domestic travel, lack of knowledge regarding control of bed bugs due to their prolonged absence, and the continuing decline or elimination of effective vector/pest control programs at state and local public health agencies.
In recent years, public health agencies across the country have been overwhelmed by complaints about bed bugs. An integrated approach to bed bug control involving federal, state, tribal and local public health professionals, together with pest management professionals, housing authorities and private citizens, will promote development and understanding of the best methods for managing and controlling bed bugs and preventing future infestations. Research, training and public education are critical to an effective strategy for reducing public health issues associated with the resurgence of bed bug populations.
Although bed bugs are not known to transmit disease, they are a pest of significant public health importance. Bed bugs fit into a category of blood-sucking ectoparasites (external parasites) similar to head lice (Pediculus humanus capitis). Bed bugs, like head lice, feed on the blood of humans but are not believed to transmit disease. Other ectoparasites, such as body lice (Pediculus humanus corporis), are known to transmit several serious diseases. Differences in the biology of similar species of pests, such as body lice and head lice (or bed bugs) can greatly impact the ability of pests to transmit disease.
Photo 2. Skin Reaction to Bed Bug bites. Photo courtesy of Dr. Harold Harlan
Bed bugs cause a variety of negative physical health, mental health and economic consequences. Many people have mild to severe allergic reaction to the bites with effects ranging from no reaction to a small bite mark to, in rare cases, anaphylaxis (severe, whole-body reaction) (2). These bites (Photo 2) can also lead to secondary infections of the skin such as impetigo, ecthyma, and lymphanigitis (3,4). Bed bugs may also affect the mental health of people living in infested homes. Reported effects include anxiety, insomnia and systemic reactions (1).
Research on the public health effects of bed bugs has been very limited over the past several decades, largely due to the noted decline in bed bug populations in the latter half of the 20th century. Now that bed bug populations are rapidly increasing, additional research is needed to determine the reasons for the resurgence, the potential for bed bugs to transmit disease and their impact on public health.
Economically, bed bug infestations are also a burden on society. Although the exact dollar amount is not known, the economic losses from health care, lost wages, lost revenue and reduced productivity can be substantial. The cost of effectively eliminating bed bugs may be significantly more than the cost of eliminating other pests because bed bug control usually requires multiple visits by a licensed pest control operator and diligence on the part of those who are experiencing the infestation. Control in multi-family homes is much more difficult than in single family homes because bed bugs frequently travel between units, either by direct transport by humans or through voids in the walls. There are additional costs and complexities associated with coordinating and encouraging participation from multiple residents.
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CDC - EHS - Bed Bugs CDC-EPA Joint Statement
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