Bed Bugs and Public Health: New Approaches for an Old Scourge (original) (raw)

2012, Canadian Journal of Public Health

B ed bugs (Cimex lectularuis) are small, elusive insects that feed almost exclusively on human blood. Bed bug infestations have become prominent worldwide, generating increased public concern. 1,2 Despite the attention to bed bugs by the public, researchers, governments and pest control companies, their control has been a challenge. 3,4 Because bed bugs have not been proven to transmit disease between humans, 3 there is resistance to framing their resurgence as a public health threat. Nevertheless, bed bugs have been associated with negative health effects, including allergic reactions, bacterial skin infections and scarring as a result of the intense scratching they provoke. Improper insecticide use can result in acute health effects 3 and may lead to chronic disease. 5,6 Perhaps of greatest concern to public health is the psychological stress on persons living with bed bugs. While bed bugs do not discriminate-anyone can be subject to a bed bug infestation-health impacts differ depending upon people's social and economic circumstances. One study conducted with Winnipeg's inner-city residents found that bed bugs negatively impacted the former's ability to lead healthy lives. Respondents reported that bed bugs disrupted their sleep and led to stress, social isolation, loss of self-worth, and social stigma. 4 Moreover, the financial costs (and associated stress) incurred from an infestation can be overwhelming for those with limited means. 4 METHODS A workshop at the 2010 Canadian Public Health Association (CPHA) Conference* examined the re-emergence of bed bugs in Canada, discussed the state of bed bug science (summarized elsewhere) 7 and compared the approaches to bed bug identification and control of municipal and public health authorities in four large Canadian cities. Here we report on the experiences of the four cities-Toronto, Winnipeg, Montreal and Vancouver-with regard to their efforts to respond to the public health threat posed by bed bugs. By drawing on the experiences of the four cities (including updates since 2010), we make the case that framing the bed bug problem as a public health threat is key to the implementation of effective strategies for its management-especially for vulnerable populations.