Bed bugs are challenging to eradicate. Since they can hide in so many places, inspections must be thorough and elimination is not always a certainty. Whenever resources allow, it’s prudent to enlist the services of a professional. Experienced pest controllers know where to look for bed bugs, and have an assortment of tools at their disposal. Nonetheless, owners and occupants can assist the professional in several important ways. Affording access to all living areas is crucial, and excess clutter will need to be removed. Belongings strewn about rooms offer many places for the bugs to hide, and impede inspection and treatment. Since bed bugs can disperse throughout a building, it often will be necessary to inspect adjoining rooms and apartments as well. 
Infestations with bedbugs date back to ancient Egypt.1 The incidence of bedbugs in developed countries decreased in the 1940s because of the availability of more effective pesticides (especially DDT) and improved economic and social conditions.2 In the past decade, however, a significant resurgence of bedbug populations has occurred. This is attributed to a combination of factors, including increased pesticide resistance, more frequent travel, lack of public awareness, and inadequate pest control programs.3 In a 2010 survey, 95 percent of more than 500 U.S. pest management companies reported encountering a bedbug infestation during the preceding year, compared with only 25 percent of companies during 2000.4 Bedbugs spread actively by migrating from one infested room to another, often through ventilation ducts. They also spread passively, carried in the seams of travelers’ luggage, bedding, or furniture.5 Bedbugs do not travel directly on human hosts.6
Bed bugs are an increasing cause for litigation.[69] Courts have, in some cases, exacted large punitive damage judgments on some hotels.[70][71][72] Many of New York City's Upper East Side home owners have been afflicted, but they tend to be silent publicly in order not to ruin their property values and be seen as suffering a blight typically associated with the lower classes.[73]
In the case of beds, a more economical option is to encase both the mattress and box spring in a protective cover like those used for allergy relief. Encasements specifically designed to help protect against bed bugs are available through retail or pest control firms. Higher quality ones tend to be more durable and comfortable to sleep on. Once the encasement is installed and zipped shut, any bugs which happen to be inside are entombed and eventually will die. Encasements also help protect newly purchased beds, and make it easier to spot and destroy any bugs residing on the outer surface during subsequent examination. Encasements will not, however, keep bed bugs from crawling onto a bed and biting a sleeping person.
Some people have no reaction whatsoever to bed bugs. In addition to not having much of an effect on the elderly, some are just not allergic. Since the irritation and welting appears as the result of an allergic reaction, it is possible to not even know that you were bitten at all. It is entirely possible for several people to live in the same house, and have one person not be affected.
Bedbugs are found all over the world. Bed bug infestations were common in the U.S. before World War II and became rare after widespread use of the insecticide DDT for pest control began in the 1940s and 1950s. They remained prevalent in other areas of the world and, in recent years, have been increasingly observed again in the U.S. Increases in immigration and travel from the developing world as well as restrictions on the use of stronger pesticides may be factors that have led to the relatively recent increase in bedbug infestations. While bedbug infestations are often reported to be found when sanitation conditions are poor or when birds or mammals (particularly bats) are nesting on or near a home, bedbugs can also live and thrive in clean environments. Crowded living quarters also facilitate the spread of bedbug infestations.
"In the past, bedbugs have repeatedly shown the ability to develop resistance to products overly relied upon for their control. The findings of the current study also show similar trends in regard to chlorfenapyr and bifenthrin resistance development in bedbugs," study researcher Ameya Gondhalekar, research assistant professor at Purdue's Center for Urban and Industrial Pest Management, said in the Entomology Today statement. "With these findings in mind and from an insecticide resistance management perspective, both bifenthrin and chlorfenapyr should be integrated with other methods used for bed bug elimination in order to preserve their efficacy in the long term."
Symptoms may not appear until some days after the bites have occurred.[5] Reactions often become more brisk after multiple bites due to possible sensitization to the salivary proteins of the bed bug.[3] The skin reaction usually occurs in the area of the bite which is most commonly the arms, shoulders and legs as they are more frequently exposed at night.[5] Numerous bites may lead to an erythematous rash or urticaria.[5]
Blood spots found on one’s sheets, bites and the presence of bed bug feces and cast skins are some of the indications of a bed bug infestation. Bites are commonly found on the parts of the body that are more likely to be exposed to bed bugs during sleep – the hands, neck, face, shoulders, legs and arms. While not always the case, bed bug bites are often grouped together in a small area and at times may occur in a line or a zigzag pattern. Bites normally look like small, flat or raised areas that may become inflamed, itchy, red or blistered. Bed bug bite reactions don’t always appear immediately after you’re bitten and may take a few days to begin causing symptoms. However, not everyone reacts to bed bug bites in the same manner.
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