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
Unlike those of other insects, bed bug bites may sometimes appear in tight lines of multiple, small, red marks where multiple bed bugs have fed along an exposed area. Bed bug bites can cause itchiness. Initially, a victim may detect a slight burning sensation. The burning area then develops red bumps, known as papules or wheals (rash). In extreme cases, bites may swell dramatically or turn into blister-like skin inflammations.