Agriculture Reference
In-Depth Information
infestations by vacuuming and reducing
clutter in itself improves the household
environment. On the other hand, under-
estimating the public health impact of a
haematophagous arthropod that is not a
vector effectively reduces government and
industry funding for research and control.
In the last 10-20 years, the incidence of
bed bug infestations has increased expo-
nentially in North America, Europe and
Australia (Krueger, 2000; Doggett et al. ,
2004). The National Pest Management
Association reported a 71% increase in
calls for bed bug control between 2000 and
2005, and 95% of pest control agencies
responded to bed bug problems in 2010
compared with 25% before 2000 (NPMA,
2010). The US Environmental Protection
Agency (EPA) and the Centers for Disease
Control and Prevention (CDC) consider bed
bugs to be of 'signifi cant public health
importance' (CDC and US EPA, 2010). Bed
bug bites result in itching, redness and
infl ammation. Dermatitis, lesions, rashes,
papules and secondary infections are also
common consequences of bed bug bites
(Goddard and de Shazo, 2009). Excessive
bites can also result in anaemia
(Venkatachalam and Belavady, 1962;
Paulke-Korinek et al. , 2012). To date, there
is no laboratory evidence that bed bugs
transmit human pathogens. As a con-
sequence, bed bugs are considered nuisance
pests and not vectors. Their public health
importance is underestimated and funding
for research is limited. A recent study found
that 79% of public health workers in the US
state of Ohio agreed that bed bugs are a
public health concern and their inability to
transmit pathogens did not decrease their
impact (Balster, 2011). However, 24% of
health departments were incapable of man-
aging bed bug complaints because of
insuffi cient funding (Balster, 2011).
Mental health is an underappreciated
aspect of public health. Bed bugs are a
psychosocial stressor and living with bed
bugs can result in nightmares, insomnia,
anxiety, depression and social isolation
(Goddard and de Shazo, 2012; Rieder et al. ,
2012). Compulsive hoarding behaviour,
especially among the elderly, is grounded in
a fear over 'loss of place', isolates individuals
and creates easy harbourages for bed bugs
(Whitfi eld et al. , 2012). This desperation
can lead to an excessive and dangerous
misuse of insecticides (Jacobson, 2011).
Feelings of isolation and stigma can also
affect personal and romantic relationships.
A survey of more than 100 singles on an
online dating site revealed that about half
would reject a prospective partner because
of bed bugs (PRNewswire, 2013). Surpris-
ingly, twice as many respondents would
reject a partner because of bed bugs than
because of HIV.
The public fear associated with bed bugs
incurs a signifi cant fi nancial burden. Hotels,
department stores and other businesses
have lost millions of dollars because of
prolonged closures and lawsuits (Fanelli,
2010; Odell, 2010). Lawsuits against hotels,
in particular, have sought payments for
negligence ranging from $2,000,000 to
$20,000,000 in damages. Actual settlements
have been in the range of $71,000 to
$382,000 (Grill, 2012). These dollar values
do not refl ect the revenue loss to hotels
owing to continued perceptions of neg-
ligence and squalor. In addition, if bed bugs
return home with a guest, the ensuing
infestation may incur costs for fumigation,
heat treatment or even personal property
destruction. Lawsuits between landlords
and tenants are becoming more common,
and plaintiffs are also suing summer camps,
universities and furniture stores because of
alleged bed bug bites and infestations.
Reports of bed bugs in expensive hotels
and department stores misrepresent actual
risks of infestation. Chronic bed bug in-
festations disproportionately affect eco-
nomically disadvantaged and minority
populations (Hwang et al. , 2005; Brouqui
and Raoult, 2006). Bed bugs can reach
population densities of hundreds per square
foot and recur in low-income housing or
when tenants are elderly, obese, visually
impaired, or mentally or physically dis-
abled. Bed bugs thrive in sites that support
transient populations with a constant turn-
over, such as homeless shelters and nursing
homes. In the developing world, bed bugs
are commonly found in unsanitary and
 
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