Bed Bugs
Legislative Advocacy Session
Amy Ost and Tolu Onigbanjo
A “Dr. O” Presentation
Outline
 Background
 Scope of the Problem
 Legislation in Motion
 New York City’s Action Plan
 Resources for Residents
Background
Background
 Beg Bugs (Cimex lectularius)
 Wingless, obligate ectoparasites
 Feeds on bats, birds, mammals
 After blood meal, increase in length by 30%-50% and in
weight 150%-200%
 Seeks warmth, which helps locate warm-blooded hosts
 Hides during the day, and feeds at night
Life Cycle
Where to Hide?
 Mattresses
 Crevices in box springs
 Backsides of Headboards
 Clothing
 Loose wallpaper
 Behind hanging pictures
 Migrating from one
apartment to another
through holes in walls,
water pipes or gutters
Clinical Manifestations
 Common Reactions
 Treatment of Bite Reactions
 2 to 5 mm pruritic
maculopapular, erythematous
lesions at feeding sites.
 Antipruritic Agents
 Complex Reactions: Local
urticaria, or bullous rash
 Topical Mupirocin
 Resolves within a week
 Intermediate potency
Corticosteriods--Triamcinolone
Beg Bugs as Vectors of Human Disease
 Transmission of more than 40 human diseases has been attributed to
bed bugs, but there is little evidence of such transmission
 HIV
 Detected in bed bugs up to 8 days after ingestion
 No viral replication
 No virus in bed bugs feces
 HBV
 Hepatitis B surface antigen persist for up to 7 weeks
 No viral replication
 Seen in beg bugs feces for up to 6 weeks
 No effects of a 2-year eradication project in Gambia on the rates of HBV
infection despite 100% reduction of bed bug numbers
Beg Bugs as Vectors of Distress
 Significant health effects including onset of
 Stress
 Anxiety
 Depression
 Fatigue
 Unable to receive home healthcare services if concerned about an
infestation
How to Get Rid of Bed Bugs!
 Don’t throw away mattresses—vacuum and seal.
 Wash all clothing, linens, and bedding in hot water
 Vacuum the house to remove bugs and eggs from carpet, and
walls
 Repair cracks in plaster, and glue down loosened wallpaper
 Apply insecticides to cracks but not in your sleeping area. Repeat
in 2 weeks
 Enlist the services of a professional pest control firm
\\\
Scope of the Problem
dd
Scope of the Problem
Scope of the Problem
 Bed bug complaints and violations have risen dramatically
 Homes
 Apartments
 Hotel rooms
 Hospitals
 Dormitories
 Retail Stores
 Resurgence of Beg Bugs
 International travel
 Immigration
 Change in pest control practices
 Insecticide Resistance
Scope of the Problem
 Bed Bugs are historically a problem…
 Early 1900s prior to central heating they used to die in the winter
 Success against the bed bug battle came with DDT and
subsequent pesticides
 Related to changes in cockroach management
 New bedbugs were likely introduced from overseas
 Resistance pattern in insecticides is now commonly being seen
with cities
Scope of the Problem
 Bed bug infestations in NYC are reported to be increasing:
 Complaints rose from 537 in 2004 to 10,985 in 2009
 Violations rose from 82 in 2004 to 4,084 in 2009
 426 confirmed cases of bed bugs reported 243 different New York
City public schools in 2009 (twice as many as preceding year)
 311 received 33,772 bed bug-related inquiries (increase of 54%
from previous year)
Scope of the Problem
 Related to several factors:
 Lack of public awareness and knowledge
 Density of Multi-unit living spaces
 Inadequate access (and difficult to afford) to quality pest control
services and resources for bed bug treatment
 Limitation of the materials and methods
 Lack of efficient procedures to resolve landlord/tenant disputes in
an equitable way
New York City’s Action Plan
New York City’s Action Plan 2009
 New York City adopts Local Law 14
 Created a “Bed Bug Advisory Board”
 Convened to issue a report to the Mayor and City Council
 First convened in September 2009 and spent 7 months
gathering information
Recommendations for the Management
of Bed Bugs in New York City
 April 2010, Published a Three-Part Report
 I: Education, Awareness and Early Detection
 II: Treatment and Remediation
 III: Monitoring and Policy
Part I: Education, Awareness and
Early Detection
 Take a proactive approach to public education and
awareness
 Provide bed bug training to stakeholders
 Launch and maintain an online “Bed Bug Portal”
devoted to bed bug facts and resources
Part I: Education, Awareness and
Early Detection
http://www.nyc.gov/html/doh/html/vector/vector-faq1.shtml
Part I: Education, Awareness and
Early Detection
http://www.nyc.gov/html/hpd/html/courses/courses.shtml.
Part I: Education, Awareness and
Early Detection
 Take a proactive approach to public education and
awareness
 Provide bed bug training to stakeholders
 Launch and maintain an online “Bed Bug Portal”
devoted to bed bug facts and resources
Part II: Treatment and Remediation
 Establish protocols for proper disposal of infested items
 Develop suggested minimum pest management
practices
 Create guidelines for the donation of used and secondhand items
 Develop triage approach for immediate response
 Offer guidelines for self-remediation
Part III: Monitoring and Policy
 Assemble a Bed Bug Team, headed by a qualified
entomologist (or equivalent professional) and support
staff, to coordinate city-wide bed bugs efforts in
conjunction with a Bed Bug Working Group
 Develop integrated monitoring, tracking and reporting
tools
 Improve Department of Housing Preservation and
Development (HPD) bed bug infestation inspection
protocols and code enforcement capacity
 Increase the capability of New York City Housing
(NYCHA) to take a proactive stance in preventing and
addressing bed bug infestations
Part III: Monitoring and Policy
 Evaluate current housing court procedures as they relate to both
landlords and tenants and look for methods to compel compliance and
access to ensure effective bed bug management
 Utilize Article 151 of New York City Health Code to help overcome
obstacles associated with bed bug management in buildings with
widespread infestation
 Require landlords to provide written bed bug information to tenants
upon lease signing and renewal
 Disseminate consumer warnings about bed bug risks from used furniture
and mattresses
 Encourage small business and social enterprise start-ups to provide bed
bug preparation services to low and moderate-income households
New York City’s Action Plan: 2010
New York City’s Action Plan: 2010
 Deputy Mayor Gibbs and Speaker Quinn announce
funding of $500,000 for Web-Based Bed Bug Portal and
other initiatives
 Implemented by the Department of Health and Mental
Hygiene
New York City’s Action Plan: 2010
Goals of the City:
 To identify the scope of the New York City Bed Bug
Epidemic
 To effectively disseminate information about proper
identification and handling
 To assist in the coordination of an effective response to
bed bugs
 To deter the adverse health and well-being effects that
develop among those with bed bug infestation
Who’s on the Committee?
 Entomologist
 Advocates
 Representatives from numerous city agencies
Who else is helping out?
New York City’s Action Plan: 2010
Branches of New York City Government must work together.
 Department of Health and Mental Hygiene (DOHMH)
 Housing Prevention and Development (HPD)
 New York City Housing Authority (NYCHA)
 Environmental Health Tracking Network/Portal
New York City’s Action Plan: 2010
Fall/Winter 2010
 Department of State Division of Licensing Services issued
new bedding regulations
 Bed Bug Disclosure Act
Action Plan Across the Country: 2010
 Bed Bug Summit in Washington DC (February 2011)
 Environmental Protection Agency
 Center for Disease Control
 Federal Bed Bug Groups
The Bedbug Registry
There’s an app for that!
Reference

Goddard, J. and DeShazo, R. Bed Bugs (Cimex lectularius) and Clinical Consequences of
their Bites. JAMA 2009; 301 (13): 1358-1366

Potter, M. et al. Bugs without Boards-Executive Summary: Defining the Global Bed Bug
Resurgence

Recommendations for the Management of Bed Bugs in New York City. New York City Bed
Bug Advisory Board. Report to the Mayor and City Council. April 2010.

Stop Bed Bugs in Hotels Safely. The New York City Department of Health and Mental
Hygiene. http://www.nyc.gov/html/doh/downloads/pdf/vector/bed-bug-hotel-eng.pdf

Preventing and Getting Rid of Bed Bugs Safely.
http://www.nyc.gov/html/doh/downloads/pdf/vector/bed-bug-guide.pdf

Brody, Jane. Keeping Those Bed Bugs from Biting. 2009.
http://www.nytimes.com/2009/04/14/health/14brod.html
THE END: DON’T LET THE BED
BUGS BITE