Bed Bugs: A Municipal Case Study
and Beyond
Phil Alexakos, MPH, REHS
Chief of Environmental Health &
Emergency Response
Manchester Health Department
Bed Bug History in Manchester
• First Calls 2002
• Langdon Mill Building
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20 Units
Multiple Languages
Older Construction
Multiple Complaints
Health Department Role
• Not in the business of housing code
enforcement
– Some in the audience may be wearing both
“hats”
– Educational role
– Connections and access to resources in the
Community
More History
• Collaborative Efforts
– 2005
• Mailings to all Laundromats, used furniture
providers (that we knew of), furniture rental
businesses
• Development of educational materials for the public
– Awareness and Treatment Guidelines
– English, Spanish, Russian, Bosnian
• Posted on Web
Langdon Mill 2005
• October 2005
– Identification of a major bedbug and cockroach
infestation
– Coordination with Housing Code to ensure
proper enforcement
– Coordination with Pest Control Company to
assure that residents were instructed on
treatment preparation
Langdon Mill 2005
• Major issues encountered
– Language Barriers
– Functional Needs Barriers
– Cooperation Barriers
• Laundering
• Site Prep
– Financial Barriers (for tenants and owner)
• Where it all fell short…..LONG TERM
SUSTAINABILITY
Landon Mill 2009
• March 2009
• Reports of children and infants were being
“eaten alive” by bed bugs in this building
• Community advocacy groups began to act
on behalf of these residents on their behalf
• Meetings of stakeholders were organized
Langdon Mill 2009
• Organizers
– Granite State Organizing Project (GSOP)
– American Friends Service Committee
• Utilized their resources to bring all parties to the
table
• Ensured that meetings were well organized and
people/ agencies were accountable to effort
Langdon Mill 2009
• Property Ownership
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Engaged from DAY 1!!
Committed to a solution
Ensures that resources invested are effective
Integral in the success of any effort
Langdon Mill Part 2009
• City Government
– Health Department
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Hosted meetings
Provided access to educational materials
Functioned as the primary linkage to all City services
Provided technical expertise and training to volunteers and
participants
– Public Works
• Provided free access to the City Transfer Station for disposal
Langdon Mill 2009- Community
Organizations
• Multiple Faith-Based groups and most importantly
volunteers were energized and trained to continue
engaging the residents
– Remember, one of the shortcomings of the previous
initiatives was sustainability!
• Social Service Agencies
– These groups are likely to encounter people affected by
bedbug issues
– Training these workers also protects them from
unknowingly putting themselves at risk
Langdon Mill 2009- Community
Organizations
• Cultural Organizations
– Assist with translation and training efforts
– Increased “buy-in”
– Enhanced understanding of issues and
challenges for planners and volunteers
– Allowed effort to penetrate deeper into the
community
Langdon Mill 2009
• School Department
– Social workers, nurses and teachers are likely to
encounter the issue
• They can help identify problems before they become
severe
– Provided two great “Case Workers” during the
effort which increased trust and continuity
during the relocation
Langdon Mill 2009
• Colleges
– Provided an opportunity for “service learning”
in the community.
– Provide an unlimited supply of volunteers over
time.
– Access to grants and research opportunities
Langdon Mill 2009
• Businesses
– Provided needed monetary support and
resources needed to properly enact the effort
– Increase awareness and reduce the stigma
associated with bed bugs
– Local Pest Control Company lent its expert to
the effort
Langdon Mill 2009- Timeline
• April/May Community Planning
• May/June Tenant Education
• June
Media and Community Awareness
• June/ July
Furniture and Household Items
• July/August Tenant Relocation
• August
Treatment of Building and Maintenance
• August
Re-Housing
• ONGOING Education and Prevention
Langdon Mill 2009- Logistics
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Housing
Transportation
Volunteer Coordination
Donation Coordination
Food
Case Workers
$$$$ ????
Everyone is Back…Now What?
• Ongoing involvement
– Owner has designated an apartment as a “volunteer
office”
– Local college remains a strong presence in the building
with student volunteers
– Tenants are engaged to ensure safe practices
– New tenants are educated upon arrival
– Units are surveyed for any signs of activity
– Action is taken immediately at the first sign of an issue
Next Steps
Keeping the Momentum Going
This Isn’t the Only Problem in
Town, Let Alone the State
• Bed Bug “Task Force”, “Policy Group”,
“Coalition” was formed
• Knowing this continues to be an issue the
members of the Langdon Mill Project were
determined to energize others to advocate
for bed bug awareness and infestation
prevention
New Partners
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NH Department of Agriculture, Pesticides
New Hampshire Legal Assistance
The Way Home
NH Cooperative Extension and UNH
Manchester
• Medical Providers
• Many Community-Based Agencies
Subcommittees
• Public Education
• Policy
• Funding
Public Education
• Who needs information
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Tenants
Property owners
Policy makers
Businesses
• Where to go for information
– UNH Cooperative Extension
– NH 211
– Websites
Public Information
• Needs
– Pamphlets
– Magnets
– Stickers
• Considerations
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Ease of reading and understanding
Culturally appropriate
Consistency
Funding $$$
• Grants and Partnerships
Policy
• Assessment and Ownership of the Problem
– Data collection
– Target areas for interventions
– Municipal Policy Maker Resolution
• Evidence Based Best Practices
– What are other places doing?
• Minimizing Risk
– Enforcement, trash collection, regulation of used furniture place
• Consistency
• Linkage to Resources
Funding
• Increase public and civic awareness
• The more people and businesses know…
– This is a REAL problem
– Less stigma
– More apt to want to commit resources to
prevention and treatment
– Opportunities to collaborate
• Healthy Homes
Future
• Bed Bug Task Force will continue to
expand and meet
• Hope to organize a statewide conference
• Formalize a centralized location for bed bug
information
• Engage state policy makers