It comes out at night to gorge on human blood. It prefers unpleasant, uncomfortable surroundings to hide in. And it's coming to a facility near you. No, not a plaintiff's attorney—this particular louse has had the entire nation at siege.
If you've been asleep for the past year, it might be time to wake up and check your immediate living area for bedbugs. Chances are they've made a meal of you. Even worse, your residents might be on the menu. The problem has gotten so severe in some high-population markets, an entomologist from Cornell University told Crain's New York Business last fall that she'd be “surprised to hear of a hospital in New York that didn't have a bedbug problem.” Even Capitol Hill took notice, having hosted the official Congressional Bedbug Forum in November.
“Bedbugs are an issue just about anywhere,” says Patti Costello, executive director of the Association for the Healthcare Environment (AHE). “We're getting calls not only from care facilities, but from even outside of healthcare.”
The problem with healthcare facilities is the transient nature of its guest population. Depending on the size of a long-term care facility and the frequency of new arrivals and family visitors, the insects can become just as bad of a nuisance as in hospitals.
“It's not necessarily the residents who have brought them in,” Costello says, “unless they're just newly moving in, as much as it is somebody carrying them on their person or they're bringing in a suitcase or some type of bag from the home into the facility. That's how [bedbugs] hitch a ride. And once they get in, it's really difficult to stop them. So the people who are on the frontline, who actually discover the bedbugs, would be the environmental services workers. They're usually the first ones who notice a problem.”
Adult bedbugs are hardy pests and thrive if well-fed. (They can live even longer when dormant, surviving past a year without food.) Females lay about two eggs per day that hatch at normal room temperatures. A typical specimen is about 1/5 of an inch long with a reddish brown to mahogany-colored body, which is flat, allowing it to fit within the cracks of walls, light fixtures, electrical sockets—anywhere out of plain view until the early morning hours when we are in our deepest of sleep.
“They particularly like bedding,” Costello says. “They tend to hide in the creases of mattresses, pockets between bedrails and headboards, draperies, upholstered furniture. Clutter certainly will mask a problem if you have one, so by keeping clutter to a minimum, by being vigilant in training the cleaning staff to know what they look like, you can control them. And really there is no control once you've got them—you have to get rid of them.
“From our perspective, training the staff is absolutely paramount,” she continues. “They need to know what they're looking for and where to look, particularly when you're doing a deep clean in a long-term care facility.”
AHE partnered with Orkin Commercial Services to release an updated version of its Recommended Practice for Integrated Pest Management “how to” guide. One of the main reasons for the update? There's a new section on bedbugs. “It's not a commercialized document,” Costello emphasizes. “It's strictly technical, it's written by two entomologists, and it focuses primarily on integrated pest management, which is taking all the necessary actions to prevent the infestation of all pests without the use of chemicals. And, of course, there's a section there that talks about when you have to employ the use of chemicals, the proper way to do that.”
Besides strict EPA regulations and a general level of unpopularity, chemical treatments are discussed as a last resort because bedbugs have slowly developed a resistance to many of them. “What we're told is that heat is the way to go,” Costello says. This can mean laundry services using water “as hot as the fabric can withstand” to drying items on the highest setting, she advises. A good detergent also helps. “There are other means if you have an infestation where you'd have to heat the room up to 121 degrees Fahrenheit for one minute, and that's a difficult thing to do. You really have to work in very close contact with a pest control company.”
And if your facility is unfortunate enough to have an infestation, the best thing you can do is not panic, Costello says. Hey, it's not like a lawyer is on the way. LTL
EPA-Registered Bed Bug Products http://cfpub.epa.gov/oppref/bedbug/
NPMA Bed Bug Management www.pestworld.com/bed-bug-BMPs
AHE Recommended Practice Series: Integrated Pest Management 2nd Edition ($25 for members, $45 for non-members)
Long-Term Living 2011 April;60(4):50-52