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There has been a resurgence of bed bugs in recent years, and this has increased interest in how to get rid of an infestation.

It has also increased the chances that people will take action to prevent an infestation in the first place.

Depending on the stage of the infestation, it may be possible to get rid of bed bugs using natural means. If the infestation has taken hold, however, these methods may not work.

Insecticides are available from stores, but these are not usually strong enough to be effective. Many people will need to call a pest controller for professional help.

Some factors make it difficult to get a bed bug infestation under control. First is the difficulty detecting them, as they are small and well adapted to hiding in small places. In addition, growing resistance means there is a lack of effective insecticides.

Fast facts on eliminating bed bugs

Here are some key points about getting rid of bed bugs.

  • Bed bug infestations have recently become more common again in the U.S.
  • Infestations are difficult to control because they evade pesticides and are not easy to see.
  • Tips for avoiding bites during an infestation include encasing mattresses and box springs in special impermeable fabrics and installing traps at the bases of bed legs.
  • Decluttering and disposal followed by careful vacuuming and cleaning help to reduce the numbers of bed bugs and eggs.
  • To get rid of an infestation, it may be necessary to call a professional pest control company, as they have stronger pesticides that are often more effective.

The first step in removing an infestation is detection.

Detection

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Bed bug bites can be uncomfortable, but the bugs do not spread diseases.

If a person is bitten by a bed bug, they may notice spots of blood on the sheet. Symptoms of a bite include lesions, wheals on their skin that can reach 5 centimeters (cm) in diameter, and intense itching.

Bites usually happen overnight, because the mattress is infested. Bed bugs tend to hide along the mattress piping and to live within 8 feet of where people sleep.

Bed bugs start as eggs and pass through juvenile to adult stages. They grow from 1 millimeter (mm) to 5 mm in length.

Evidence of various life stages can be found in the piping, along with dark spotting from feces.

Stripping the bed

The first step is to remove the bedding and isolate the bed.

To do this:

1. Strip the bed linen directly into a double plastic bag, to reduce the chance of spreading the bugs.

2. Wash bedding in hot water for at least 30 minutes and then dry at a high temperature for 30 minutes. Seal and discard the inner plastic bag when you put the linen in the washer.

3. Vacuum to remove any remaining bed bugs and eggs as far as possible. This may not remove deeply harbored bed bugs.

4. Dispose of the contents of the vacuum cleaner outside, into a sealable plastic bag.

5. Ensure the bed frame is free of bugs by spraying it with a pesticide.

Encasement

The second key element to isolating the bed from bugs is encasement. You encase the box spring and mattress in a fabric that traps the bugs inside and prevents introduction from outside.

Special zippered sheets are used to achieve this. The cost of these commercially available products is lower than the cost of a replacement mattress. Encasement should be left on for at least one year.

Encasement removes hiding areas and makes it easier to spot bed bugs. This helps prevent infestations of new mattresses.

Follow the home measures described above before encasing the bed.

Encasement materials are available for purchase online.

Traps

Moat-style traps may be used to isolate the bed and intercept bed bugs between their hiding places and their journey to bite the host.

Sticky pads under the legs of the bed can catch bugs, but they can be messy.

Such "interceptor" devices are available for purchase online, but they can also be made at home.

Scientists from the University of Florida have produced the following video, available on YouTube, explaining how to create home-made moat traps.

Pulling the bed away from the walls and ensuring that bed linen does not touch the floor helps to make the bed an island.

Heat

Laundering in hot water is an effective way of killing bed bugs on fabrics.

Bed bugs die when their body temperature is over 45° Celsius, or 113° Fahrenheit. Exposing the bugs for an hour to temperatures higher than these can kill all stages. At temperatures over 60°C (140°F), all bed bugs are killed rapidly.

Heating a room is unlikely to work, because of the high temperatures needed. It may also spread an infestation, because bed bugs will seek the cooler areas in the room, beyond the reach of the heat.

Cold

Bed bugs can be killed by cold temperatures, but it requires temperatures below -18°C (0°F) for at least 4 days in order for the cold to penetrate an object and kill all the bugs and eggs.

Smaller items that may contain bed bugs can be put in a suitably cold freezer and the 4-day period should be counted from when the center of the object reaches -18°C (0°F). This takes longer for bulkier objects.

However, the EPA note that home freezers may not be cold enough to kill bugs, and it can take a long time for this to work.

Gas systems designed for instant freezing are ineffective and may spread an infestation, as the high air pressure can blow the bugs away.

Turning off the heating and leaving windows and doors open is not an effective strategy. The temperature is unlikely to be cool enough.

Leaving a room empty for more than a year can be effective for killing bed bugs as this deprives them of sustenance. They may, however, migrate to a nearby property and return later.

Some chemicals are available for purchase online or from hardware stores. These can be hazardous when used indoors.

It is important always to use an approved product and to follow the instructions with care.

These include:

  • pyrethrins and pyrethroids, derived from chrysanthemum flowers
  • desiccants, such as boric acid and diatomaceous earth, which dry out the protective coating on bugs
  • biochemicals, specifically cold pressed neem oil
  • pyrroles, of which cholfenapyr is the only registered product in the U.S.
  • neocotinoids, a synthetic form of nicotine that affects the bugs' nervous system
  • insect-growth regulators, which affect the growth process of bugs

You will find more detail on these below.

When buying a product, you should:

  • check that it is EPA-registered
  • make sure bed bugs are mentioned on the label

It is important to follow the instructions carefully when applying the products, so that they make direct contact with the bed bugs.

"Bug bombs," or total release foggers, are not considered effective. They are unlikely to reach the cracks where bugs hide, and they can be harmful to health. There is also a risk of explosion.

Some products, including those that contain pyrethroids, have a flushing effect. This could spread the infestation.

The Environmental Protection Agency (EPA) provides a search tool that can help you find a suitable registered product.

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Bed bugs can hide but they are big enough to see with the naked eye.

Insecticides that are available to the public are often not strong enough to be effective, or they are unable to reach the bugs' hiding places.

In this case, it is best to involve a registered pest controller.

Catching a bug or taking a photo to share with the professional can help them see what type of bug is causing the problem.

Pest controllers may start with nonchemical methods and then use pesticides if these do not work.

Some pesticides can only be applied by licensed professionals.

Chemicals for pest control

In the U.S., around 300 insecticide products are registered for treating bed bug infestations. These are the main chemical classes:

Pyrethrins and pyrethroids: These are the most commonly used pesticides for bed bug treatment. Pyrethrins are derived from chrysanthemum flowers, and pyrethroids are the synthetic equivalent. They act on the nervous system of the bugs. Some bed bug populations have become resistant to these chemicals, especially older-generation products.

Silicates: These include diatomaceous earth dust (DED). They are desiccants. They destroy the bed bugs' waxy, protective outer coating and kill them through dehydration. The effects are physical, not neurochemical, so the bugs cannot become resistant to these products.

Insect growth regulators (IGRs): Examples include (S)-methoprene and hydropene. The insects must bite for blood before the pesticides take effect. This makes them an unattractive option.

Carbamates: Examples include bendiocarb and propoxur. They are more effective than pyrethrins and pyrethroids, but cases of resistance are emerging.

Neonicotinoids: Examples include imidacloprid. These have been found to produce no resistance and are effective. They have no residual effect.

Pyrroles: These are very slow acting, and they have limited efficacy but no issues of resistance. The only pyrrole bed-bug pesticide registered in the U.S. is chlorfenapyr.

Organophosphates have been used in the past, but they are no longer available in the U.S.

Pyrethrins and pyrethroids are largely thought to be ineffective against modern bed-bug strains. Bedding fabrics that are marketed as being impregnated with these chemicals are unlikely to be effective.

Desiccants such as DEDs are effective options against bed bugs. They have several advantages, including:

  • a long shelf life
  • low toxicity to mammals
  • long residual life
  • low possibility of resistance
  • they can be used as a preventive measure

Professional pest controllers can effectively remove an infestation of bed bugs.

The Pest World website provides a list of practitioners who are licensed with the National Pest Management Association.

Pest control professionals can be expected to:

1. Confirm the infestation

2. Inspect the location and possibly neighboring areas

3. Use a combination of nonchemical control and insecticides

4. Review treatment to check that it is successful

5. Recommend or put preventive measures in place

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Isolating clothing and bedding in double-layer plastic bags and washing and drying at a high temperature can help prevent the spread of bed bugs.

The key to reducing the risk from bed-bug infestation is early detection, as this is more likely to lead to effective control.

There are four stages at which intervention can take place:

  1. when the pest first appears
  2. as the infestation becomes established
  3. while the bug population is growing
  4. as the problem spreads

Tips for early detection include:

  • checking bed sheets for small blood spots
  • looking for signs of bites on the body
  • monitoring areas where pets sleep

Factors that make it harder to control bed bugs include:

  • clutter, especially under the bed
  • cracks and crannies in the walls, where bugs can hide
  • infestation in a neighboring property

Other prevention tips

Second-hand furniture: Second-hand furniture and bedding should be avoided or checked carefully before bringing it into the house.

Reduce clutter: A tidy home that is free from clutter will have fewer hiding places for bed bugs.

Fill the cracks: Use metals and plastics to fill cracks and crannies instead of wood.

Travel check: Bugs can travel in suitcases and other bags after a vacation or visit to a home that has an infestation. Check a hotel room for signs of bugs before settling in.

Preventing spread: Use interceptor devices, such as traps and encasement, to isolate beds.

What not to do

If you have bed bugs, do not:

  • panic and reach for the insecticide spay at once, but do keep calm and make a plan.
  • use agricultural, garden, or "home-made" pesticides, as these can be hazardous, ineffective, and may make the problem worse
  • use products that are not EPA-registered and do not have an English label
  • apply pesticides to the body, as this can be dangerous
  • use rubbing alcohol, kerosene, or gasoline, as these can start a fire
  • move things from room to room or get rid of belongings, as these will spread the problem and most things can be treated successfully
  • put items in black plastic in the sun, as it will not be hot enough to kill the bugs

Bed bugs are found in all 50 states, and they can affect anyone in any place, although they are more common in urban areas.

It is worth remembering that bed bugs:

  • do not spread disease
  • are not more common among low-income households
  • occur in both clean and unsanitary environments
  • are visible to the naked eye

Being observant and treating an infestation early is the best strategy.