The scourge of bedbug misdiagnosis and false alarms.

The scourge of bedbug misdiagnosis and false alarms.

The scourge of bedbug misdiagnosis and false alarms.

The state of the universe.
Sept. 13 2010 10:04 AM

Don't Let the Bedbugs Fright

False alarms can be just as bad as the real thing.

Illustration by Mark Alan Stamaty. Click image to expand.

In September 2009, a small population of bedbugs gulped my blood and took sanctuary in my mattress. For a few weeks, I endured ferociously itchy bites and prepared for the trio of invasive chemical treatments that would rid them from my home. When the pest management technician finished his work, he warned me that even though the bedbugs were gone for now, they might be waiting to relaunch their invasion from the neighbors' place. A friend at the health department had the same advice: I should always be on guard for a resurrection.

On two separate occasions, both months after the original plague, I came very close to hiring an exterminator once again. The appearances of a strange bug near my bed, and then a smattering of unexplained bites, led me to consider dousing my home with chemicals at great expense. But I never did spend that money, nor did I suffer the same blazing blisters I'd had last fall. Yet the considerable anxiety and angst I felt during these false alarms easily matched the effects of the real thing: hours and hours spent brooding over where they might have come from, pacing the house, and cursing violently.


The bedbug panic—abetted by the flurry of high-profile infestations at prominent movie theaters, retail shops and hotels—is at an all-time high. The New York Times has run 15 stories on bedbugs this summer. The mayor of Boston recently spent part of a day cautioning undergrads about the dangers of bedbugs in used furniture. And Web message boards and comment fields abound with shrill declarations from bedbug victims (actual and suspected) that a catastrophic plague has arrived.

The epidemic is real—I can tell you that from personal experience. Researchers don't have good data on Cimex lectularius infestation rates, but they generally agree that bedbugs are spreading and that their ubiquity has become an important public health issue. The itchy bites aside, health officials are concerned about the emotional distress caused by bedbugs and the sleep we're losing over them. With those concerns in mind, it's time to address what may be an even bigger scourge than bedbugs in American cities: bedbug misdiagnosis.

Bed bug fumigation. Click image to expand.
Bedbugs? Maybe, maybe not

The pest management industry is one that would benefit handsomely from an epidemic of false alarms. Treating a one-room apartment typically costs hundreds of dollars; for a single-family house, the bill might reach several thousand dollars. According to the National Pest Management Association, exterminators made $258 million from bedbugs in 2009, up 263 percent from three years before. That creates a major incentive for stoking idle fears and promoting a radical "better-safe-than-sorry" approach to the problem.

Consider my own experience: This past July, less than a year after my original infestation, a visiting friend napped in my bed and later noticed a couple of bites on her leg as well as a small black bug lying belly-up on the floor. When she informed me of her discovery, a familiar anxiety flooded my mind. Suddenly the two small bites on my own leg began to look suspiciously like the ones I'd had back in September. I called a well-respected pest control company and discussed the situation with the most senior inspector, who, after looking at an e-mailed photo of the insect, assured me that it was indeed a bedbug. Reluctantly I scheduled the first of the expensive chemical treatments for the next morning and began the lengthy preparations. (You're supposed to decontaminate all your clothing, sheets, and towels by washing, drying, and plastic-bagging them. Then you have to keep all your fabrics bagged through the series of treatments, which can last all month.)


I lay awake most of that night, waiting for a bedbug to bite, but it never happened. In the morning, my skepticism kicked in, and I took another look at the bug we'd found. The invader was about the size and color of a black lentil, with a line running down its rounded back. It definitely reminded me of the bedbugs I'd seen in September, but something about it wasn't quite right. According to the Internet, at least, bedbugs are flat and amber-colored. Could this have been something more benign? When I shared my hunch with the inspector, he told me that bedbugs weren't easy to identify and that the prudent course of action would be to get treated. To be absolutely sure, however, I decided to send my photo to Louis Sorkin, a researcher at the American Museum of Natural History in New York City, who donates his time as a diagnostician for insect pests.

Sorkin's response came in just 45 minutes. The bug in my bed was not a bedbug, he said. It was a black carpet beetle. I danced with glee.

My story isn't unusual, it turns out. Entomologists like Sorkin, who do bedbug consultations by e-mail and post, often see carpet beetles, fleas, moths, book lice, and springtails that have been misdiagnosed by frantic homeowners or sloppy pest management companies. Richard Pollack of the Harvard School of Public Health has spent 15 years analyzing suspected bedbug infestations and claims that more than half end up being false alarms. More often than not, he says, the specimens turn out to be other household insects, bits of lint, sesame seeds, crumbs, or scabs. Mysterious red welts may also inspire fear, but ticks, mites, spiders, and mosquitoes are the more likely culprits. (For Pollack, it's ironic how little attention is paid to mosquitoes, relatively speaking, given their status as vectors for West Nile Virus and dengue fever.)

It's the "better safe than sorry" mentality that has people pursuing full treatments before their infestations have been confirmed by an authoritative entomologist. Even skeptics may be overcome by feelings of disgust or fear of being ostracized. And they're persuaded to call in the men (or women) in protective suits with spray hoses, terrified by the possibility of infecting friends and loved ones.

The costs of these unnecessary treatments extend beyond the bill from the pest-management company. Formicating consumers may also shell out hundreds of dollars for dry cleaning, mattress covers, and new mattresses. And the superfluous use of chemicals may expose people to needless health risks. Bedbug populations have high levels of resistance to available pesticides, and some states are now lobbying the Environmental Protection Agency to approve the use of a chemical, propoxur, that is considered a probable carcinogen and has been banned from indoor use since 2007.

So how can you know for sure whether a bedbug scare is the real thing?  Rule No. 1 is not to place all your trust in a local exterminator. Those businesses may be scrupulously honest, but it's hard to know for sure whether their employees have had any real training in bedbug biology. The best way to assess the situation is by seeking out a professional entomologist through your local university or cooperative extension office. Pollack's company, IdentifyUS, also offers identification services by email for $20. If you do go to a pest control company—some have entomologists on staff— be sure to ask for a full inspection, and a written outline of the bedbug control program, before signing up.  And finally, don't panic. Bedbugs—real and imagined—have robbed too many Americans of precious sleep; cling tight to yours.

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