COF 2019 #4 : A communication was received from City Clerk Donna P. Lopez, transmitting a memorandum from Councillor Kelley regarding Bed Bugs Overview.

CAMBRIDGE CITY COUNCIL Craig A. Kelley City Councillor CITY HALL, CAMBRIDGE, MASSACHUSETTS 02139 [phone removed] FAX: [phone removed] TTY/TDD: [phone removed] EMAIL: ckelley@cambridgema.gov To: Donna Lopez, City Clerk From: Craig A. Kelley, City Councillor Date: January 24, 2019 Subject: Memorandum Submission Please place the attached memorandum, “Bed Bugs Overview”, on the City Council agenda as “Communications and reports from Other City Officials” for the January 28, 2019 meeting. Thank you.

CAMBRIDGE CITY COUNCIL Craig A. Kelley City Councillor CITY HALL, CAMBRIDGE, MASSACHUSETTS 02139 [phone removed] FAX: [phone removed] TTY/TDD: [phone removed] EMAIL: ckelley@cambridgema.gov MEMORANDUM To: Cambridge City Council From: Craig Kelley, City Councillor Mark Gutierrez, Council Aide Date: January 28, 2019 Subject: Bed Bugs Overview 1. Introduction For more than 3,300 years, bed bugs have been considered a household problem for humans around the world. They were first brought to the United States by early European colonists, but advancements in pest control products and household cleaning (including washing machines and vacuums) nearly eradicated bed bugs in the developed world by the 1950s.1 Infestations have returned and spiked in the past two decades, largely due to the insects’ development of pesticide resistance and exacerbated by a massive increase in global air travel.2 Of the many species of bed bugs, Cimex lectularius is the most familiar and most likely to be found in homes, as their primary diet is human blood. All bed bug species live on blood, mostly from warm blooded mammals. Some species need blood from a certain animal while others can feed on any blood available to survive. Bat bugs may also be found in homes and can feed on mammals other than bats, but primarily feed on bat blood as it is required to reproduce. They are also far more likely to be found in attics than beds, due to the habitat of their host.3 Neither young nor male bugs will generate an infestation, but a pregnant female can lay up to five eggs a day, and 500 in a lifetime.4 Bed bugs typically feed once or twice per week but can survive several months without food. Adulthood is reached about 37 days from when eggs are laid. At the size of an apple seed, bed bugs hide in and around beds, couches, box springs, wheelchairs, mattress tags, crevices, and other dark and protected areas in proximity to where humans rest. 5 Bed bugs typically hide during the day and come out when the host is sleeping. Bites are

2 painless, and one third of people show no allergic reaction and are therefore unaware of their bites.5 If a reaction occurs, bites may result in itchy red spots organized in a cluster or rough line. Symptoms of a severe reaction include severe itching, blisters, or hives.6 Although a bed bug infestation can be psychologically upsetting and a physical and costly nuisance, they are not known to carry any harmful diseases. In fact, some researchers that raise bed bugs for scientific study actually allow the bed bugs to feed on their arms.2 2. Where Bed Bugs are Problematic The National Pest Management Association (NPMA) and its official website, PestWorld.org, regularly survey pest control professionals in the U.S. Findings for the 2018 Bugs Without Borders Survey were released earlier this year which revealed the most common places bed bugs are found:7 Figure 1 Additionally, bed bugs:7 • Are very common: 97% of pest professionals have treated for them in the past year. • Have also been found on airplanes, stuffed animals, wheel chairs, school buses, and in purses and bags. • Are easily confused with other pests: 84% of customers that contacted pest professionals initially reported other pests, only to be identified professionally as bed bugs. 91% 89% 68% 59% 47% 46% 45% 39% 36% 19% 16% 13% 0% 20% 40% 60% 80% 100% Single Family Homes Apartments/Condos Hotels/Motels Nursing Homes Schools/Day Care Office Buildings College Dorms Doctor’s/Outpatient Hospitals Public Transit Retail Stores Movie Theatres Percent of pest control professionals who have treated for bed bugs in the following places

3 • Are seemingly on the rise: 69% of pest professionals report an increase in bed bug service work and 66% state the prevalence of these insects is increasing. • Are the number one most difficult pest to control, according to most pest professionals. Bed bugs are found in all 50 states and are a comparably problematic issue across all regions. However, they are three times more likely to be found in urban areas than rural areas due to larger populations and increased density and mobility.8 This year, Orkin released their Top 50 Bed Bug Cities List, ranking Baltimore, Washington D.C., Chicago, Los Angeles, and Columbus as their top five infested cities. Boston came in 32nd place, down from 28th place a year ago.9 3. Challenges of Eradication The eradication of bed bugs is a difficult and complicated process. Some have a genetic mutation that makes them resistant to common insecticides, others have enzymes that break down insecticides, thus reducing the toxicity and effectiveness, and yet other research shows some bed bugs are developing thicker exoskeletons that makes insecticide penetration more difficult.2 Bed bugs can survive temperatures from near freezing up to 122 degrees Fahrenheit.8 Detection is not always easy because many people are not allergic and therefore show no reaction, so it’s not uncommon for people to sleep in beds with bed bugs and never notice. The bugs and their bite reactions are easily confused with other insects and insect bites, and their near nocturnal behavior allows them to hide in tiny, undetectable areas during the day and feed at night on sleeping hosts.2 While they typically express nocturnal behavior, they’re known to come out during the day and when lights are on at night. Their activity mirrors the host’s behavior, so if the host works at night and sleeps during the day, they will be active during the day when the feeding source is home.10 These insects are excellent hitchhikers and may be transported in suitcases, backpacks, dirty laundry, furniture, books, and other items.11 To get rid of bed bugs, city dwellers often need to work with family members, roommates, adjacent neighbors (with shared walls, floors, and ceilings), and landlords or management staff, as well as hire a pest control professional which can be very costly. Mattresses, box springs, and other furniture may need to be quarantined for cleaning, and storage areas and personal items inspected. This process can be daunting, expensive, time-consuming, and difficult to the point of impossibility for many. The development of new pesticides would be beneficial in combatting bed bugs, but new treatment is difficult to bring to fruition. New pesticide research is estimated to cost around $256 million per active ingredient and take nearly a decade to develop. Chemical companies are also less interested in this field, as their main focus is on the far more profitable and massively larger agricultural industry. Additionally, it’s becoming more difficult to identify the right chemicals

4 that are safe for use around humans, especially in delicate sanctuaries such as bedrooms.2 There are other barriers as well. Professional treatment can cost thousands of dollars, and if it’s not done in coordination with adjacent neighbors, infestations may creep back soon after treatment. Many over-the-counter chemicals advertise their products to kill bed bugs on contact, but it’s rarely effective as the elusive bugs need to be sprayed directly. If the property has a landlord or is otherwise managed, working with them is an important step and requires that they are amenable and responsive to the issue and the suggested treatment options.2 4. Prevention and Control In Cambridge12 The Cambridge Public Health Department (CPHD) issued a statement in response to policy order number six from March 1, 2010 requesting more information on protocols and how to fight bed bugs. Under Massachusetts Law, the State Sanitary Code entitles renters to a safe and habitable living environment through the entirety of their tenancy. If there are two or more units in a building, the owner is responsible for keeping them free from rodents, cockroaches, and insect infestations. Renters are responsible for incidental costs such as new beds, furniture, or laundry services, unless an existing owner-renter contract states otherwise. In Cambridge, the Inspectional Services Department (ISD) is responsible for enforcing State Sanitary Code if an owner fails to respond to an infestation in their building. The inspections are provided free of charge and inspectors will further instruct the owner to take action and move forward with hiring professional pest control services. Forcing a reluctant landlord to undertake what may be a complex, expensive and ultimately imperfect infestation response may require multiple administrative and legal steps, which can be an additional challenge to a timely bed bug response. CPHD works closely with ISD on complex cases in addition to providing community-wide education and best practices. Elsewhere Public knowledge and awareness of bed bugs is alarmingly low. They are consistently misclassified by the general public as other insects and they can infest nearly any area where humans assemble. The NPMA declared June 3-9, 2018 as Bed Bug Awareness Week to help draw attention to the issue.7 Twenty-one states have laws or regulations that apply to bed bugs.13 The University of Washington Evans School of Public Policy and Governance in partnership with the Pesticides and Toxics Unit of the Federal Environmental Protection Agency (EPA) created A Starter Guide for Local Government on tackling bed bugs. The guide reviews policy and regulatory options, ordinances implemented in other cities, reporting mechanisms, and other considerations for municipalities as well as provides models and indicators for success.14

5 Recommendations for Individuals Bed bugs don’t differentiate between clean and dirty homes, though removing clutter may reduce the number of hiding spaces. Traveling, bringing home furniture, and spending time in high-turnover, densely populated areas all increase the risk of having bed bugs. Some risks are unavoidable, and the CDC says that the most effective way to prevent bed bugs is regular inspection.15 There are a few smartphone applications one may download to help identify and learn more about these insects, including the Bed Bug Field Guide and Bed Bugs 101. There are other in-home steps to prevent infestations:5 • Understand bed bug behavior: what they look like, their size, and where they like to hide. • Inspect the mattress and box spring when changing sheets, especially at seams and under mattress tags and purchase bed bug resistant bedding. • Remove clutter under and around one’s bed. • Repair and seal cracks and crevices in walls, windows, and baseboards. • Inspect hotels rooms before unpacking luggage or going to sleep. • When returning from trips, inspect luggage thoroughly, and place clothes in the dryer on high heat for 30 minutes or more, as this is one of the best ways to prevent introducing pests to a home. If a home shows signs of a bed bug infestation, experts recommend contacting a pest control professional. At-home, over the counter chemical treatment is not recommended and is rarely effective. Specially trained bed bug sniffing dogs may be used in the detection of these pests. There is some skepticism in the industry, but dogs are reportedly accurate at finding infestations 97% of the time, compared to the average person’s visual detection accuracy rate of only 30%.16 Once infestations are confirmed, pest professionals will try one or several options to control infestations:15 • Insecticide treatments, depending on species and known resistance. • Heat treatments that warm a room to 122 degrees Fahrenheit, a deadly temperature for these insects. • Freeze treatments that cool items or areas to near 0 degrees Fahrenheit is a rare but effective treatment in some cases. • Traps, depending on species, may be effective. In lieu of, or in coordination with, a pest control professional, there are additional steps to take to control infestations at home:5 • Talk with adjacent neighbors with shared walls and reach out to landlords or management. • Remove as many bed bugs as possible with a vacuum, or even tape or lint rollers. • Bedding, clothing, and other durable items should be placed in the dryer on high heat for 30 minutes or more. • Mattress and box spring encasements are effective at trapping and killing bed bugs and

6 eliminating hiding places and further infestations. • Place bed bug traps under the bed and keep linens from touching the ground. • If discarding items or furniture due to infestation, clearly write “bed bugs” and post pictures so they are not reused by others. • Be wary of picking up items from the curb or reuse area. Check them in good light for bed bugs before bringing them home. Figure 4: Mattress/box spring encasements Figure 5: Bed bug interceptor Figure 6: Bed bug glue trap Figure 2: Example of possible skin reaction Figure 3: Size comparison by life cycle

7 References 1 https://www.pestworld.org/all-things-bed-bugs/history-of-bed-bugs/ 2 https://www.vox.com/2015/4/27/8502491/bed-bugs-kill-increase 3 https://www.terminix.com/blog/bug-facts/what-do-bed-bugs-eat-do-they-only-feed-on-humans/ 4 https://www.pestworld.org/all-things-bed-bugs/bed-bug-facts-statistics/ 5 http://npic.orst.edu/pest/bedbug/index.html# 6 https://www.mayoclinic.org/diseases-conditions/bedbugs/symptoms-causes/syc-20370001 7 https://www.pestworld.org/news-hub/press-releases/pest-control-professionals-see-summer-spike-in-bed-bug-calls/ 8 https://www.pestworld.org/news-hub/pest-articles/six-facts-you-didnt-know-about-bed-bugs/ 9 https://www.orkin.com/blog/orkin-at-home/sleep-tight-orkins-2018-top-bed-bug-cities/ 10 https://www.orkin.com/other/bed-bugs/come-out-when-lights-on/ 11 https://www.pestworld.org/pest-in-the-house/bedroom/ 12 https://www2.cambridgema.gov/CityOfCambridge_Content/documents/Bed%20Bugs%20response.pdf 13 https://www.epa.gov/bedbugs/bed-bug-laws-and-regulations 14 http://npic.orst.edu/pest/bedbug/tacklingbbstarterguide.pdf 15 https://www.livescience.com/42297-bed-bugs-facts-information.html 16 https://www.bedbugs.org/dogs/ Figure 1: Mark Gutierrez, based on date from: https://www.pestworld.org/news-hub/press-releases/pest-control- professionals-see-summer-spike-in-bed-bug-calls/ Figure 2: https://www.aad.org/public/diseases/itchy-skin/bed-bugs#overview Figure 3: https://www.thebuguy.com/services/bedbugs/ Figure 4: https://pestseek.com/best-bed-bug-mattress-covers-encasements/ Figure 5: https://globepestsolutions.com.au/product/climb-up-bed-bug-interceptor/ Figure 6: https://www.amazon.com/Expel-Insect-Interceptors-Bedbug-Activity/dp/B01MYNBRFT