The Bed Bug Resurgence: What's Happening in Toronto?

The Bed Bug Resurgence – What’s Happening in Toronto? Some weeks ago Toronto Council voted to provide $250,000 to the Toronto Public Health Bed Bug Project from some millions of dollars of surplus in the most recent Budget. This week it was reported that certain staff at TTC would receive salary increases that amount to about “$35.7 million to hike all non-union staff salaries by 2% in 2011, 2012 and 2013 and dole out some benefit improvements.” Is $250,000 enough? Getting rid of bed bugs is not easy. When the problem was first reported in pest management trade magazines back in the late 90’s, not even those who were involved in addressing this from the very start could have imagined the scale of the resurgence. There has certainly been a lot of “handwringing” as these nasty bugs grew to huge numbers across North America, UK, Europe, Australia and elsewhere. They are actually part of the group of insects known as “true bugs” that feed by piercing and feeding on plants or other insects , with a very few being bloodsuckers that feed on mammals, and birds. A related local species the Giant Water Bug actually can kill frogs and small fish. We’re lucky that we don’t have another group of bugs here in Canada that are found in the tropics and which spread Chagas disease a very serious debilitating infection – caused by an organism related to the syphilis microbe. Nevertheless even though bed bugs do not cause serious transmissible diseases, they do create a lot of stress and anxiety. It is no fun if one goes to bed with the prospect of being bitten in the middle of the night, and for parents of children who are bitten this can be very disheartening and embarrassing. This is becoming more common to the extent that at a recent International Conference on Integrated Pest Management held in Memphis, educators from the University of Florida presented a school curriculum to educate teachers and students, in order that prevention be emphasized and families with bed bug problems could take the necessary steps to help in their own homes and get professional help to get rid of these bloodsuckers. Some schools have had policies of sending home information on bed bugs with children when evidence has been found on their clothing or backpacks, but this puts a lot of pressure on kids to carry bad news home. There was a case reported of a child being punished by parents as reaction to this kind of message. No one would like to think a parent would punish a child for something not their fault, but it can happen. Direct contact with parents by trained school staff instead of putting this onto children is a better approach. In this way, the school facilitates and aids in helping families get rid of bed bugs. Having bed bugs in a home is embarrassing as it carries stigma, and cases have been reported of seniors becoming isolated due to embarrassment and not wanting to spread infestation to their children and grandchildren. There have been two cases reported in medical journals, one in Canada, of elderly patients diagnosed with anemia from blood loss caused by uncontrolled bed bug infestations. This likely happened because the seniors had not sought help and were isolated. In one of these cases, it was a family doctor’s intervention that brought this to light. In a recent news item reporting Montreal’s Bed Bug initiative in advance of the moving season, it was estimated that nearly 2% of households have bed bugs (1.8%). That means that with 867,602 households, 17, 352 were infested. If the rate of infestation of households in Toronto was similar, there would be about 19,589 homes in Toronto with infestations. How did this happen? Most of us, including pest management professionals, had not had any encounters with bed bugs through decades from the late 40’s right to the turn of the century. This is attributed to a number of factors with the leading causes blamed for this being the banning of stronger pesticides such as DDT, and others that were commonly used till the early 90’s, and the resistance of bed bugs to products currently available. There have been both appeals and demands asking for use of some of these products. Ohio where there are major problems in some cities had practically demanded that the Environmental Protection Agency allow use of propoxur, one of the banned products. This was refused because of possible risk to children as a consequence of repetitive treatments that are common in these situations. There just is no “magic bullet” that will eliminate bed bugs cheaply with a single treatment and not even with multiple treatments if not performed meticulously. Scientists who are familiar with insect resistance to insecticides are not surprised. This is not the first time people have faced difficulty in control due to the amazing abilities of insects to develop resistance. The problem also exists with mosquitoes, cockroaches and agricultural pests. Recent research in the U.K. has shown that being able to get rid of bed bugs is clearly linked to income, and those in lower income categories have greater difficulty getting rid of them. There are clear reasons for this. It is related to proportion of people living in single family dwellings which have a lower risk of getting infested (no spread between units as in apartments), but also due to ability to purchase high quality services to get rid of the infestation, whereas people of lower income have less resources and greater risk of ongoing infestation due to infestations in other units in a building. Spread of infestation in a multi-dwelling building can result from only one or two introductions of single gravid female bed bugs if infestation is not reported or the treatment is disorganized and ineffective. How can the problem be halted? In simple terms, more bed bugs means more bed bugs. If there are units in buildings with infestations that are not eliminated, and there are more buildings with infestations as a consequence then the risk of even more infestations increases. Spread of infestation occurs within a building between units, but also between buildings by a variety of means such as people visiting others – family and friends, kids on sleepovers, from discarded furniture, from people moving from one building to another, or even from people getting them on the job and bringing them home. This is what has happened from the late 1990’s up to the present. Bed bugs were extremely rare prior to 1999, but now they are more common than imaginable. Some buildings have even more than 2% infestations. People are then in a vicious cycle of repeated treatments. There have been cases in which a market rent building owner was brought near to bankruptcy as the word spread and tenants left and new tenants avoided the building. The problem will be not be halted until bed bugs are totally eliminated from a building... and of course that means from ALL the units in the building, and are kept out of the building by excellent preventive measures. Unless this is accomplished, then spread will continue as it has done at a rampant rate since the late 1990’s. Bed bugs create a lot of fear as the fact of getting infestation into one’s home is frightening – it is very disruptive and generates great anxiety that remains until the “all clear” as it were. That fear of going to bed and being attacked in the middle of the night even if it is by stealth, and mostly painless, and of the angst of one’s children being attacked – a parent’s nightmare in failing to protect one’s children through no fault of one’s own. The $250,000 funding of the Toronto Public Health unit’s Bed Bug Project Team will help a few people as they have reported, but the numbers are small, and the impact on the bigger picture may be miniscule. The 180 or even 200 cases of nearly 20,000 addressed are only the “tip” of the iceberg. This will help some people, but will not likely do much to stop the resurgence. There are certainly measures and means of sourcing assistance that are outlined on the Toronto Public Health Website, but without a broader process of addressing infestations in buildings, the effect may be quite limited. Tenants are sometimes fearful of complaining and even with the Landlord Tenant Board as the adjudicator to interpret the facts in relation to the law, the process can be complex, and there is a potential for conflict and blame. Public health may issue orders under the Health Promotion and Protection Act as noted in the Toronto Public Health website, but this problem is so expensive to address that the means of how such orders are executed and enforced is not as simple as “treat the unit” or “prepare the unit for treatment” or else. Those are the polarities between landlords and tenants. Treating one unit for bed bugs can be very expensive and time consuming. The actual resources allocated to treatment by public or private landlords may be very limited resulting in substandard or, at best, inadequate treatment. In this age of technological wonders that abound with smart phones and tablet computers that we carry around that have more capacity and power than the NASA computers that enabled the landing of men on the moon, and yet, bed bugs have managed to recover and are out there in the millions. It actually seems almost “silly” that with all of human abilities, these creatures seem to be “besting” our efforts in Toronto and elsewhere. Bed bugs can be eliminated. Yes, we could call them “superbugs”, but they can be defeated – it takes a systematic co-operative societal approach using Integrated Pest Management as was reported in a Joint Statement by the U.S. Centres for Disease Control and Environmental protection Agency. This involves the education of key stakeholders in society that includes all citizens – private homeowners and tenants, as well as landlords, and caregivers as well as facility managers in a wide range of sites from nursing homes, hospitals, schools, and hospitality industry, and all levels of government in appropriate roles. Current legislation at provincial and municipal levels has just proven inadequate to address this situation, and this has been upgraded and augmented in many jurisdictions around the world in order that appropriate Integrated Pest Management measures and processes are being practiced properly. There have been initiatives to address the issue in Ontario and there are efforts underway in different sectors, such as upgrading of procedure manuals and education in many institutions, but there does not seem to be a broader pro-active action of enforcement and of facilitation, and there is a lack of addressing whether appropriate standards of practice are being followed. The $250,000 budget in Toronto will certainly help a few people, but it will only provide a little band-aid to a problem that is now of major proportions. The personal cost to Torontonians for treatment will be millions of dollars – both to landlords and to tenants. The problem is greater in major urban centres. And it affects those who are most vulnerable and who do not have major financial resources. This problem can be solved and stopped, but it is going to take change, and it will need more than a band-aid.

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