They only come out at night: Bed bugs and their alarming resurgence
Kelley Miller Wilson MSN, RN

January 2011 
Volume 41  Number 1
Pages 54 - 58
  PDF Version Available!

"GOODNIGHT, SLEEP TIGHT, and don't let the bed bugs bite..."Most of us have heard (or said) this expression, yet probably not given it much thought. Bed bugs have survived for thousands of years and are mentioned in ancient Greek and Roman writings dating back to the time of Aristotle.Cimex lectularius (named by the Romans; cimex meaning "bug" and lectularies referring to "bed" or "couch") is the species of bed bug most adapted to living in human conditions and present in North America, Europe, and Central Asia.1 Large cities are currently experiencing record infestations. The National Pest Management Association reports that bed bug-related extermination calls were up about 80% in the last decade.2 Some experts claim those numbers are conservative and that the problem is actually much worse than documented.In the early 20th century, bed bug infestation was considered common. After World War II, improvements in hygiene and the use of DDT resulted in bed bugs all but vanishing from the United States.1 They prevailed, however, in other parts of the world, including Eastern Europe, Asia, and Africa. The current influx of bed bugs in the United States has been noted virtually everywhere-in dorms, apartments, houses, hotels, schools, healthcare facilities, and other public areas, including movie theaters and modes of transportation, such as trains.3Experts cite various reasons for this resurgence. Immigration, decreased public awareness, overcrowding in residential properties, increased international travel, and changes in pest control practice all play a part. The insects' resistance to some insecticides is another likely factor.Fast-moving, nocturnal insects, bed bugs are most active during predawn hours. They hide in cracks and crevices during the day. The mature bed bug is oval, wingless, and a deep brown/red color. It measures between one-quarter and three-eighths of an inch long and resembles an apple seed.4These creatures painlessly pierce exposed skin (most commonly

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