What you need to know about Bed bugs ! - Division of Environmental Health and Protection Public Facilities Program

What you need to know about Bed bugs !

                                  Division of Environmental
                                    Health and Protection
                                    Public Facilities Program
                                         502-574-6650
                                  www.louisvilleky.gov/health
                                                                     7-2013

 Many Thanks to following for the information contained in this handout.

The History of Bed Bugs
Bed bugs trace back to the time when humans moved into caves for shelter from the
weather and predators. Bat bugs lived in the caves feeding only on bats until we moved in
and they started feeding on us. Colonists traveling from Europe introduced bed bugs to
North America in the early 17th century. The bed bugs traveled the oceans with us in the
bedding we carried to America and then moved into our homes with us.

Why are Bed Bugs Back
Bed bugs have made a comeback in the United States and across the world. In the 1940’s
and 1950’s, most people had a certain level of bed bug knowledge. Whenever they left
home to visit family and friends or public places, they knew they might be exposed to bed
bugs and were very careful with their belongings. The widespread use of pesticides such as
DDT in the 1950’s killed off most bed bug populations. DDT is no longer used because of its
danger to our environment and us. Studies show that today’s bed bugs are immune to DDT.

Today, most people have never seen a bed bug! Bed bug populations are on the rise in the
United States because of increased international travel, people moving from one home to
the next, and changes in modern pest control efforts. Bed bugs can easily hitchhike from
one location to the next on our clothing, luggage, and backpacks. Once they are in our
homes, they can rapidly increase in numbers by hiding in our beds and other dark, cluttered
out-of-the-way areas. Whether you have lots of money or not; bed bug infestations are
found in both clean and unclean conditions.

What are the Health Risks from Bed Bug Bites
Bed bugs are not known to spread any diseases. Bed bugs in our beds trigger panic and
disgust and we just want to get rid of them as fast as possible. Currently there is no simple
or inexpensive way to get rid of bed bugs. The products you buy at the store could make
your problem worse if the pesticide is NOT used according to the label. You could also have
a harmful reaction to the pesticide if applied improperly. The Louisville Metro Department of
Public Health and Wellness recommends calling a professional pest control operator because
they are trained and licensed to do these treatments safely. They also have access to
professional-use pesticide products that are not available to consumers.

What are the Social Effects of Bed Bugs
People living in bed bug infested homes may experience panic, stress, anxiety, and very
little sleep because they fear being bitten. Feelings of stigma (shame), anger, frustration
and depression are common. Individuals and families dealing with bed bugs may be told the
bed bug problem must be taken care of before returning to work or sending their children
back to school. Live bed bugs on belongings or visible bites trigger emotions of disgust and
fear in public situations. For these reasons, people often isolate themselves from others and
do not report bed bugs to their property owners or ask for help. Many say when they do ask
for help, family and friends do not want to help for fear they could transport bed bugs to
their own homes. The cost for professional pest control can be high for those least able to
pay and using home remedies or store bought pest control products may not get rid of the
bed bugs. If these homes remain untreated or improperly treated, bed bug populations will
grow rapidly and spread to new locations in our community, including the public places we
visit!
 Knowing how to protect yourself and what to do to prevent bed bugs
  is the key to stopping the spread of bed bugs in our community!

Bed Bug Biology
Bed bugs are small insects that feed mainly on human blood. A newly hatched bed bug
(nymph) is semi-transparent, light in color, and the size of a poppy seed. The color of a
nymph will appear red if it has just fed. Adult bed bugs are flat, have rusty-red-colored
oval bodies, and are about the size of an apple seed. The bed bug life cycle has five
stages. The bed bug must take a blood meal before it can grow to the next stage. Bed
bugs have their skeleton on the outside of their body (exoskeleton) and must shed their
exoskeleton to grow bigger. Adult bed bugs, both male and female need to have regular
blood meals to reproduce. Below is a diagram of bed bug life cycle.

                                             •   A female bed bug will produce between
                                                 1- 7 eggs per day for about 10 days after
                                                 a blood meal. She will have to feed again
                                                 to produce more eggs.
                                             •   Most nymphs will develop to the next stage
                                                 within 5 days of taking a blood meal.
                                             •   The average time for the bed bug to go
                                                 through the life cycle is about 37 days.
                                             •   The blood meal provides hydration
                                                 (moisture) to the bed bug, just like water
                                                 is necessary for humans.
                                             •   Bed bugs pack tightly together in small
                                                 cracks and crevices. This helps keep their
                                                 hiding places at favorable temperatures
                                                 and humidity. Bed bugs can live without a
                                                 blood meal, hiding together for over 70
                                                 days when a home or apartment is vacant

Bed bugs can be easily confused with other small household insects, including small
beetles and newly hatched cockroaches. Bed bug identification must be confirmed !
 “One pair of bed bugs can become 35,000 in just 10 weeks if not controlled.”
              Phil Koehler, Professor of Entomology, University of Florida

Bed Bug Bites
Bed bug bites are most often found on the upper body: neck, arm and shoulders, but can
be found on legs or ankles. Bed bugs feed on exposed skin, but can feed under loose
clothing. In most situations, they usually feed at night in the dark but may feed during the
day, especially if you sleep during the day. Some people do not react
to bed bug bites and others are very sensitive. Bite marks may appear
within minutes or days. They can be small bumps, a rash or large itchy
welts. The bumps, rash or welts usually go away after a few days. Bed
bug bites can be very itchy and irritating. Usually an anti-itching cream
will help, but if bites become infected, you should see a doctor.
Bed bug bites may resemble mosquito
and other insect bites. It is critical to
confirm bed bugs in the sleeping or living
area by inspecting for the signs of a bed
bug infestation. Bites alone do not
confirm that you have bed bugs.

How to look for Bed Bugs                     Tools that can help with your search:
•   A magnifying glass.                        •   Small tool kit/screwdriver to get behind
•   Strong flashlight (LED is better)              baseboards, electrical sockets
•   Tape (capture bed bugs for samples)        •   Thin plastic card to check cracks/crevices
•   Jar with a lid (for samples)               •   Cleaning wipe/alcohol-cotton swab to
•   Tweezers ( to pick up small bed bugs )         dissolve fecal marks

What to Look for in your Home
                              Live Bed Bugs : Bed bugs can look different after they
                              have fed. If an adult bed bug has not fed recently, it will
                              look like a flat disc, about 3/4 inches long and oval in shape.
                              After feeding, the body blows up like a balloon and the color
                              will be red. After it digests the blood, it will turn reddish
                              brown and flatten back out. Bed bug nymphs also change in
                              appearance after they feed. They look pale white or yellow
                              before they feed and turn bright red and plump after a
                              blood meal. Nymphs are easier to see once they have fed.
Bed Bug Eggs : Females will deposit one, two or more eggs
each day. The eggs are tiny (about the size of a dust speck),
whitish and hard to see without a magnifying glass. When first
laid, the eggs are sticky, causing them hold tight to surfaces.
                   Fecal Spots : After the bed bug feeds, it starts digesting the blood
                   meal. The fecal waste comes out in a semi-liquid form and is black in
                   color (looks like a small magic marker spot). Fecal spots can be found
                   along the mattress seams, the wood frame of the box springs, behind
                   the headboard, along the tops of baseboards, at the edge of carpeting,
on ceiling and wall junctions, behind pictures on the wall and at electrical outlets. If the
bed bug infestation is large, check all furniture and the same areas in other rooms.
Molted Skins : Look almost the same as a bed bug. They are the same
shape and usually clear (see-through) in color. They look like an empty bed
bug shell. They will be different sizes depending on the life stage of the bed
bug that molted. Look for molted skins along mattress seams, box spring,
headboards, in ceiling/wall junctions, along baseboards and stuck to personal belongings.
         Blood Stains : Rusty or reddish smears on bed sheets or mattresses from
         crushed bed bugs that have recently fed.
Bed Bug colonies : Bed bugs hide together so you will see live bed
bugs (multiple life stages), fecal spots, molted skins, and eggs. Look
along mattress seams, in the tufts and under the mattress tags, behind
the headboard, inside the holes for set-in screws, along wood creases
in the box springs or in bed frames, where the box springs fabric is
stapled to the wood frame, behind any loose wallpaper, behind chipped
paint, under the base of the air conditioner, beneath the wood framing that holds the bar
in the closet, along the interior frame of closet doors or window sills, inside curtain rods,
and on the curtains near the top where they are pleated, behind baseboards, behind the
electrical outlets and sockets, in personal belongings, books, stuffed animals, picture
frames and hundreds of other locations.

Bed Bug Prevention
Bed bug infestations are becoming more common in the Louisville Metro community.
There are steps that can be taken to prevent bed bugs from infesting your home. When
bed bugs are present, they can be safely controlled and/or eliminated. The best way to
prevent bed bugs is the regular inspection of your home for signs of an infestation.
You also need to know how to recognize situations or locations where you are most at risk
for picking up bed bugs. Bed bugs do not just appear in your home or apartment. They
cannot fly so most of the time people move bed bugs from place to place by the things
they carry with them. Once brought inside your home, apartment or condominium, bed
bugs can travel to your other bedrooms and living spaces through wall voids, along utility
lines and heating ducts.

The most common ways bed bug infestations get started:
• Travelers bring bed bugs home from infested hotels or motels in their luggage.
• Bed bugs can be brought home with infested used furniture.
• Bed bugs can hitch a ride to another location by hanging on clothing.
• Family members not living with you may bring them to your home during visits.

Bed Bugs and Traveling
One of the most common ways to be exposed to bed bugs is during travel. Bed bugs could
be in your hotel room, in the trunk of a taxi, the luggage compartment of a bus or even in
the baggage handling areas of the airport. Inspecting your hotel room and your luggage
when you get home are two ways to stop bed bugs from getting into your home.
• Luggage: Consider using a duffel bag for traveling instead of a suitcase. Duffel bags
   can be run through a dryer when you get home.
• Check your hotel room: Put your luggage and belongings in the bathroom while you
   inspect the room.
• Headboard: Hotel headboards are often hung on the wall with hooks fastened to the
   wall. It is the most likely location where bed bugs will be found in a hotel room. Lift up
   the headboard, lay it face down on the bed and examine the back carefully, especially
   where there are grooves, cracks, or screw holes. Use your flashlight and examine the
   hooks on the wall. Use a small penknife or plastic card (credit card) to run through small
   cracks you find. If you do not find anything, put the headboard back on the wall.
• Bed: Remove bedding, look carefully at the head of the bed and examine for bugs and
   fecal droppings. Because bedding is changed with each guest, you are not likely to find
   bed bugs here, but you will need to remove it anyway to get to the mattress.
• Mattress: Examine the mattress and pay special attention to rounded corners, near the
    cording. Examine the mattress tag if it still has one. Lift up the mattress from the bed
    and carefully check for bed bugs and spots between the mattress and box springs.
• Box springs: Bed bugs are often found in the box springs. Some box springs have
   plastic corner guards; check these areas carefully.
• Encasements: To prevent bed bugs from infesting mattresses and box springs, some
   hotels and motels are encasing them. These encasements often have a zip-lock tie that
   prevents the zipper from being unzipped. If they are encased, you cannot go any further
   but do carefully check the encasement for signs of bed bugs.
• Changing rooms: If you find bed bugs or their fecal droppings, you should ask the
   management for a different room. Ask for a room on a different floor. If the hotel says
   no other rooms are available, you should not stay there.

•   Ready to settle in the room: If everything looks okay, it is a good idea to take the
    following precautions:
•   Do not place your luggage on the carpeted floor. Use the top of the dresser, a table,
    luggage racks, or store luggage in the bathroom overnight because this is when bed
    bugs are most active. Hanging clothes can be placed in a garment bag or dry cleaner
    bag and hung in the bathroom.
•   Be careful where you place camera cases, computer cases, purses, or backpacks.
    Do not store them on the floor and especially not near the bed.

Preventing Bed Bugs from getting into your Home
•   When returning from a trip or just staying with friends, unpack your suitcases outside
    the house. Carefully look at everything you unpack for signs of live bed bugs, fecal
    marks, blood stains and eggs. Small items like a shaver, makeup, combs, and
    brushes can be placed in plastic zippered bags when you travel so checking them is
    easier when you get home.
•   While you are still outside, remove clothing from luggage and place in a plastic
    bag and seal with a twist tie.
•   Remove the clothing you are wearing and launder it immediately or place it in a dryer
    for 30 minutes or, put your clothing in a plastic bag, seal it with a twist tie, until you
    do the laundry.
•   When you are ready to do your laundry, take the bag directly into the house to the
    laundry room. Remove clothes from the bag and immediately place them in the
    washer and wash as you normally would and then dry on high heat for 30 minutes.
•   Items that cannot be washed, like a wool blazer, can be placed in a medium-hot
    dryer for 30 minutes.
•   Immediately discard the plastic bag in an outside trash receptacle.
•   Shoes can be placed in a dryer, although it will be noisy. If you have a dryer with a
    drying rack, you can dry leather shoes and other items as well. If your shoes have
    laces, you can tie them together and catch the knot in the dryer door, with the shoes
    inside the dryer. It will dry them without the noise.
•   Instead of bringing your luggage into the house, store it outside. If you must bring
    it inside, place it in a large plastic bag and seal it with twist ties. Store it in an area
    as far away from the sleeping areas as you can.
•   Computer cases and other items often cannot be run through a washer or dryer. You
    could place these items in a sealed plastic bag with Nuvan™ Prostrips. Place the bag
    in a warm location with a low relative humidity for 48–72 hours.
    Nuvan (dichlorvos, DDVP) is an organophosphate
    insecticide with high vapor pressure that makes it a
    fumigant. This active ingredient is not considered safe for
    people to breathe for extended periods of time so it should
    never be used in living areas of a home. This product has been
    tested and is effective against bed bugs. Luggage can also be
    fumigated in a sealed plastic bag with Nuvan™. Contact a pest
    control company to obtain this product.
•   If you travel a lot, you may want to invest in a portable mobile
    heater for suitcases and other items that cannot be washed or
    dried. These devices surround the items and heat them to 120°F
    for up to six hours.

Other Prevention Methods
    There are several other ways bed bugs can be introduced into homes. They include:
•   Visitors: to your home can bring bed bugs with them. Be particularly cautious if they
    have traveled recently or if they live in multi-family dwellings. This includes college
    students coming home for visits. If family members are not insulted, run their clothing
    through the dryer before they settle into the house.
•   Used furniture: Do not even think about picking up furniture sitting by a dumpster or
    at the curb. There is probably something wrong with it or it is infested.
•   Always inspect used furniture before bringing into your home. Inspect the items in the
    garage or another location away from your house. Store it away from your home for a
    short time to make sure there are no bed bugs in it
•   Inspect along the edges and seams of the sofa or couch and cushions. Turn each piece
    of furniture over, pull back the fabric dust cover and inspect near the staples where
    the fabric is attached; where pieces of wood butt against each other and along the
    metal springs.
•   Pay special attention to overstuffed couches and chairs, the extra padding makes it
    hard to see bed bugs.
•   Be careful about what you purchase from the Craig’s List or other web sites offering
    used or nearly new items.
•   Be careful with rent or rent-to-own furniture. Ask management if they have a system
    for inspecting and treating returned or repossessed furniture.
•   Used clothing: When you get home and before wearing any thrift store or garage sale
    clothing you have bought, wash the clothing and put in the dryer for 30 minutes.
•   New clothing: New clothes should be inspected before you take them into your home.
•   At the Laundromat: Most people that have their home or apartment treated for bed
    bug infestations have been told by their pest control company to bag up (in plastic
    bags) everything that can be laundered. They are then instructed to wash and dry all
    infested items. Many people go to the nearest laundromat. Protect your belongings
    from becoming infested:
     *Do not transport laundry in cloth bags unless you plan to wash and dry these also.
     *Use white plastic baskets that are easy to inspect for bed bugs when they are empty.
     *Do not set your laundry basket on the floor or on top of the washer. Put it back in
      your car when it is not in use. If you do not have a car, place the basket on top of
      the washer and inspect it thoroughly before putting clean laundry back into it.
     *Do not set your laundry basket anywhere near the seating areas or trash cans.
     *Inspect any chairs in the seating area of the laundromat before sitting on them.
     *Inspect the table used for folding laundry before placing your clean clothes on it.
•   Your job: If you have a job where you must visit other people’s homes, you could
    bring bed bugs home with you. Do not take items you do not need into the home. If
    you must take items in such as electronics or medical equipment, keep them in a
    plastic tote or special carry bag (keeps bed bugs out) until ready to use. Do not sit on
    upholstered furniture; sitting in the kitchen on a hard chair is a better choice! After
    leaving the home, inspect yourself and the items you carried into the home for bed
    bugs. Most professionals that visit client homes wear dedicated clothing and shoes that
    they change out of and then bag. When they go home, the bagged clothing is washed
    and run through a hot dryer for 30 minutes.
•   Be careful with your coats and jackets. Never leave them on someone’s couch or bed.

Early Detection Tools
•   If you find a bed bug in your home, call a qualified and experienced pest management
    company to do an inspection. Comply with all of the directions for preparing your
    home for inspection and treatment.
•   Isolate the location where the bed bug was seen. Catch the bed bug and put it in a jar
    with a lid for positive identification.
•   Pull the bed away from the wall. Wash and dry all bedding once a week. Light colored
    bedding allows you to see the signs of bed bugs, such as fecal spots much easier.
•   Remove bed skirts and any bedding that touches the floor which gives easy access for
    bed bugs to climb up into your bed.
•   If you have the money, protect your mattress and box spring with special bed bug
    proof encasements. Both mattress and box springs should be encased, but the box
    spring encasement is very important because more bed bugs will live there.
•   Mattress/box spring encasements must be fabric, not plastic that can rip easily and
    should have a special zipper that locks or is covered to keep bed bugs out.
•   Check for signs of bed bugs and vacuum your mattress, box spring, bed frame and
    headboard frequently.
•   Vacuum floors often and use the vacuum accessories to get in cracks and crevices.
•   Keep clothes off the floors so bed bugs do not end up in your dresser drawers.
•   If you have an active infestation, headboards should be removed, treated and stored
    until the infestation is over or thrown away.
•   ClimbUp™ or other similar trapping devices, when used properly,
    are excellent tools for determining whether or not a small bed bug
    infestation has been eliminated.

I have Bed Bugs... What to do
• If bed bugs have been identified and you rent, talk to your landlord. Check your rental
  agreement to see if you or the landlord will be responsible for getting rid of bed bugs.
• Whether you rent or own, a professional pest management company (PMP) should be
  called to help solve this problem.
• The PMP will apply insecticides and use other known techniques to get rid of bed bugs
  but will not do the rest of the steps.
These are actions you must take to help get rid of the bed bugs.
• Do not move to another room to sleep, bed bugs will follow and infest the new room.
• Use a good vacuum cleaner to suck up all the live bed bugs you see. This is a very
  important step in reducing the bed bug population right away.
• Bed bugs can be found in carpets but they are most likely to be found in the cracks
  and crevices in and around the bed. Use a crevice tool to vacuum bed bugs you find
  in the mattress, box spring, bed rails and headboard.
• Look for the signs of bed bugs in other places where they hide and vacuum those
  places thoroughly. Bed bugs can often be found in the space where the carpet and
  baseboard at the wall meet, vacuum this area thoroughly.
• Remove electrical outlet covers; if you find signs of bed bugs, carefully vacuum.
• While no vacuum is powerful enough to remove all the bed bug eggs because the eggs
  stick to surfaces, the removal of the bed bug debris makes it much easier to see if
  anything is still alive in these hiding places after the area has been treated.
• Vacuuming should be done weekly or even more until the bed bugs are gone.
• After vacuuming, immediately place the vacuum bag in a plastic bag, seal it, and
  throw it in an outdoor trash receptacle.

•   Heavily infested mattresses, box springs, and upholstered furniture may need to
    be removed. When removing these items, you must completely wrap the item to
    keep bed bugs from falling off when carrying these items out of your home.
•   Sofas are more difficult to treat than beds, so throwing away a sofa might be the
    best thing to do. Mark or deface the furniture so someone does not pick it up.
•   Some mattresses have metal grommets on the sides that reinforce handles.
    These grommet holes are large enough for bed bugs to enter and live inside a
    mattress. The inside of these mattresses cannot be treated and must either be
    encased or thrown away.
•   Next is to get rid of all the extra clutter in the bedroom. You need to start doing this
    as soon as you can after you know you have bed bugs. Clutter near where you sleep
    gives more hiding places for bed bugs.
•   Place items to be discarded in heavy plastic bags so you do not spread bed bugs to
    other locations in your home. Do not reuse these bags.
•   Any item that has been in the bedroom or in an infested area could have a bed bug
    inside. Bed bugs have been found in shoes, purses, billfolds, cell phones, computers,
    clock radios, curtains and pictures on the wall.
•   Start bagging washable clothing and linens to launder them. Washing and drying
    kills bed bugs. Wash in hot water and dry clothing for 30 minutes on high heat.
•   Laundry does not have to be done all at once, but you must do this methodically so
    you don’t put clean (bed bug-free) clothing back into dresser drawers where bed
    bugs might be hiding.
•   If you have a garage or another place away from your home such as rental storage
    unit, you can take bagged items from the bedroom to this area. Items must be
    treated and all bed bugs removed before you return them to your home.

Chemicals and Insecticides to Kill Bed Bugs
•   Pest control professionals (PMP) should apply chemical treatments in the home. They
    are trained and licensed to do these treatments safely.
•   Sprays, bug bombs and products bought by consumers at hardware stores often
    contain pyrethroid and pyrethrin insecticides. These products no longer work very
    well because the bed bug is becoming more resistant to this insecticide.
•   Bug bombs and whole room indoor foggers contain pyrethrin insecticides and will not
    kill all the bed bugs that have scattered into the walls voids.
•   Liquid insecticide sprays may kill some bed bugs if you directly treat where you see
    bed bugs crawling. After the insecticide dries, it will no longer kill bed bugs.
•   Insecticidal dusts containing pyrethroids are applied in protected cracks and crevices
    where there is very little risk of the dust drifting into open areas.
•   No single insecticide will get rid of your bed bug infestation if used alone. PMPs will
    use a variety of insecticides and non-insecticidal methods to treat for bed bugs.
•   Repellants often used for cockroaches, ants and mosquitoes will NOT stop bed bugs
    from biting you. Consumer insecticides have been misused by people putting these
    products on their beds or on their bodies.
•   Rubbing alcohol which is very flammable (catches on fire easily) can kill live bed
    bugs on contact. People using rubbing alcohol to kill bed bugs have started fires
    completely destroying their homes and apartment buildings. This is DANGEROUS!
•   Over-the-counter products claiming to be “green” or safe may not be very effective
    against bed bugs. Not all of these products have been tested against bed bugs. You
    should choose a product that has been labeled by the EPA for bed bugs.

What NOT to Do with Chemicals and Insecticides
•   Do not use any insecticide product that is not labeled for indoor use.
•   Do not spray bed covers, linens or the mattress with any product unless it specifically
    says you can do this.
•   Do not buy or use boric acid. It does not work for bed bugs. Boric acid is a stomach
    poison. Bed bugs cannot ingest it. They feed on blood!
•   Do not buy and use over-the-counter foggers or aerosols. They are expensive for what
    you buy and do not work very well. Research at Ohio State showed bed bugs located
    only two feet from a discharged fogger did not die from the treatment. It is obvious
    that bed bugs located in cracks and crevices will not be killed either.
•   Do not even consider using a chemical that does not have an insecticide label.
    There have been reports of fires started when flammable liquids have been used.
•   When using any insecticide : Read, understand, and follow label directions!
    Use personal protective equipment as the label directs. Wear long sleeves, pants,
    and shoes. Keep insecticides out of the reach of children.
      When we use products that do not work, bed bug populations
     continue to grow, resulting in more insecticide use and greater
                   exposure and health consequences.

Non-Chemical Ways to kill Bed Bugs
•   Clutter removal will improve your chances of getting rid of bed bugs.
•   Diatomaceous earth (DE) kills bed bugs by sticking to their bodies and absorbing the
    wax layer that keeps them from losing their body moisture. DE that is labeled for
    crawling insects can be used in wall voids, behind electrical receptacles and switch
    plates. DE for swimming pool filters should never be used and is a lung hazard.
•   Mattress and box spring encasements seal in or seal out bed bugs and are effective.
•   Steam heat (115°F) can be used to treat bed bugs in carpets, behind base boards and
    on your upholstered furniture. Steaming is slow, methodical work that takes patience.
•   Portable large heat chambers can be used to treat furniture to kill the bed bugs. Many
    rental furniture stores use portable heat chambers.
•   Professional heating systems used to treat entire rooms and homes are often used by
    professional pest management companies but can be expensive. Rooms must reach
    135°F and the heating process continued for an extended time to kill bed bugs/eggs.
•   Heat treatment of any kind (except your home clothes dryer) can be expensive and has
    no long lasting activity. This means that bed bugs can be re-introduced back into your
    home days later and you have the problem again.
•   The use of cold in the form of pressurized carbon dioxide (COK) snow will freeze bed
    bugs. The COK is blown out of a pressurized cylinder through a nozzle that forms
    vapors to penetrate baseboards, bedding, box springs, the furniture, other cracks and
    crevices where bed bugs hide. This process requires patience and will not eliminate a
    bed bug infestation if used alone.

There is no silver bullet for eliminating bed bugs. Long-term control of bed bugs
requires that non-chemical methods be used in combination with insecticides as
part of an integrated bed bug management program. It also means that we must
learn about bed bugs and teach others to prevent bed bug infestations.