Our Latest Perspectives Posts

When Fresh Ingredients Make Consumers Sick
Written by Water Quality & Health Council

Over 140 Boston College students were sickened recently after eating at a Chipotle restaurant near the Chestnut Hill, Massachusetts campus.  The culprit:  norovirus, the most common cause of foodborne illness in the US.  The norovirus outbreak comes on the heels of a multistate outbreak of E. coli associated with Chipotle that made 52 people sick in the Pacific Northwest.

In response to these outbreaks, Chipotle has been in frequent communication with the media, including a pointed interview with Chipotle’s founder, Steve Ells.  Additionally, according to the Chipotle website, the company is taking several steps to ensure “best-in-class food safety.” These steps include voluntarily closing restaurants, conducting deep cleaning and sanitization of restaurants in the affected area, testing surfaces, equipment and food, and enhancing internal training.  These are all steps in the right direction.

The Public Health Perspective

Chipotle prides itself on using fresh produce and meats, traditional cooking methods and local and organic produce, when seasonally available, factors that the company admits in its 2014 annual report, may present additional foodborne illness risk:

“…we have made a significant commitment to serving local or organic produce when seasonally available, and a small portion of our restaurants also serves produce purchased from farmers markets seasonally as well. These produce initiatives may make it more difficult to keep quality consistent, and present additional risk of food-borne illnesses given the greater number of suppliers involved in such a system and the difficulty of imposing our quality assurance programs on all such suppliers.”

The statement above is telling and honestly assigns a degree of risk to what many perceive as an unquestionable health advantage:  produce that is local, organic, seasonally available and sourced from farmers’ markets.

Folks will look at this in one of two ways:

  1. For some, the increased risk of foodborne illness is acceptable to avoid produce harvested using traditional agricultural practices, including manufactured fertilizers and pesticides.
  2. Others may be wary of the trend for restaurant chains to increase their use of organic produce without increased steps by suppliers and restaurants to prevent food contamination.

Chipotle should be congratulated for their honesty in acknowledging their food safety problems, and the company should continue to share its findings and plans to tackle those problems.  For their part, consumers must make their own choices about where and what to eat based on their own health perspective.  As with all decisions we make regarding acceptable or unacceptable risks, the accuracy of the decision depends upon the use of accurate and reliable information.

Click here to download this article.

In the coming weeks:  “What is Organic Produce?”


Five Flu Facts

CDC director, Dr. Tom Frieden gets this year’s flu vaccine. Photo from www.cdc.gov/flu/professionals
  1. Getting the flu vaccine is strategic. Getting the annual flu vaccine is the single best thing you can do to prevent the flu.  The US Centers for Disease Control and Prevention (CDC) recommends a yearly flu shot for everyone six months old and older.  Some folks are proudly posting their “vax” photos on the CDC’s website!  Follow on Twitter at #VaxWithMe.
  1. Flu can be complicated. Although most people who get the flu will have a mild illness, flu complications can include pneumonia, bronchitis, sinus or ear infections and even death.  Those at high risk for flu-related complications include pregnant women; children younger than five, but especially children younger than two; people 65 years old and older; and people of any age with certain chronic medical conditions such as asthma, diabetes and heart disease.

Unsure as to whether you have the flu or the common cold?  This chart can help you decide.

  1. Timing is everything. According to CDC, flu activity usually peaks in January or later, but outbreaks can happen as early as October.  It takes about two weeks after being vaccinated for the body’s immune response to kick in fully. 

Planning holiday visits?  Take a look at the calendar and schedule your flu shot to make sure you arrive for holiday gatherings as fully protected as possible. 

For Frequently Touched Surfaces:

Clean surfaces first with detergent and water and then sanitize using 1 tablespoon of regular strength household bleach (5.25%) in 1 gallon of water.  If using concentrated bleach (8.25%), reduce bleach volume to 2 teaspoons per gallon of water. Let surfaces air dry.

  1. Prevention is key. The flu virus wants you!  Evade it by:
  • Avoiding close contact with people who are sick
  • Staying home when you are sick
  • Covering your coughs and sneezes with a tissue, or cough into your sleeve
  • Washing your hands frequently with warm water and soap for at least 20 seconds
  • Keeping your hands away from your eyes, nose and mouth
  • Cleaning and disinfecting frequently touched surfaces in your environment
  • Getting sufficient exercise, hydration, nutrition and rest
  1. A flu pandemic (a world-wide flu epidemic) would be another story altogether. Flu severity is unpredictable from year to year.  While it’s not expected this year, a flu pandemic is always a possibility.  To keep tabs on the flu, CDC provides a weekly flu surveillance report.  The website includes a handy “Flu Activity Map” to indicate the geographic spread of flu through the US.

To get an idea of how you could prepare for a pandemic flu outbreak, check out Dr. Ralph’s Flu Preparedness Closet.  Forewarned is forearmed!

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN

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This Holiday Season, Don’t be a Germ Re-gifter
Written by Water Quality & Health Council

As you gather with family and friends to mark the holidays, beware the coughing, sneezing person who should have stayed home.  This person is a re-gifter, not of an unappetizing fruit cake, but of germs that can hardly wait to make you sick.

View/download full coloring page

Germs survive by re-gifting, propelled by guest “A” through the air in an uncovered cough to be inhaled by guest “B” in her next breath.  Now “B” is infected and soon will be culturing her own army of germs to be re-gifted by coughing and sneezing.

The downloadable poster at left, based on messages from the US Centers for Disease Control and Prevention, offers practical tips for curtailing the spread of germs to others.  It reminds everyone to cover their cough or sneeze with a tissue or by blocking the cough with their sleeve.

These responses to coughing and sneezing are preferable to using hands to cover a cough.  After all, it is our hands that reach into the bowl of chips and touch all the serving spoons in the buffet line.

Disinfecting frequently touched surfaces such as door knobs and hand rails with a simple chlorine solution goes a long way to blocking the spread of germs from surfaces to hands.  And speaking of hands, don’t miss the hand-washing tip on the poster:  It’s still the single most important strategy we have for preventing the spread of germs.

Healthy habits are best instilled at a young age.  Help raise a new generation of children who act to prevent germ re-gifting! Download the poster to give to the children in your life for coloring.

How to Mix a Flu Germ-Busting Solution

1 gallon of water

1 tablespoon of regular strength bleach or 2 teaspoons of high strength bleach

  1. Clean surface with detergent and water.
  2. Sanitize using the bleach solution.
  3. Let air dry.


Healthy Holidays to You and Yours!

Click here to download this article.



Trendy or Traditional, Safe Food Preparation is a Must this Thanksgiving
Written by Linda Golodner

As I prepare to host Thanksgiving once again, I think about how the holiday has changed over the years.  Traditionally the day is marked by a scrumptious feast with a turkey in the spotlight.  Increasingly, in many households, there is greater focus on vegetable and grain dishes to please those who prefer a healthier cuisine and for the vegetarians around the table.  Creative holiday recipes abound on TV food channels and the Internet!

Whether your holiday menu will include turkey or tofu, be trendy or traditional, or contain elements of all of these, safe food preparation is a must.  And remember, food safety is not just about meat, poultry and seafood.  A 2013 study by the US Centers for Disease Control and Prevention concluded that between 1998 and 2008, vegetables accounted for the single greatest percentage of foodborne illnesses, although meat and poultry were responsible for the greatest percentage of deaths.

Help keep Thanksgiving healthy and happy by following the food safety tips below.

Avoiding Foodborne Illness this Thanksgiving

Clean – wash all food contact surfaces with hot, soapy water followed by sanitizing with 1 tablespoon regular strength or 2 teaspoons of high strength chlorine bleach in 1 gallon of water. Do this before and after working with raw foods. And don’t forget to wash all fruits and vegetables with tap water, even the pretty grapes you might use for decoration. Cooking destroys many pathogens, but we eat many uncooked fruits and veggies in salads, for example.

Separate – keep fresh fruits and vegetables separate from raw meat, poultry and seafood.

Cook – to kill any bacteria that might be present, thoroughly cook meat, poultry and eggs to the appropriate temperature.

Chill – refrigerate leftover perishables at 40 degrees Fahrenheit within 2 hours of cooking or serving. This safety tip is a difficult one to remember at Thanksgiving. It is often a time to linger over food with family, but tear yourself away from the table and put those leftovers in the refrigerator within 2 hours.


Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.

Click here to download this article.



Healthy Visits to Patients in Healthcare Facilities
Written by Barbara M. Soule, R.N. MPA, CIC, FSHEA

Much of human life begins and ends in healthcare facilities.  These institutions are also places of treatment, healing and recovery.  It is natural, therefore, that visitors to patients in healthcare facilities can be so focused on the emotional aspects of connecting with their friends and loved ones that they forget to take precautions to avoid spreading infection.
The following tips are meant to promote healthy visits to patients in healthcare facilities.

Infection Prevention Starts with Your Hands 

According to the US Centers for Disease Control and Prevention (CDC), hand washing is the single most important means of preventing infections.  Wash your hands as you enter the patient’s room, frequently while in the room, before and after touching the patient or the patient’s immediate environment, and just before leaving the room.  Use hand sanitizer stations if warm water and soap are unavailable.  It is perfectly acceptable to remind family, friends and healthcare providers, including doctors, nurses, certified nursing assistants and physical therapists, to wash their hands upon entering a patient’s room.  The CDC provides detailed directions for proper hand washing.

The Heywood Hospital website also notes that your skin is an important barrier to infection, so use moisturizers, especially in winter, to prevent cracking.  Keep all cuts and scrapes clean and covered with a bandage.  Never touch patient wounds or catheters (tubes) unless instructed by the staff.

Stay Home if You’re Sick

Don’t visit a healthcare setting if you have a cough, cold, fever or diarrhea.  A phone call, text, email or written note can communicate your good wishes without the risk of spreading unwanted germs.  The MedlinePlus website also recommends you stay home if you were exposed to chickenpox, the flu or any other infections.

Stay up to Date with Your Immunizations

The seasonal flu vaccine is recommended for everyone six months old and older.  The flu shot is especially important for people who are at high risk for serious complications from the flu, including children younger than two, adults 65 years of age and older, pregnant women, residents of nursing homes and other long-term care facilities and people with weakened immune systems. Your doctor can advise you about obtaining other vaccines, such as a pneumonia vaccine.

Observe Good Visitor Hygiene

Don’t sit on the patient’s bed or put your feet on the bed.  Don’t share the patient’s food or drinks.  Use toilets meant for visitors, and not the patient’s toilet. Don’t bring food, toys or special pillows, blankets or pets into the patient’s room unless approved in advance by the staff.

The MedlinePlus website urges visitors to keep their hands away from their faces and to cough and sneeze into a tissue or the crease of the elbow.  Avoid coughing or sneezing into the air.  Wash your hands after tending to a cough or a sneeze.

Don’t Contribute to Hospital Room Clutter

The Association for Professionals in Infection Control and Epidemiology website recommends you think twice about cluttering up the patient’s room with personal items.  Clutter makes cleaning more difficult, and cleaning and sanitizing surfaces are a critical part of healthcare.  The association notes patient items should be kept off the floor and away from waste containers. The bedside table and over the bed table also should be kept clear of unnecessary items that interfere with environmental cleaning.  In fact, a recent Wall Street Journal article on reducing hospital infections quotes this advice from a founder of a patient advocacy and education group:  “forget flowers and candy; bring bleach wipes instead,” she says. “It could save their life.”

Visiting friends and family in healthcare facilities can be an emotional experience, but keep in mind that your actions in the healthcare setting can affect the health of the patient you visit.  Tuck these hints away for the next time you call on someone in a healthcare setting to help ensure your visit is a healthy one.

Barbara M. Soule, R.N. MPA, CIC, FSHEA is an Infection Preventionist and a member of the Water Quality & Health Council.

Click here to download this article.



A Fun Way to Teach Kids about Hand-washing
Written by Water Quality & Health Council

How can you help your children avoid some of the infectious illnesses that will be shared this season? According to the US Centers for Disease Control and Prevention, proper hand-washing is one of the most important ways to avoid getting sick and spreading germs to others. But nagging kids to wash their hands is seldom effective.

We suggest delivering the hand-washing messages in a fun way using the activity sheets below. The following sheets were developed by the University of Nebraska, Lincoln Extension and the Lincoln-Lancaster County Health Department. Unlike this year’s flu, cold and norovirus, we hope these sheets “go viral,” helping your children develop a life-long healthy hand-washing habit!

Click here to download this article.


Foodborne Illness: It’s Not Just about Meat, Poultry and Seafood
Written by Linda Golodner

Fresh fruits and vegetables are the stuff of healthy diets, so it may surprise you to know that fresh produce can be implicated in foodborne illness.  Salmonella, Listeria and other foodborne pathogens can contaminate your salad ingredients just as they can contaminate meats, poultry and seafood.

Recently, imported cucumbers from Mexico were reported to be responsible for 671 cases of Salmonella Poona infection in 34 states, according to the US Centers for Disease Control and Prevention (CDC).  As of September 29, CDC reports 131 people have been hospitalized, and there have been three deaths linked to the outbreak.  Bottom line:  Good food safety practices include an awareness of the risks of foodborne illnesses from fresh fruits and vegetables.  Recall information and advice to consumers, restaurants and retailers are available on this CDC webpage.

Which Foods Make Us Sick?

CDC scientists used data from over 4,500 US foodborne illness outbreaks between 1998 and 2008 to find out which types of foods are most responsible for food poisoning.

The researchers categorized each outbreak into 17 food categories.  Produce (fruits, nuts and vegetables) accounted for 46 percent of all illnesses.  Meat and poultry accounted for 22 percent of all the illnesses.

The researchers point out that there are many outbreaks involving fresh produce because we eat so much fresh produce. Fresh produce has many health benefits, and CDC does not recommend curtailing our produce intake.

Learn more about the study here.


The following tips are based on the CDC “Test Your Produce Safety Savvy”:

  • Wash your hands for 20 seconds (the time it takes to sing the “Happy Birthday” song” twice) with warm water and soap before and after preparing fresh produce.
  • At the grocery store, be sure your fruits and vegetables are separated from raw meat, poultry or seafood in your cart and bagged separately at the checkout.
  • Choose produce that is not bruised or damaged, especially if you are not planning to cook it.
  • Store precut fruits and vegetables in the refrigerator or surrounded by ice in a cooler (for picnics, for example).
  • Even though the package indicates that produce is pre-washed, add an extra layer of caution and wash it before eating.
  • Keep fruits and vegetables separated from raw meat, poultry and seafood in the fridge. If fresh produce that will not be cooked contacts raw meat, poultry or seafood, throw out the fresh produce.
  • Remove visible dirt and wash fruits and vegetables, even the ones you peel, under running water just before eating, cutting or cooking.
  • Do not use the same cutting board for fresh produce that you use for raw meat, poultry or seafood. To sanitize cutting boards and other food-contact surfaces, first clean with detergent and water and then sanitize with a solution of 1 tablespoon of regular chlorine bleach in one gallon of water (or 2 teaspoons of concentrated bleach in one gallon of water). Let air-dry.
  • Do not eat recalled produce. If you are unsure of the safety of your produce, ask the place of purchase or your supplier for information.
  • When in doubt about the safety of produce, if you cannot get more information, do not eat, sell or serve it to anyone, and throw it out.

Click here to download this article.

Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.


How to Drain a Residential Swimming Pool
Written by Chris Wiant, MPH, PhD

Summer’s nearly over and many backyard swimming pool owners will soon undertake their annual “pool draining ritual.” Draining the water helps prevent damage to pools in geographic areas subject to freeze-thaw cycles. This article provides information to help you drain your pool responsibly.

What’s the Big Deal?

It’s easy enough to fill your pool with water, so why is draining it a big deal? First, all summer your swimming pool water has been treated with chemicals to help keep it safe for you and your family. Chlorine-based sanitizers, for example, probably were used to help destroy waterborne pathogens that can cause diarrhea, swimmer’s ear and skin infections. These germs can enter the pool on the bodies of swimmers and in animal feces. Chlorinated pools also prevent your backyard pool from becoming a mosquito breeding ground; mosquitoes potentially spread diseases like West Nile virus. But the same low levels of chlorine-based sanitizer that help keep pool water safe for your swimmers can be harmful to fish and wildlife.
The second reason to stop and think before you pull the plug is to consider the sheer volume of water and where it will flow to or pond outside the pool. Will it flow onto your neighbor’s property? Will it pond in a depression? Are you planning to drain your pool directly into a sewer? Better find out what type of sewers are nearby. A storm sewer will channel your pool water directly into a natural stream or other body of water with no treatment. Only sanitary sewers channel wastewater flow to treatment facilities.

This storm sewer in Montgomery County, Maryland bears a sign that indicates water flowing into it drains into Rock Creek, a tributary of the Potomac River, and warns residents not to pollute.

Tips to the Drainers

  • Consult your local municipal Department of Environment Quality for specific guidelines or codes. The US Environmental Protect Agency (EPA) website highlights, for example, Montgomery County, Maryland’s Department of Environmental Protection guidelines.
  • According to an Oregon Department of Environmental Quality Fact Sheet, if possible, swimming pool water should be sent to a treatment plant via a sanitary sewer. This is most important for large (especially community) pools, and happens automatically when in-ground pools are built with a drain that goes to a sanitary sewer.
  • If drainage to a sanitary sewer is not possible, water may be allowed to evaporate to a lower level for the winter, if desired, or disposed of on the ground or used to irrigate your property. Water should be released, however, only after the pool owner stops adding chlorine or other treatment chemicals, or shuts off the chlorination system and holds the water in the pool for at least one week while chlorine levels drop.
  • When disposing of pool water on the property or using it to irrigate your property, do so in a manner that water will not flow off your property or into a stream or storm sewer.
  • When disposing of pool water on your property, do so in a manner that water will not pond for a prolonged period, resulting in nuisances such as odors and insect breeding conditions.
  • If discharge to the ground will result in flow to a stream ditch or storm sewer, increase the holding time of water in the pool with no added chlorination to at least two weeks to allow chlorine to dissipate.
  • Use a pool test kit to measure the chlorine level of the pool water prior to draining to ensure there is no detectable chlorine level (for example, the Washington, DC Department of Energy and Environment website indicates less than 0.1 mg/l free chlorine is acceptable). A longer holding period may be necessary if free chlorine levels are above 0.1 mg/l.

Happy Swimming Pool Winterizing!

Chris Wiant, M.P.H., Ph.D., is president and CEO of the Caring for Colorado Foundation. He is also chair of the Water Quality & Health Council.

Click here to download this article.


US Shigella Infections: “A Troubling Trend”

Graph from City of Cincinnati Health Department website

A dramatic increase in the number of recent cases of shigellosis is being recorded in certain areas of the US, including Cincinnati, Pittsburgh and northern Kentucky. Shigellosis, also known as “bacillary dysentery” is an acute infection of the intestine caused by Shigella bacteria1. According to the US Centers for Disease Control and Prevention (CDC), within one or two days of exposure to the bacteria, most people infected with Shigella develop watery or bloody diarrhea, fever and stomach cramps. Others may become infected and experience no symptoms, but pass the bacteria on to others. There are no vaccines for this disease. A person with shigellosis can remain infectious for up to four weeks after symptoms resolve.

Shigellosis is a disease that is maintained through infections in the human population; there is no other significant reservoir for this pathogen. Shigellosis likely caused frequent outbreaks of dysentery in the US prior to the early 20th century introduction of drinking water chlorination. During the Civil War dysentery and other infectious diseases were responsible for twice as many deaths as battle wounds (see the National Park Service website).

Shigellosis Facts

Shigellosis is a fecal-oral disease and therefore environmental and hand hygiene are very important factors in preventing the spread of the disease. Shigella bacteria are very potent and resemble virus in that very few are needed to initiate an infection. Children in day care are very likely to contract shigellosis if good disinfection practices are not practiced. Some individuals with shigellosis may develop reactive arthritis (Reiter’s syndrome), which can last for months or years and may be difficult to treat (see Complications of Shigella Infection).

Travelers arriving from developing countries may be spreading an antibiotic resistant strain of shigellosis, which could cause longer periods of illness. CDC Director Tom Frieden calls recent domestic outbreaks “a troubling trend.” (see press release).

CDC estimates there are approximately 500,000 cases of shigellosis annually in the US. Worldwide, there are 80-165 million cases of the illness annually and approximately 600,000 deaths. Proper hand-washing—especially after using the bathroom or changing a diaper—is critical. Foods can become contaminated with Shigella from infected food handlers or from contaminated agricultural (irrigation) waters. Additionally, shigellosis can spread by infected individuals contaminating frequently touched surfaces. Swimmers may be exposed to the bacteria by swallowing contaminated water, and campers who collect and drink improperly disinfected stream water may be infected with Shigella.

Between May, 2014 and February, 2015, a drug-resistant strain caused over 200 cases of illness in the US. The strain was repeatedly introduced as sick travelers returned to the US, according to CDC. A CDC report notes some patients had traveled to Hispaniola (both the Dominican Republic and Haiti), India, Morocco and other destinations in both Asia and Europe before exhibiting symptoms. Ciprofloxacin-resistant Shigella has become so common that CDC recommends doctors use lab tests to determine which antibiotics will effectively treat shigellosis.

Shigella sickened 80 people in Jordan in early August, 2015. A news report stated the outbreak was traced to out-of-temperature chickpea hummus served at a restaurant.

Avoiding Shigellosis in Daycare

Proper hygiene and sanitization are critical to preventing shigellosis in daycare. This includes appropriate hand-washing after using the toilet or changing or handling soiled diapers. Additional important measures include hand-washing before preparing or handling food, and properly sanitizing food contact surfaces and shared toys (see bleach and water mixing recommendations for disinfecting various surfaces and for cleanup following vomiting/diarrhea).

Children experiencing diarrhea should not attend daycare or activities with other children.

Avoiding Shigellosis during International Travel

Travelers are encouraged to practice proper hand hygiene and avoid touching hands to the mouth, nose or eyes. CDC encourages travelers to use over-the-counter medications such as bismuth subsalicylate (e.g., “pink bismuth”) or loperamide (anti-diarrheal medicine) to treat mild or moderate travelers’ diarrhea, reserving antimicrobial medications for severe cases.

CDC also recommends travelers make smart food and drink choices, such as steaming hot food and drinks from sealed containers. The CDC app “Can I Eat This?” can provide on-the-ground information to inform eating and drinking decisions.

The rise of antibiotic-resistant species of pathogens like Shigella represents a global threat to public health. As we have pointed out before, everyone can play a role in suppressing the rise in antibiotic resistant pathogens by:

  • Adopting a healthy life style to promote a strong immune system
  • Staying up to date with vaccinations and flu shots
  • Using safe disinfection practices when an infectious illness strikes a family member
  • Practicing safe food handling
  • Using antibiotics responsibly
  • Frequently washing your hands.

For more information on shigellosis, please visit: http://www.cdc.gov/shigella/.

For more information on the global trend in antibiotic resistance, please see: http://www.waterandhealth.org/fighting-antibiotic-resistance-home-globally/.

Barbara M. Soule, R.N. MPA, CIC, FSHEA is an Infection Preventionist and a member of the Water Quality & Health Council.

Click here to download this article.

1There are four species of Shigella bacteria: Shigella dysenteriae, S. flexneri, S. boydii, and S. sonnei



Disinfesting Bed Bugs
Written by Linda Golodner

Bed Bug Life Stages

A resurgence in bed bug infestations since around 2000 is making travelers wary of hotel beds, and not just lumpy mattresses in budget hotels.  Bed bugs travel the world secreted in luggage and clothing; they respect no boundaries, infesting everything from low-cost housing to five-star hotels.

In contrast to surfaces harboring disease-causing microorganisms, such as E. coli, and norovirus, which should be disinfected with EPA-registered disinfectants like chlorine bleach, items harboring bed bugs should be disinfested with an appropriate EPA-registered insecticide.  Because bed bugs are very difficult to eliminate, a licensed professional exterminator is your best bet.

Bed Bug Bites

Bed Bugs are flat parasitic insects ranging in size from one to seven millimeters (about the size of Abe Lincoln’s head on the face of a penny).  They are visible to the human eye and are usually active at night.  When the lights are out they feed on human and animal blood, which causes their bodies to change in color from light brown to reddish-brown.

According to the US Centers for Disease Control and Prevention (CDC), when bed bugs bite, they inject an anesthetic and an anticoagulant that prevents a person from realizing he or she is being bitten.  Bed bug bites can take as long as 14 days to develop in some people.  Bite marks—slightly swollen, red areas that may itch and be irritating—look similar to those of a mosquito or flea.  CDC reports bite marks may be random or appear in a straight line on the skin.

Scratching skin bites can lead to infection, but generally speaking, bed bugs are a nuisance that causes people to lose sleep.1 Whereas bed bugs generally do not spread disease, most of us prefer not to serve as a nocturnal meal for an army of insects.

Unwanted Travel Companions

People who travel frequently and share living and sleeping quarters where others have previously slept have a higher risk of being bitten or spreading a bed bug infestation, according to CDC.  The flat bodies of bed bugs help them hide in very small spaces for long periods of time.  Bed bugs are often transported by travelers as stowaways in the seams and folds of luggage, overnight bags and folded clothes.

Waking up to Bed Bug Infestations

One clear sign of a bed bug infestation is multiple skin bites, but there are environmental signs too.  Clusters of dark brown or black spots of dried excrement in bedding, for example, indicate bed bug infestation, as does a subtle, sweet, musty odor, according to the Orkin website.  Virginia Tech entomologist Dini M. Miller, PhD, reports molted bed bug “skin” is another common indicator of infestation.  Each bed bug molts five times in its life, leaving plenty of evidence of its presence.

A Common-sense Approach to Controlling Bed Bugs
At a 2013 meeting of the American Chemical Society, researchers from Washington State University and the University of Kentucky presented their findings that the genes bed bugs use to develop resistance to pesticides are active in the bug’s hard outer surface, or cuticle, where they can impede insecticides from reaching the insect’s nervous system (see press release). The researchers suggest that new pesticides should focus on ways to subdue those genes, but emphasize that insecticide use must be paired with common-sense measures such as “removing bedroom clutter where bed bugs can hide, frequent vacuuming of dust and other debris, washing bed linens in hot water and heat-drying in a dryer, and sealing cracks and crevices to eliminate hiding places.”

Miller recommends inspecting for evidence of bed bugs in mattress seams and tufts and under mattress tags, behind headboards, inside the holes for set-in screws, along wood creases in box springs or in bed frames, and where box spring fabric is stapled to a wood frame.  When checking into a hotel room, pull back the sheets and mattress cover in one or two corners of the bed to inspect the mattress.  Use luggage racks provided by the hotel and avoid placing your suitcase on the bed, lowering your risk of picking up unwanted passengers.

Orkin notes bed bugs may be present in objects within five to eight feet of a bed.  They may also inhabit cracks and gaps behind wall outlets, floor molding, window and door molding and where carpet edges meet the wall.

Be Proactive

Left untreated, bed bugs will spread into adjoining rooms and apartments, so treatment should be prompt.  In addition to consulting a reputable pest control company, websites like the Texas A&M AgriLife Extension site lists several helpful steps individuals can take.  These include isolating beds to make them bed bug-free and treating affected materials with heat, cold or sunlight.

When it comes to bed bugs, forewarned is forearmed.  Taking steps to avoid bed bugs can be less trouble than getting rid of them, but if you do get them, by all means, be proactive.


Linda Golodner is President Emeritus of the National Consumers League and Vice Chair of the Water Quality & Health Council.

Click here to download this article.

1 One exception is an allergic reaction to the bites that could require medical attention.


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