Updated December 08, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

She woke up in the morning and saw a red bump or maybe two bumps on her arm. The next morning there were a bunch more clustered together on the same arm. The next morning she had more on both legs below the bottom of her pajamas. They itched. The more she scratched them, the redder her skin was. She now had welts down her arm, big bumps and little bumps.

She thought they were mosquitoes. Then, she thought she had scabies.

She had bed bugs.

What are Bed Bugs?

Bed bugs are just bugs that eat our blood and really do live in our beds. They are a reddish-brown bug called either Cimex lectularius (or Cimex hemipterus). These bugs require blood from humans (or other mammals and birds).

They pierce the skin with a long tube 'snout' to drink blood from people. This lasts less than 10 minutes.

They cannot fly. They just crawl up and around our beds.They are often carried, unknowingly, by someone bringing in pillows and mattresses. They are known however to crawl between rooms.

Bed bugs stay in dark places, avoiding the light. They can hide in mattresses, wooden bed frames, sheets, even wallpaper. They mostly come at night only, when it's dark.

They are usually visible if not hidden - except young ones are smaller and almost clear in color.  They grow up to about 1/4 inch long (or 5-7mm) and are more reddish after they have eaten blood. Their eggs are white and the size of pinheads. 

There's a sweet, musty smell to bed bug infestations which is often recognizable.

 

Do they spread disease?

Not that we know of.

There's a worry they might be able to spread Chagas Disease (Trypanosoma cruzi). At least in a lab with mice, bed bugs transmit Chagas. This has never been shown to happen in humans and we do not know if this happens where Chagas is found (such as South and Central America and into Texas).

They have not been shown to spread any infectious diseases. Because they bite people and draw blood, there is always a concern that they could possibly spread disease. Study of over 40 types of infections they might spread hasn't yet found one that they do.

Instead they can cause an itchy - and sometimes unsightly rash. This bite rash is often mistaken for the rash of an infectious disease. They make people anxious and sleepless, but they have not been found to spread any infections. There is also worry they may be associated with asthma, but what effect they may have is unclear.

How do I avoid Bed Bugs?

If you have stayed in a hotel that has Bed Bugs, be careful not to bring any home with you. Don't bring home any items (clothes, pillows) you don't need. Any clothing should be washed in hot water - and if possible put in the dryer for at least 30 minutes - before putting them in your room. You may want to leave any items outside in a black garbage bag in the sun before even bringing them inside, if possible. Bed bugs can persist for months and months without eating - so it is really hard to get rid of them if you do bring them home. 

How do I get rid of them?

You can either hire someone to help you or you can get rid of them yourself.

For many it is best to higher a professional. If you plan on hiring a professional, please look through the EPA's guidelines on how to hire a pest management specialist.

It is a lot of work to get Bed Bugs on your own. The EPA can also help guide you through strategies to combat Bed Bugs on your own. 

Here are some hints:

• You may want to ask for help from neighbors - as the bugs often travel back and forth between apartments.
• Items you cannot clean entirely you will need to seal away for over a year; bed bugs can live for months, maybe a year, without feeding.  This will mean throwing away your mattress and box spring if you can't cover and seal/zipper it away for at least a year.
• Be careful not to throw away furniture outside where others might use it. You don't want to spread the infestation again. It might just come back to you.
• Throw away clutter you don't need. Do not give the bugs a place to hide. You may need to seal cracks in the wallpaper as well.
• You will need to clean all bedding, curtains, clothing in hot water and then in a dryer. Try to do the same for stuffed toys, shoes - or at least put them in the dryer. Some put items in black plastic bags out in the sun to heat (and kill bugs). 
• You also should vacuum around the bed and then seal and dump the vacuum bag in the garbage outside. 

The EPA has other recommendations for how to best rid yourself of these bugs, including 

Be Careful

There have been cases where people have become sick, including one death, where insecticides were misused and/or overused. Be careful to read the instructions carefully to avoid anything dangerous.

Why are Bed Bugs causing so many more problems these days?

Bed Bugs had been dwindling since the 1950s in the US and elsewhere. They have been returning in large numbers since the early 2000's. 

They appeared in cities. They have crawled into Single Room Occupancy hotels and youth hostels, exclusive hotels, offices, and retail stores. Bed Bug reports in NYC rose from 500 in 2004 to 10,000 in 2009. Ohio also faced high numbers - as do most major cities in the US. Their numbers have been seen to grow 70% a year in Philadelphia.

This sudden rise was at first a surprise. Even now it isn't quite clear why it was getting so bad. Bed Bugs have also grown resistant to insecticides used to stop them. Travel has helped scatter them. Also once they start spreading it is hard to stop them. Small numbers can grow into large colonies. Just one pregnant bed bug could infest an entire building. Giving the bugs a place to hide - either in clutter or wooden bed frames - also has let them persist and spread. 

There is hope a common deworming pill could be taken by people and the bed bugs that bite them would die.