With Bed Bugs, the Cure May Be Worse Than the Disease

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Bloodsucking bed bugs have made a comeback in recent years. But as victims of infestation have become increasingly desperate to rid their homes of the bedeviling pests, many have only done themselves more harm.

Bed bugs do not transmit disease or cause illness — but the insecticides used to kill them do. A total of 111 illnesses associated with bed bug-related insecticides were reported in seven states between 2003 and 2010 (mostly in the last three years), the Centers for Disease Control and Prevention (CDC) said Thursday. Most cases of poisoning were not severe, but the data included one death.

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That case involved a 65-year-old woman in North Carolina who died in 2010. After she complained to her husband about bed bugs, the CDC report said, he saturated the interior of their home, including the baseboards, walls and the area around the bed, with the insecticide Ortho Home Defense Max. He then applied a different product, Ortho Lawn and Garden Insect Killer, to their mattress and box spring. Neither insecticide is registered for use against bed bugs, the CDC said.

That day, the couple also released nine cans of Hot Shot Fogger in their home. Two days later, they reapplied the insecticides and unleashed nine more cans of Hot Shot Bedbug and Flea Fogger. The woman then applied the pesticide Hot Shot Bed Bug and Flea Killer directly to her arms and chest, and doused her hair with it before covering her head with a plastic cap.

Two days later, her husband found her unresponsive. She was taken to the hospital where she remained on a ventilator for nine days until she died. The woman had had a history of health problems, including kidney failure, heart disease, Type 2 diabetes, high blood pressure and cholesterol, and depression, the CDC report said. She had been taking at least 10 medications at the time of her death.

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In other cases where the factors contributing to insecticide-related illness could be determined, the CDC found that excessive insecticide application was among the most frequently reported. Other contributors included the failure to wash or change pesticide-treated bedding, as well as the improper use of pesticides. People used outdoor-only bug killers inside, for example, or sprayed insecticides not meant for use on humans or against bed bugs. Nearly 90% of exposures involved insecticides containing pyrethroids, pyrethrins or both.

Aside from the one reported death, most other cases of poisoning were mild. Commonly reported symptoms of exposure included headache and dizziness, breathing difficulties, nausea and vomiting.

The actual number of insecticide-related illnesses may be far higher than found in the CDC study, because it included only those that were reported to a surveillance system in 12 states. Further, many people experiencing minor symptoms, who didn’t seek medical treatment or advice from a poison control center, would not have been captured by the system.

In nearly 40% of cases of insecticide-related illness, extermination was attempted by consumers who weren’t certified to use pesticides. The problem is only being made worse by bed bugs’ increasing resistance to commonly available pesticides, the CDC said, which may further drive people’s misuse of toxic chemicals.

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To lower the risk, the CDC recommends that people with bed bug problems seek professional pest control companies that employ both chemical and non-chemical methods to eradicate bed bugs. The report advises:

CDC and EPA promote integrated pest management (IPM) for bed bug control. IPM is an effective pest control method that uses information on the life cycle of the pest and incorporates nonchemical and chemical methods. Nonchemical methods to effectively control bed bugs include heating infested rooms to 118°F (48°C) for 1 hour or cooling rooms to 3°F (-16°C) for 1 hour by professional applicators; encasing mattresses and box springs with bed bug–excluding covers; and vacuuming, steaming, laundering, and disposing of infested items.

Do-it-yourselfers should follow product instructions carefully. For more information on the safe use of pesticides, you can download the Environmental Protection Agency’s safety guide here. The CDC’s full report on insecticide-related illness is available here.

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Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.