Advances in the Biology and Management of Modern Bed Bugs

Book Title: Advances in the Biology and Management of Modern Bed Bugs

Book Author: Stephen L. Doggett, Dini M. Miller, and Chow-Yang Lee, editors

Publication Information: Hoboken, NJ, Wiley Blackwell, 2018, 472 pp., $200 (amazon.com: $169.25), hardcover

In 1966, Robert Usinger published The Monograph of Cimicidae, a thorough review of the family that includes bed bugs.1 At that time, infestations were becoming less common; perhaps he thought this was the last opportunity to write about a once-common but now-vanquished foe. How times have changed! Bed bugs have made a resurgence, and rare is the family physician who has not encountered a patient with concerns about these pests. Whether living in homeless shelters, or amidst the clutter of affluence, our patients are once more at risk of this ancient scourge. It is into this setting that Doggett et al have contributed the first comprehensive treatment of the topic since Usinger.

The authors begin with a fascinating review of the history of bed bugs, from their origins and spread to the variety of efforts at extermination and prevention through the years. The place of bed bugs in popular culture, poetry, and both visual and performing arts is described. Whether one’s interest is in medical history, biology, the arts, or epidemiology, the first couple of sections of the book are real page-turners; you could read them just for fun!

Following the establishment of the historical context, the book continues with a review of the modern global resurgence of these arthropods as a public health issue. While the reader’s focus may be their own nation, it is enlightening to realize this is a global phenomenon, ranging from the penthouses of Manhattan to the huts of sub-Saharan Africa. Proceeding from there, the authors discuss the wide-ranging impact of these infestations: dermatological, immunological, psychological, pulmonary, hematological, toxicological, and financial. For primary care physicians treating the whole patient, this part of the text provides valuable insight for the care of patients affected. Of particular value is Table 13.1 on page 128, which summarizes the evidence linking infestations to mental health issues.

The next sections on the biology of bed bugs makes for intriguing reading, though they are of less direct clinical relevance. While details of maintaining a bed bug colony in the lab may be of limited interest to most readers of this review, the behavior of the bugs, their means dispersal, the various pheromones involved, and oddities of their biology (eg, traumatic insemination, mitochondrial heteroplasmy, obligate endosymbiotes) reawakens that fascination with the remarkable diversity of life processes that first led many a physician into the biological sciences and ultimately to medicine.

Management of bed bug infestations makes up a significant portion of the volume. Beginning with an overview of the establishment of public policies and codes in all corners of the globe, the authors address various detection methods, chemical and nonchemical extermination approaches, and prevention strategies. Individual chapters focus on special high-risk situations, including low-income housing, shelters, multiunit housing, hotels, health care facilities, and the transportation industry. While offering a thorough overview of methods and strategies, the authors include a valuable discussion of the limits of technology. While emphasizing the importance of education, they do not shy away from the mixed results found when evaluating the effectiveness of education.

The final portion of the book specifically addresses legal issues related to bed bugs, and not only from a US perspective. Topics such as pesticide and pest management professional licensing and regulation (including the potential of global standards), public health laws, public housing and temporary occupancy regulations, and civil lawsuits are all discussed. An interesting chapter on the role of expert witnesses in bed bug litigation (a role that family physicians could conceivably find themselves playing) rounds out the section.

While reading the book for this review, several passers-by commented “Ooo! There’s a whole book on that?!” Indeed there is, and it is well written by 60 coauthors and skillfully edited to read as a united whole, not merely a collection of loosely related essays. It is packed with valuable information including historical, clinical, biological, and legal perspectives. A wide audience will benefit from its contents, ranging from clinicians to policy makers to innkeepers to exterminators! This is an important book that should be acquired by your local library, and perhaps even for your personal collection.