A reader asked me a question the other day:
I think the worst thing a hospital can do is not be transparent about bed bugs. People talk. Employees tell their husbands and wives. Patients will write of their experience on Twitter and Facebook for all the world to see. There is even a website at bedbugregistry.com dedicated to providing user submitted bed bug reports from all across the United States and Canada. Tell the public you have strong policies in place for surveillance and eradication and you'll earn their trust when the bugs come a knockin'. I learned from the all mighty Google that bed bug sniffing dogs are a popular strategy to hunt down these pesky super villains. The New York Times did a piece last year describing businesses with bed bug sniffing dogs that will come out to your home for $350 and do an inspection. Reportedly, these dogs' sniffers can detect bed bugs with 96% accuracy. However, the NYT did a follow up story indicating the false positive rate in these $11,000 dogs might harm their credibility.
Dear Happy. I'm a hospitalist in a NYC hospital. I'm wondering if you've ever heard of bed bugs infesting a hospital. We had an infestation earlier this year and our infection people went into crisis mode. It was like Fukushima met Professor Falken met The Joint Commission. What's your take on bed bugs in the hospital?
I can't even say I've given any thought to bed bugs (Cimex lectularius) in the hospital, although I suspect any hospital that claims they have never treated a case of bed bugs is probably giving you a statement that's too good to be true. And you know how that saying goes. We've all heard about the bed bugs taking over our hotels in this country. That story has been plastered all over the evening news on many occasions over the last few years. These bed bugs have no mercy. They will enjoy a nice meal anywhere they can whether that's in an apartment, on a cruise ship or in a public school. We aren't even immune in a movie theater.
As a hospitalist that cares for the general public on a daily basis, it doesn't surprise me that bed bugs could find their way into a hospital. Why wouldn't they? To believe that hospitals are somehow immune would by wishful thinking. Hospitals are filled with sick and immuno-compromised people that carry with them MRSA, VRSA, VRE and clostridium difficile. Why not bed bugs too? Our patients and employees come from all walks of life. To assume we leave reality behind when we enter the hospital doors would be shortsighted at best.
Without much knowledge of the issues surrounding beg bugs in the hospital, I injected myself with a double dose of Google truth serum. Without warning, I was overcome with Google Shock. That's feeling you get when Google opens your eyes to the reality all around you. Bed bugs are showing up in hospitals all across this country. These aren't just sporadic cases. This is an epidemic. These bed bugs are everywhere. Just Google "hospital bed bugs" and you'll see what I mean. You'll discover some patients have even been refused care because they showed signs of a bed bug infestation.
For patients trying to battle a potentially life threatening illness, having a concern about bed bugs is the last thing they need to be thinking about when they get admitted to the hospital. In fact, just like our pets can carry MRSA, some studies also suggest bed bugs can be carriers of MRSA and VRE as well. We want to try and minimize bed bug exposure in the hospital for medical reasons, of course, but exposure could also be a legal issue as well. Witness these sisters in London who were recently awarded several thousand dollars after being bitten over one hundred times by bed bugs at a London hotel. I know it's impossible to prevent bed bugs from showing up anywhere that people go. We have to accept that as a fact of life. What's important is having a surveillance plan in place to attack them head on with any sign of activity.
I don't know about you, but I'm OK with bed bug sniffing dogs having a horrible positive predictive value as long as their negative predictive value is close to 100%. For all the hospitals out there, now's the time to get a bed bug sniffing dog on your payroll, dress the little fella up in your favorite camo snuggie and have him go to town on the little buggers, Chuck Norris style. No mercy!