"Goodnight. Sleep tight. Don't let the bedbugs bite."
The old nursery rhyme is gaining new relevance as the blood-sucking insects are crawling into households and businesses, and straining the finances of many families.
Exterminators, public housing officials, social service providers and tenant advocacy groups report sharp increases in the number of bedbugs in recent years. The pest control company Terminix recently ranked Minneapolis as the 15th most infested city in the nation.
The apple-seed sized insects can cost thousands of dollars to eradicate, and many families cannot afford the expense.
"It's almost impossible for many of our families to call someone in to do this professionally, so they end up getting rid of everything and doing without, or they just have to live with them," said Amy Goodhue, co-director of clinical services for the Minnesota Visiting Nurse Agency.
The nonprofit organization provides home health services to thousands of low-income families. When nurses started noticing bedbugs at their clients' homes several years ago, the agency provided mattress covers and replacement portable cribs.
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Since then, demand for these items has risen sharply, but Goodhue acknowledges that it does little to solve the problem, because bedbugs can survive for up to a year without regular feeding.
Bedbugs consume the blood of humans and other mammals. The reddish-brown insects usually emerge from mattress crevices to feed at night, leaving itchy, red bumps on the skin of unsuspecting victims. They retreat to mattress crevices, dresser drawers, and other hiding places during the day.
Exterminators said they've found bedbugs everywhere, including on coat hangers, inside slippers, and behind photo frames and clocks.
"I can't even guess the number of places a bedbug could think to hide," said Stacy O'Reilly, president and owner of Plunkett's Pest Control.
The most effective extermination method -- heating a home to at least 120 degrees for several hours -- costs about $1,000 for an efficiency apartment, and between $2,500 and $3,500 for a 2,500 square-foot-home, O'Reilly said.
On an average job, O'Reilly said exterminators use at least four portable furnaces, along with a dozen high-powered fans and an electrical generator, to heat the area to 135 or 140 degrees. The company also places 24 temperature sensors in "tough-to-heat spots, like in a laundry basket full of clothes," to make sure the entire apartment or home reaches the correct temperature, she said.
The method works, but landlords often refuse to pay for it, said Mike Vraa, an attorney who manages a statewide tenant advocacy hotline run by HOME Line, a Minneapolis-based nonprofit.
"More than any other topic I've seen -- mice, rats, cockroaches, mold -- bedbugs are the one topic where landlords try to blame tenants," he said.
Minnesota law requires that landlords pay for the extermination, unless they can prove the tenant brought the bedbugs into the building by acting in a negligent or reckless way, Vraa said.
When a landlord refuses to pay for extermination, a tenant should write a letter to the landlord to document the problem and ask for help, he said. If the landlord doesn't provide an exterminator within two weeks, the tenant can file a rent escrow case and request a court hearing to force the landlord to pay for extermination costs.
HOME Line has received 182 calls from tenants dealing with bedbug problems so far this year, compared to 121 over the same period last year. Most tenants are able to resolve the problem without going to court, Vraa said.
But tenants' rights advocates like Vraa acknowledge that landlords often face problems paying for extermination.
At public housing units in Minneapolis, the cost of paying for a private exterminator led the Minneapolis Public Housing Authority to buy two $60,000 heaters to treat the most infested units.
Mary Boler, managing director of the low-income public housing program, said the investment will save the agency thousands of dollars. The public housing authority, which operates 5,800 housing units, had been paying an exterminator up to $1,300 per apartment to eradicate the pests.
Public housing maintenance crews now operate the heating machines almost every day, she said. Last month, agency officials received 332 work orders for bedbugs, and used the high-powered heaters in 43 units. All units also receive pesticide treatment from a private extermination company.
"We just have to fight it in every way possible," Boler said. "It's just infuriating, and driving people crazy to imagine that there are bugs crawling in your bed at night."
Boler said the agency has been looking for ways to cut funding in other programs to be able to hire additional staff to operate the machines, and help elderly and disabled tenants remove belongings that cannot withstand high temperatures.
"Our true hope would be that scientists could come up with [a less expensive treatment] quickly," she said.
But insect experts said that could take years. Most scientists stopped studying the insect decades ago, when DDT and other pesticides all but eradicated bedbugs.
Stephen Kells, an entomologist at the University of Minnesota, estimates he's one of about five bedbug experts in the nation. He has turned to research papers published 80 years ago to try to find a way to control the pest. He said the banning of DDT in 1972, and an increase in the number of world travelers, has contributed to the current outbreak.
"It's fairly bad, and I think it's going to get worse as time goes on if we don't get control of the situation," Kells said.
In the meantime, Kells said tenants should avoid bringing used furniture into their homes, and travelers should carefully check mattresses and luggage racks for bedbugs when they stay at hotels.