Warning: Reading this may cause extreme itchiness.
I was so excited to be in Kathmandu! I had dreamed for a long time about coming to Nepal. Just the name Kathmandu sounded so exotic and brought up visions of adventure. So why after just ten hours was I wishing I'd never come?
Good night, sleep tight.
Don't let the bed bugs bite!
-- Nursery Rhyme
Bed bugs? What the *#^%! are bed bugs? If you don't know, count yourself as lucky. I thought they were just a mythical creation in a nursery rhyme, but they are real. Bed bugs were very common (for example, in military barracks during World War II), but were essentially eradicated from the U.S. and the developed world by the 1950's. Now these human parasites are making a comeback with a vengeance. Why? Because world travelers let them hitch rides and unfortunately, they (bed bugs not world travelers) have a constitution that makes a cockroach look like a wimp (though cockroaches are one of their predators).
I didn't even know these critters existed until about six years ago. I was in Belize City staying at a hotel I had used several times over the years. In fact, I had just stayed there just the week before in the very same room. I had laid on the bed after my shower and accidentally fallen asleep. When I woke up, it was dark. I turned on the lights to prepare for bed and got a glimpse of some movement. Euuwww! What was that? I flipped off the lights and then on again...the same creepy, stealthy moves. There seemed to be tiny bugs in the pillow.
It was about 2 am, so what should I do? I knew there would only be a security guard downstairs. I tossed the pillow onto the floor, wrapped myself in a sarong and slept on top of the sheet with no cover (it was hot, so none was necessary). I turned on the light once or twice more and didn't see any more bugs so I figured I was okay. I was leaving in the morning anyway to catch a plane home. I'd just let the owner know when I left in the morning.
When I took a shower the next morning, I discovered some bumps on my neck. A check in the mirror confirmed they were bites. Dang... mosquitoes or those mystery bugs? By the end of my shower, I had discovered more bites on my upper arms and around my ankles. They seemed to be multiplying! By the time I was checking out, I was using all my will power not to scratch. I was in misery.
The hotel owner admitted they had had a problem with bed bugs recently, but she had the place professionally treated and sprayed at great cost. The exterminator had even sprayed the bushes around the entrance. She apologized and said she'd make it up to me the next time I stayed there. When my airport transport arrived, I was in even more misery. By the time, I was at the airport, my arms were covered with large, red welts where I'd been bitten. Someone next to me in the waiting room asked if those were from the South American super-mosquito she'd heard were becoming a problem (kind of like the killer bees). Oh my god! I didn't realize how many big welts had popped out on my arms! My whole arm was covered with them.
Once on the plane, I was grateful for the cool air so that I could cover up with a long sleeved sweater. I was sure everyone was looking askance at me with so many huge welts on my arms and neck. And I kept discovering new bites... Good god! Was I carrying these bugs on me? I imagined them crawling all over me. Ugh, ugh, ugh!
When I changed planes in Houston, I couldn't refasten my sandals. My ankles and feet were horribly swollen. But not from sitting on the plane. My feet were covered with angry red bites and huge blood blisters. Walking was painful as the straps on my sports sandals rubbed on the bloody bumps. To hide the hideous sight and hopefully get some relief I put on socks and shoes. Walking was a little less painful, but things were getting worse.
Getting on my connecting plane, I was relieved when they turned out the cabin lights to let us sleep. There was no way I could sleep, but I didn't want the people around me to see my transformation-- especially if I might end up passing these bugs to them! My right ear was hot. I reached up to feel it and found it was swollen and sticking straight out from my head like Dumbo the Elephant's! There was a row of bites along the rim. More bites had popped out on my neck. Thankfully, none were on my face. With the exception of my head, the bites were essentially the areas not covered by my sarong: ankles, feet, hands, arms, shoulders and neck.
It was the longest flight in the world. I had covered up almost everything, but I was sure my "Dumbo" ear was going to attract unwanted attention. Thank heavens again for the dark of the night. I went straight to my reserved shuttle and made a plan as we headed into the city. I wouldn't even go into my apartment. When I got there, I would throw my bag into my car's truck and head straight for the emergency room. I'd never been to an emergency room before, but considering the size and quantity of the welts, the bloody blisters on my feet, my Dumbo ear and my absolute inflamed, itchy condition-- it seemed the only thing to do.
At the emergency room, it was a long wait, but when I stripped down to be wrapped in warm blankets and pumped full of antihistamine-- I finally felt some relief and hope. They did not diagnose me as having bed bug bites-- to do that they had to actually see one. Strangely, there was not a single bug on me, so why was I still getting bites? This is what I found out...
Bed bugs have a special "beak" that lets them inject their victims with their saliva which contains an anticoagulant and anesthesia-- that's why I never felt being bitten. Then they feed on you for 5-10 minutes. Some people never have any problem with the bites...they just experience an annoyance of a few small red marks like a mosquito might leave behind. Apparently, I was having an allergic reaction to the bed bug's anesthesia-- possibly due to the large numbers of bites I had experienced. Sometimes the bites don't become visible until hours later which is why I seemed to be getting new bites, but was actually just having a delayed response to the bites from the night before.
I was released from the emergency room after 13 hours of treatment. The itching was gone and I almost forgot about the bites (except the ones that had become blood blisters on my feet) since they were covered by my clothes. It was winter, so I wore pants and a turtleneck to work. A few days later, I decided I should have taken some photos. Most bites had pretty much disappeared, but my feet still looked ugly. Here are two views of my (still swollen) foot and ankle:
Notice how the bites tend to be in a row. Bed bugs treat you like a buffet line, taking a bite, then going down the line for another and then another. One tell-tale sign that the bites are from a bed bug and not bites of a mosquito or spider is the line up of several bites usually in groups of three. I've heard it referred to as "Breakfast-Lunch-and Dinner". I won't go into a lot more detail. You can get a good overview by looking up "bed bug" in Wikipedia. But let me just say, they can go without food for 100-300 days, get water from the air and can tolerate extreme temperatures (hot and cold)-- all that combined with their resistance to pesticides makes it incredibly hard to get rid of them.
I was psychologically traumatized after The Attack of the Belizean Bed Bugs. A few years later, I sat in my car in horror as I listened to an NPR Radio story on bed bugs in New York (Warning! That nice couch on the sidewalk may be there for a reason! Leave it there!). I was so itchy and crawly and plain freaked out that I forgot about getting groceries and went straight home. I became an bed bug expert by reading everything I could find-- especially on how to avoid them.
So how did I forget the basic rules about how to avoid bed bugs when travelling and get into this predicament? Well, after six years of vacations-- and more recently a solid 18 months of travel-- that were bug-free, I just forgot to remain vigilant. Like eating street food-- no need to be obsessive, just take some practical precautions. Here are some to consider; you can find others with a web search.
FIVE BASIC RULES FOR AVOIDING BED BUGS:
1. Upon arrival to your room, stash your bag in the bathroom while you check the bed for infestation: pull out the sheets and check around the mattress seams and headboard. You are looking for small blood stains (from squished bugs or bleeding bites) or small black dots (if it's bed bug poop a rub with a wet finger tip will cause it to smear and turn red). The largest bug will be the size of a watermelon seed (most of the ones I have seen are much smaller), but the babies are minuscule and translucent unless they have fed recently. Look at some pictures on line so that you know what they look like in the different stages.
2. Continue your search around the room (within a 15 foot range of the bed) especially soft chairs, couches, wooden wardrobes...even tucked under peeling paint. If you see white powder, the hotel may already be using an insecticide due to an existing or recent problem.
3. Keep your bag off the bed and floor during your stay. Use the luggage rack, a table or if necessary a desk or dresser top.
4. Consider wrapping your bag in plastic (bed bugs also hide on airplanes, trains, taxis, etc.). Even a plastic garbage bag might help.
5. Ask for a different room (several floors away) or go to a different hotel if you see warning signs! If you are sure there are bed bugs, please inform the manager. There is no need to be rude or accusatory...be discrete and just politely inform them of what you have found so that they can address the issue. Bed bugs can arrive unnoticed at any hotel from a cheap dive to a five-star. Bed bugs have nothing to do with a room being dirty or -- alternately-- an attractive designer room doesn't offer protection from them.
In my case, my hotel in Kathmandu was a popular, well-rated accommodation in the budget range. It was 1 am when I discovered the problem, but I didn't hesitate. I immediately went to the desk clerk, explained the problem and asked him to give me a new room. He didn't show any surprise and gave no resistance. I was moved to a new room immediately. I made an inspection and then I used my silk sleep sack and wore a Moroccan caftan that covered me from head to toe. It took awhile to get to sleep due to itching and psychological trauma, but it was a bug-free night.
The next day at breakfast, as I silently made note of where I was itching and then felt for the confirming welts to evaluate whether I needed to use my emergency epi-pen to avoid another bad allergic reaction, I was also debating on whether I should stay or find a new hotel. A new hotel would require some assistance since I could not carry my own bag (a broken arm if you are new to my blog). The hotel manager/owner stopped by my table to inquire about me and I honestly explained what I was considering. In the end, I accepted an upgrade to a room on the top floor. If it hadn't been an upgrade, I would have changed hotels. I needed comforting and the new room was much more visually appealing and had a nicer bathroom.
That night, at 11pm, I discovered a bed bug on the pillow. I immediately went to the desk clerk and asked if the owner/manager was still there. He was. We had a frank discussion of the situation and I was escorted to another hotel nearby. I let him know that I was also concerned that I might now be carrying bed bugs with me via my luggage. However, the new hotel was one that he also owned in partnership. It was not one I would normally have chosen (large, sterile and modern) and while still within my established budget and a reasonable price- it was at the high end for Kathmandu. But at this point, I deserved to be pampered (and I was given a large discount off the online price). I was given the last room available which was a double, so the next day I had to move again, but it was to yet another upgrade and I really liked the new room a lot! So five rooms in three nights...but like Goldilocks, the last one was just right! I could finally relax and enjoy my stay in Kathmandu.
Footnote: A few days later, I saw the manager/owner of the first hotel and he told me that another guest had reported a problem too. They were treating the whole floor this time instead of just one room at a time.