Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA 19104-6021.
Program for Evolutionary Dynamics, Harvard University, Cambridge, MA 02138.
Proc Natl Acad Sci U S A. 2019 Mar 26;116(13):6473-6481. doi: 10.1073/pnas.1814647116. Epub 2019 Mar 4.
Bed bugs have reemerged in the United States and worldwide over recent decades, presenting a major challenge to both public health practitioners and housing authorities. A number of municipalities have proposed or initiated policies to stem the bed bug epidemic, but little guidance is available to evaluate them. One contentious policy is disclosure, whereby landlords are obligated to notify potential tenants of current or prior bed bug infestations. Aimed to protect tenants from leasing an infested rental unit, disclosure also creates a kind of quarantine, partially and temporarily removing infested units from the market. Here, we develop a mathematical model for the spread of bed bugs in a generalized rental market, calibrate it to parameters of bed bug dispersion and housing turnover, and use it to evaluate the costs and benefits of disclosure policies to landlords. We find disclosure to be an effective control policy to curb infestation prevalence. Over the short term (within 5 years), disclosure policies result in modest increases in cost to landlords, while over the long term, reductions of infestation prevalence lead, on average, to savings. These results are insensitive to different assumptions regarding the prevalence of infestation, rate of introduction of bed bugs from other municipalities, and the strength of the quarantine effect created by disclosure. Beyond its application to bed bugs, our model offers a framework to evaluate policies to curtail the spread of household pests and is appropriate for systems in which spillover effects result in highly nonlinear cost-benefit relationships.
近年来，臭虫在美国和全球范围内重新出现，给公共卫生从业者和住房管理部门带来了重大挑战。许多城市都提出或启动了一些政策来阻止臭虫的泛滥，但几乎没有指导来评估这些政策。有一项有争议的政策是披露，即房东有义务告知潜在租户当前或以前的臭虫出没情况。披露旨在保护租户免受租赁受感染的出租单位的影响，同时也会造成一种隔离，使受感染的单位部分和暂时从市场上撤出。在这里，我们为广义租赁市场中的臭虫传播建立了一个数学模型，根据臭虫传播和住房周转率的参数对其进行了校准，并使用该模型来评估向房东披露政策的成本和收益。我们发现，披露是一种有效的控制策略，可以遏制感染的流行。在短期内（5 年内），披露政策会导致房东的成本略有增加，而从长期来看，感染率的降低平均会带来节省。这些结果对感染流行率、来自其他城市的臭虫引入率以及披露产生的隔离效果的强度的不同假设并不敏感。除了在臭虫方面的应用，我们的模型还为遏制家庭害虫传播的政策提供了一个评估框架，并且适用于由于溢出效应导致高度非线性成本效益关系的系统。
