Bed bugs do not signal poor housekeeping, but ignoring them lets a small problem spread between rooms and homes. Speed and thoroughness are what contain them.
Bed bugs hitchhike on luggage, used furniture, and visitors, so anyone can get them. Left alone, they spread from room to room and into shared walls in multi-unit buildings, which turns a contained problem into a building-wide one.
The reason thoroughness matters is biology: they hide in seams, frames, and cracks, and a partial treatment relocates survivors rather than clearing them. A full inspection that maps every harborage, followed by heat or targeted treatment and a verification visit, is what ends an infestation.
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They hitchhike on luggage, used furniture, or visitors. It is not about cleanliness.
Usually not. A treated and encased mattress can often stay.
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