Before providing any type of bed bug treatment, the pest control operator should determine whether treatment is necessary based on a careful inspection and the needs and concerns of the client.

— Live bed bugs are evidence of an infestation, but sometimes are difficult to observe in low-level infestations.

— Intact, unhatched, or viable bed bug eggs are evidence of an active bed bug infestation.

— Bed bug cast skins, bed bug fecal staining on sheets, and fecal staining near typical harborage sites may be considered evidence of an active infestation if the area has not been previously treated.

— When a live bed bug or viable eggs cannot be located during an inspection, the technician should make further effort to confirm the infestation through a more aggressive inspection or other methods that have proven effective for bed bug detection.

— Some clients may elect to have an area treated based on reports of bites or the proximity of other infested areas, even if visual evidence of infestation cannot be confirmed.