Apple-seed-sized bed bugs can hide in luggage, purses, and backpacks—in some cities more than others.

Pest control company Orkin has put out its annual list of cities with the most prevalent problems with bed bugs, and not a whole lot has changed. The same city has been at the top of the list for three years in a row and, for the most part, anyone in a major U.S. city needs to check their hotel beds carefully.

“Bed bugs are the number one urban pest in many cities today,” said Chelle Hartzer, an Orkin entomologist.

The list is based on treatment data from the metro areas where Orkin performed the most bed bug treatments from December 1, 2017 – November 30, 2018.

These were the cities, in ascending order, that were at the top of the list for most Orkin bed bug treatments:

10. Philadelphia

To combat the bed bug epidemic, the city created Philadelphia Against Bed Bugs and the Bed Bug Task Force to bring awareness and resources to those affected by the growing problem.

 

 

9. Atlanta

Atlanta joined the top 10 for the first time this year. 

 

 

8. Detroit

Detroit is just one of Michigan’s cities to make the list this year. Lansing is new to the list at spot 32. Grand Rapids moved up three spots to round out the top 20. Flint dropped nine spots since last year to 47.

 

 

7. Cincinnati

The Queen City improved from last year’s ranking, moving down a spot. Ohio has three cities in the top 20, including Cleveland. Dayton dropped eleven spots since last year, while Youngstown was a newcomer to the list.

 

 

6. New York

The Big Apple moved up two spots in the list. The MTA has received multiple reports of bed bugs on trains, buses, and subway cars in the city.

 

 

5. Columbus, Ohio

Columbus is the highest-ranking city on the list in Ohio. Susan Jones, an entomologist at Ohio State University, has developed an app to identify bed bugs. The Bed Bug Field Guide also gives tips on prevention and getting rid of an infestation.

 

 

4. Los Angeles

Los Angeles ranks as the highest Golden State city to make the list. San Francisco fell out of the top 10, dropping three spots to No. 12. San Diego fell eight spots to 49.

 

 

3. Chicago

In 2013, Illinois passed a law that requires landlord to give tenants a brochure on bed bugs when a lease is signed. Under the law, the tenant and the landlord share the duty of preventing and controlling bed bugs.

 

 

2. Washington, D.C

Our nation’s capital has remained the second worst in bed bug issues. To combat the growing problem, the city provides information on its website to help residents deal with the problem.

 

 

1. Baltimore

The city takes the top spot for the third year in a row. Baltimore does not have a bed bug program, but offers information and resources through the Baltimore City Health Department website.

The full report can be viewed here.