You may think bed bugs are found only in unsavory hotel rooms and apartment buildings. But experts say they've actually been spotted all over our towns and cities: on trains and airplanes, in movie theater seats, offices, schools, libraries, laundromats—even restaurants.

That's according to a 2015 survey of 236 pest control professionals nationwide, conducted by the National Pest Management Association (NPMA) and the University of Kentucky.

Their survey reveals that these tiny reddish-brown creatures—whose bites can cause red, itchy welts but aren’t thought to transmit disease—are far more widespread than we may realize. 

That said, experts also say we really don't have to worry too much about these critters hitching a ride home with us when we're out and about.

“They can show up just about anywhere imaginable,” says Michael Potter, Ph.D., a longtime bed bug researcher and professor of entomology at the University of Kentucky. But, he adds, “It’s probably unlikely people will transport them home when numbers are low and it’s a ‘non-bed’ environment.”

Bed bugs generally live within 8 feet of where people sleep, according to the Centers for Disease Control and Prevention, so they most often congregate in and infest apartments, houses, and hotels.

They’re also usually active only in the wee hours of the night and tend to hide during the day. "Consequently, the chance of picking up bed bugs by simply walking into an infested dwelling during the day is unlikely," Potter explains in "Your Guide to Bed Bugs," a 2015 handout from Pest Control Technology magazine, a trade publication for pest control professionals. 

But outside of homes and hotels, there are some spots where bed bugs may appear in larger numbers, and where it’s wise to be on the alert. Here’s what you need to know. 

Nursing Homes Are a Concern

Pest care professionals’ encounters with bed bugs in nursing homes are up by more than 50 percent since 2010, according to NPMA, putting them first on the survey’s list.

In fact, 58 percent of those surveyed said they’d been asked to handle a bed bug outbreak in an eldercare facility, a significant increase from earlier NPMA surveys.

The communal nature of life in nursing homes makes it easy for residents and staff to inadvertently transport the bugs from room to room. And because older adults are less likely to experience itchy welts after a bite—thanks to immune systems that naturally become less reactive with age—nursing home residents may fail to notice a bed bug problem.

Bed bug expert Dini Miller, Ph.D., a professor of entomology at Virginia Tech, notes that elderly people may also have more difficulty seeing the bugs or their eggs.

But keep in mind, say the experts, that there's no hard data on how often true infestations occur at nursing homes. The NPMA's findings “do not mean that, for example, 58 percent of nursing homes have bed bugs—just that 58 percent of pest control companies found bed bugs in the nursing homes they serviced that year,” says Potter, who has collaborated with NPMA on four bed bug surveys since 2010.  

What to Know About Schools, Hospitals, Offices

These locations came up fairly high in the NPMA survey: Office buildings were the third most common spot that pest professionals serviced in 2015, just below shelters for the homeless. College dorms were fourth, schools and daycares fifth, and hospitals and medical facilities sixth.

Though this may sound alarming, infestations in these places actually appear to be few and far between, especially in schools, daycares, and workplaces, Potter says. (Lice, however, are a different matter.)

Infestations may be somewhat more likely to occur in college dorms, because students sleep there and often spend significant amounts of time in each other’s room and in communal areas such as lounges. But “usually the universities will spend all the money needed to get that taken care of,” Miller notes. 

Bed bug sightings, but not necessarily infestations, do appear to be on the rise in some hospital settings, notably in emergency rooms and to a lesser degree in waiting rooms—where patients and family members may transport them in.

Bed Bug Spotting and Removal

The steps you take should depend on your personal preferences and the particular environments you’re dealing with, experts say. Consider the following:

Know what a bed bug looks like. These small, disc-shaped bugs can be seen with the naked eye, as can their fecal matter—peppercorn-sized black spots.

Be attentive—where it’s warranted. There’s little need to keep your eyes constantly peeled for bed bugs, Miller says. But it’s reasonable to look for signs of them in places where people live and/or sleep, especially where they receive a lot of visitors, such as nursing homes and hospitals.

“Other places people may want to be cognizant of are lounging areas with lots of public traffic, such as sofas in public libraries, waiting rooms, and public transportation settings,” Potter says.

Protect your belongings. If you suspect a problem in your office, school, or another location, store your coats, handbags, and any other items that you’ll bring home away from those of other people. 

If you know of a problem at your office, keep your personal belongings in a closed plastic bin. If it’s your child’s school, ask to have his or her things secured in the same way.

Treat with heat. Concerned that you or your child might have brought home a stray bed bug? Try this DIY strategy (but don't rely on it for an infestation): Toss clothes, blankets, and plush toys that have come home from your child's school in a hot dryer for 30 minutes.

React—but don’t overreact—if you see one. If you spot a bed bug, remain calm. One bug does not an infestation make. Instead, ask who handles these issues in the location you've spotted the bug in—it may be management and/or the facilities staff—and report what you’ve seen.

(Management should take quick action if a bed bug is seen on premises—alerting those in the building, examining the area to determine whether it’s a single stray or a sign of bigger problems, and dealing with an infestation promptly.)

Be vigilant at nursing homes. “If you have a loved one in a nursing home, you should be inspecting his or her bed regularly, not relying on people there to do it,” Miller says. That means carefully examining the mattress and headboard (and wheelchair, if applicable) each time you visit, and checking your relative for any signs of bites—keeping in mind that they may not display any.

Consider encasing your relative’s mattress and box spring with bug-proof covers, and reduce clutter to give any bed bugs fewer places to hide.

Call in experts at the right time. Think you have a bed bug problem at home? “When in doubt, have an experienced pest control person come to your home and perform a detailed inspection,” Potter says.