Bed bugs in ambulances are making a new home for themselves—somewhere you’d least expect to find them.

We’re all familiar with the typical breeding grounds for bed bugs, but bed bugs in ambulances? We unfortunately find them in beds and couches at home, in hotels, in backpackers and youth hostels, and even on chairs in cinemas.

Second hand furniture and travel are obvious culprits when it comes to spreading bed bugs, yet cleanliness does not ensure a bed bug-free household either: bed bugs often find a way to settle and breed, and once they do, it can be very difficult to eradicate them.

Bed bugs are a widespread problem in countries all over the world, and infestations are continuing to rise at a global level. Some health experts have even dubbed the growing bed bug problem an “epidemic” – particularly because many bugs are becoming resistant to common pesticides and toxic chemicals.

Now, worrying new reports out of the US have revealed that bed bugs have actually been found in ambulances throughout Honolulu.

Emergency services in Honolulu encountered several hundred patients with bed bugs just last year. And, paramedics found bed bugs on calls about two to three times a week, according to a report from The Huffington Post.

These challenges that the Honolulu emergency services teams are facing are exemplary of how difficult it can be to get rid of bed bugs once they have established themselves – not to mention how costly. Honolulu City Council are expected to pay over $25,000 to decontaminate ambulances riddled with bed bugs.

What to do if you find bed bugs in your vehicle

While the most typical place for bed bugs to be found is, well, bed, they do travel with their hosts and can be found in cars and other vehicles, too.

If you suspect a bed bug infestation in your car or vehicle, don’t fret: There are some simple steps that can help to treat the affected areas and prevent the bugs from returning – without using toxic chemicals. While chemicals and pesticides aren’t ideal to use at home, they’re even less appealing in the car given the risk of chemical exposure in an enclosed space.

Here’s how you can treat your car or vehicle from a bed bug infestation naturally:

1. Wash all removable seat covers on a very high heat – the heat will kill the bed bugs and any eggs that were attached to the materials
2. Empty your vehicle, then clean and vacuum the entire inside area, including under the seats in in the boot – be sure to empty your vacuum cleaner immediately
3. Apply Bed Bug Killer dust to the interior and pay particular attention to corners, crevices and seams. Bed Bug Killer is a natural, non-toxic powder that kills bed bugs by dehydrating them.