Baltimore has worst bed bug infestation in America, according to study

This is one superlative no one wants their city to win.

Pest control company Orkin recently released its Top 50 Bed Bug Cities list, compiled with data of the places where Orkin performed the most treatments for bed bugs from December of 2016 to November of 2017.

The reality is that bed bugs have shown up in cities and towns all across America, from mansions to cramped apartments. They’ve been increasing in number in the United States since the turn of the century due to increased travel and limitations on certain insecticides, but numbers have been especially high in these cities.

There’s not too much you can do to stop them; early detection is critical since there is no foolproof way to keep them out of your home. Here are the warning signs you’re about to have a bed bug problem.

Taking first place on the list for the second year in a row was Baltimore, followed closely by neighboring Washington, D.C. Chicago, Los Angeles, Columbus, Cincinnati, Detroit, New York, San Francisco, and Dallas all made the top ten.

New York, infamous for bed bugs, dropped four spots to eighth place, while Los Angeles, Cincinnati, and Dallas all rose in the ranking, as well as Atlanta, where Orkin is based. New Orleans and Flint, Michigan made the list for the first time.

So if you live in or are visiting any of these cities, it’s wise to be a little more vigilant about your susceptibility to bed bugs. According to the CDC, bed bugs often come into contact with people by way of luggage, bags, clothes, bedding, furniture, or anywhere they can easily hide and hitch a ride.

Always inspect hotel rooms or any place you might be staying—here’s a guide to how to do so properly. Now, check out these secrets that bed bugs don’t want you to know.

This article originally appeared on Reader's Digest