It’s for real. More people in the U.S. are affected by bedbugs these days than ever before, according to Ron Harrison, Ph.D., an entomologist and director of technical services at Orkin, a leading pest control company. Bedbugs — hard to spot — bite at night and are notorious for living for years without a single blood meal. They’re largely resistant to treatments to wipe them out.

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Unfortunately, Baltimore, Maryland, now tops a list of cities most impacted by these buggy infestations.

Orkin just released its annual Top 50 Bedbug Cities list, and this is the first time Baltimore has made the top five. Four other major metro regions — Las Vegas, Portland, Salt Lake City and Greensboro-High Point-Winston Salem — all made the list for the first time this year.

Here are the top 10 cities for these nasty critters:

  • Baltimore
  • Washington, D.C.
  • Chicago
  • New York
  • Columbus, Ohio
  • Los Angeles
  • Detroit
  • Cincinnati
  • Philadelphia
  • San Francisco-Oakland-San Jose

Ranking was based on treatment data from the metro areas where Orkin performed the most bedbug treatments from Dec. 2015 to Nov. 30, 2016. This includes both residential and commercial treatments.