West Nile and chikungunya are two mosquito-borne viruses that can cause serious illnesses. According to the U.S. Centers for Disease Control and Prevention (CDC), 2012 was the largest and most deadly outbreak of West Nile since 1999, when it first appeared in New York. In 2013, 2,469 cases of West Nile virus, including 119 deaths, were reported to the CDC.
In a recent Morbidity and Mortality Weekly Report, the CDC reports that chikungunya virus, which was first reported in the Western Hemisphere and Saint Martin, in the Caribbean, in December 2013, has been identified in 17 countries or territories in the Caribbean or South America. Chikungunya is expected to make its debut on the Gulf Coast in the U.S. very soon.
And Lyme disease continues to be a rapidly emerging infectious disease. It's the most common insect-borne illness in the U.S. It is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans through the bite of infected blacklegged ticks. Preliminary results from three different evaluation methods suggest the number of people diagnosed with Lyme disease each year in the U.S to be around 300,000, according to the CDC.
What the Experts Recommend
Healthline sat down with two experts to find out how people can protect themselves and their families from bites, and what to do if you get bitten
Amy Artuso Heinzen, program manager at the National Safety Council, told Healthline the best way to avoid bites “is to make yourself unappetizing to bugs. Sweet smells attract insects, so do not wear colognes or perfumes, or use scented soaps or hairsprays.”
Heinzen also recommended that people wear long pants, long-sleeved shirts, socks, shoes, and hats. Dress in pale colors, such as light green, tan, and khaki. And avoid bright colors and flowery prints.
“Be aware of insects’ nests which, depending on the insect, can be found in the ground, walls, bushes, trees, or under eaves of buildings,” added Artuso Heinzen.
Angela J. Lamb, M.D., an assistant professor, Department of Dermatology, at the Icahn School of Medicine at Mount Sinai Hospital in New York recommends using tweezers to remove a tick. “Grab the tick by the head and pull on the head, because if you grab on the butt, the tick head can really stay in you,” she said.
Lamb, who diagnosed four cases of Lyme disease in patients last year, advises patients who have removed a tick to bring the tick to the appointment to make sure the tick’s head is not still embedded. “I can use a magnifying tool to look deeper and make sure nothing is left in them,” said Lamb.
Bee Stings and Ant Bites, Ouch!
Bee stings and ant bites can also be problematic. “People can get very strong reactions to stings. Bee stings can leave you with a big welt. If you feel that a stinger is still attached, grab it with tweezers and pull straight up,” Lamb said.
Ant bites are not overly dangerous, unless you have an allergy, but ants can also create huge welts. “People think it is a spider bite, but that’s very rare,” said Lamb. She recommends prescription-strength anti-inflammatory medication, such as topical steroids, two to three times a day, to reduce redness and the tight sensation these bites can produce. While applying ice can lessen the burning and tingling sensation, Lamb cautioned that leaving ice on for too long can cause a freezer burn reaction.
Tea tree oil may also reduce itching and swelling, but Lamb cautioned that some people can be allergic to tea tree oil. She recommends Cortisone 10 and oral antihistamines, such as Benadryl, for itching. “Some people can have allergies to topical antihistamines,” said Lamb, and that's why she advises against their use.
When it comes to tick prevention, Lamb recommends using products that contain the ingredient DEET and to make sure, especially if you are going to be in an area that has a risk for ticks, your pants are tucked into your socks. “Do adequate tick checks. When you come in from outside, check your scalp and groin. Ticks like the folds of skin and areas underneath clothing. Strip down and take a really good look,” Lamb advised.
Prevention Tips from the CDC
- Mosquitoes may bite at any time of day; peak biting activity for vectors of some diseases, such as dengue and chikungunya, is during daylight hours. Vectors of other diseases, such as malaria, are most active in twilight periods (dawn and dusk) or in the evening after dark. Avoiding the outdoors or taking preventive actions, such as using repellent, during peak biting hours may reduce risk.
- Ticks and chiggers are often found in grasses and other vegetated areas. Local health officials or guides may be able to point out areas with increased arthropod activity.
- Minimize areas of exposed skin by wearing long-sleeved shirts, long pants, boots, and hats. Tucking in shirts, tucking pants into socks, and wearing closed shoes instead of sandals may reduce risk.
- People should inspect themselves and their clothing for ticks during outdoor activity and at the end of the day. Prompt removal of attached ticks can prevent some infections. Showering within two hours of being in a tick-infested area reduces the risk of some tick-borne diseases.
- Permethrin can be applied to clothing and gear for added protection.
- For protection against ticks and mosquitoes: Use a repellent that contains 20 percent or more DEET for protection that lasts up to several hours.
- Products with one of the following active ingredients can help prevent mosquito bites (higher percentages of active ingredient provide longer protection): DEET; Picaridin; oil of lemon eucalyptus (OLE) or PMD; and IR3535. “Pure” oil of lemon eucalyptus (essential oil not formulated as a repellent) is not recommended.
- Apply repellents only to exposed skin or clothing, as directed on the product label. Do not apply repellents under clothing.
- Never use repellents over cuts, wounds, or irritated skin.
- When using sprays, do not spray directly on face. Spray on hands first and then apply to face. Do not apply repellents to eyes or mouth, and apply sparingly around ears.
- Wash hands after application to avoid accidental exposure to eyes or ingestion.
- Children should not handle repellents. Instead, adults should apply repellents to their own hands first, and then gently spread on the child’s exposed skin. Avoid applying directly to children’s hands.
- Use just enough repellent to cover exposed skin or clothing. Heavy application and saturation are generally unnecessary for effectiveness. If biting insects do not respond to a thin film of repellent, apply a bit more.
- After returning indoors, wash repellent-treated skin with soap and water or bathe. This is particularly important when repellents are used repeatedly in a day or on consecutive days.
- Wash treated clothing before wearing it again. This precaution may vary with different repellents. Check the product label.
- Most repellents can be used on children aged over two months. Protect infants under two months from mosquitoes by using an infant carrier draped with mosquito netting with an elastic edge for a tight fit. Products containing OLE specify they should not be used on children under age three.
Products That Repel Bugs
Many manufacturers are offering new insect repellents in new formulations.
- W.S. Badger Company is unveiling Badger Anti-Bug Balm. Ingredients include organic citronella, cedar, and lemongrass essential oils.
- Spectrum Brands is offering Cutter All Family Insect Repellent Pump, a lightly scented product that contains seven percent DEET. Another new entry from Spectrum is Unscented Backwoods Cutter Insect Repellent Pump, intended to provide up to 10 hours of protection against mosquitoes, ticks, biting flies, gnats, no-see-ums, chiggers, and fleas. Also available is Skinsations Insect Repellent Pen-Size Pump, which contains aloe and vitamin E.
- Burt's Bees is rolling out All Natural Outdoor Herbal Insect Repellent with a blend of rosemary, lemongrass, and citronella.
- Fairy Tales is unleashing Bug Bandit DEET-Free Bug Repellant, infused with natural herbs and oils from lemon eucalyptus, rosemary, citronella, lemongrass, and cedar bark.
- BugBand Insect Repellent Spray Lotion is marketing a metered pump sprayer, which dispenses a fine mist over the area to be treated. By spraying the BugBand liquid directly on clothing or skin, the geraniol vapors form a protective barrier to deter blood-sucking insects from biting, according to the manufacturer. It is intended for use around the ankles, wrist, or neck.
- Off! Explore Insect Repellent, formulated with 25 percent DEET, is making its debut from S.C. Johnson. Off! Clip-On Mosquito Repellent Fan-Circulated Device is a battery-powered fan that circulates odorless repellent. The product, which is supposed to provide head-to-toe protection for up to 12 hours, can be clipped to a belt, purse, or chair, or you can set the device next to you, for spray-free protection.