Summer's Biggest Insect Health Risks

Mitigating the Downside to Summer Fun

Hurray - summer is finally here! This is a glorious time of long hours of sun and warmth, walks and hikes, swimming, camping and barbecues. There’s something for everyone in the great outdoors.

But sometimes, don’t you just wish the mosquitoes, bees and other pests would get the memo about being on vacation and just leave you alone? Unfortunately, we all know there are downsides to communing with nature and enjoying our summer fun.

So, let’s go over some of the more common summer insects, why we should be concerned about them and what we can do to mitigate the problem. Remember —especially when it comes to summer insects — an ounce of prevention is worth a pound of cure.

Bees, Hornets, Wasps and Yellowjackets

• The upside: They pollinate plants and flowers and help give us fruits and vegetables. They also eat other harmful pests such as grubs and flies.
• The downside: They dole out painful stings and give us anxiety about being stung. Unfortunately, millions of Americans are at risk for suffering severe allergic reactions.

Although typically a source of great anxiety for fear that they might sting you, in fact, bees and yellowjackets rarely do sting unless provoked. So, the number one rule is not to panic and swat at a bee when it comes for a visit. If it lands on your skin, just blow gently rather than smack at it. There are more aggressive species, particularly wasps that can sting in painful attacks if they feel threatened or you wander too close to their nest. While painful, most insect stings usually result in a limited local reaction, with pain and swelling. Unfortunately, about 3 percent of people have more widespread allergic reactions, with rash and hives. The most extreme cases of allergic reactions are called anaphylaxis and symptoms include tongue and throat swelling, wheezing, dizziness or even life threatening shortness of breath and drop in blood pressure. If these symptoms arise, call 911. If you are allergic to stinging insects you should know how to use an epinephrine kit and carry it with you at all times.

If stung and the stinger is still in place, first remove the stinger. Then clean the area with soap and cold water and apply ice. Benadryl and over-the-counter 1 percent hydrocortisone ointment may help calm the reaction. Consider taking a pain reliever as needed.

Mosquitoes

• The upside: Is there one?
• The downside: Mosquito bites are a common, insect-related reason parents seek medical help for their children. The local reactions and itchy lesions that are results of mosquito bites are no fun, but luckily, severe reactions are extremely uncommon.

Mosquitoes bite most intensely around dawn and dusk. If you must or want to be outside during those times, it’s best to be inside a screened-in porch or dressed in clothing that leaves very little exposed skin. Your best protection will be insect repellant, such as DEET or picaridin.

A mosquito bite typically results in a pink bump that itches. As tempting as it may be, don’t scratch it! Scratching only agitates the venom and increases your itching. In addition, over-scratching might cause breaks in the skin that can serve as a port of entry for bacterial superinfections. Although less common, some people can be more sensitive to mosquito bites and have more severe reactions, such as welts or hives. All bites should be washed with soap and cold water. Benadryl and over-the-counter 1 percent hydrocortisone cream may be indicated for intense itching and the larger reactions. If there are signs and symptoms of infection you may need to see your doctor for antibiotics.

Unfortunately, mosquitoes can leave more than a local reaction. Sometimes they may transmit infections like malaria, dengue, or West Nile Virus (WNV). Luckily, in the United States we rarely encounter malaria or dengue, but WNV has become widespread. The good news is that in most cases WNV is a mild and self-limited infection. Symptoms may be so light as to go unnoticed, or present as a “summer flu,” with mild body and headaches and low-grade fever. In rare and extreme cases WNV is a potentially life threatening infection. Symptoms include higher fever, head and body aches, confusion and worsening weakness and such symptoms should prompt you to seek medical attention.

Ticks

• The upside: None.
• The downside: The serious illness that ticks can transmit, such as Lyme Disease, Rocky Mountain Spotted Fever, Babesia (“tick malaria”), amongst others.

Obviously, the best way to avoid ticks and their associated problems is to not pick them up in the first place, but that can be easier said than done. It’s a good idea to wear clothing that leaves less skin exposed that can act as a barrier to the ticks. So flip-flops, sandals, shorts and T-shirts are out when planning a hike to areas that are likely to have ticks. Wear boots and long socks, and remember to tuck your long pants into your socks when hiking. The best protection against ticks consists of permethrin-treated clothing and gear, combined with DEET applied to exposed skin.

Keep in mind that most ticks need to feed for hours before they can successfully transmit infections. So, it is very important that after hikes you do a full body check (including in the hair) to look for ticks. If removed promptly, the risk of infection decreases significantly.

If you do find a tick on your body or that of a family member or pet, it’s important to carefully remove the tick right away. Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible. Pull upward with steady, even pressure. Don't twist or jerk the tick as this can cause the mouth-parts to break off and remain in the skin. Avoid squashing the tick because spreading tick blood in the bite wound might increase the risk of infection. Once the tick is removed, clean the area with soap and water and perhaps an antiseptic. If you develop a rash, headaches, pains or fever, call your doctor immediately.

The lowdown on bug repellant

The good news is bug repellants really do work in deterring mosquitoes, ticks, biting flies, chiggers and other insects. The bad news is that they are ineffective against spiders and stinging insects, such as yellowjackets, wasps, bees or hornets.

The gold standard of insect repellant is DEET. It has been in use for more than 50 years and is recommended for use in persons above 2 months of age. The alternative repellant of choice is picaridin is also effective against mosquitoes, ticks, and sand flies.