6 Steps to Protect Your Family from Zika, Lyme Disease and Those Pesky Mosquitoes.

We are now deep into summer, and the end to the heat is nowhere in sight. One thing that outdoor summer fun brings with it are those pesky bugs.  In this article we are going to discuss how to protect your family from mosquitoes and ticks.

Now, I know we all have been run inside from a great picnic dinner due to the annoyance of mosquitoes. The sting of the bite, the raised red welts and the itching can drive you mad.

Did you know that it is actually an allergic reaction to the mosquito’s saliva that causes that red bump and the itching? And for some, they can have particularly painful and severe skin irritation from the mosquito's bite.

But the real concern about mosquito bites is the risk of the mosquito transmitting an illnesses. This is also the concern with tick bites as well. ( And they are just so disgusting!)

Zika virus is probably the most well known of the diseases  that are transmitted by mosquitos at the moment. Last year it caused quite a media stir and every parent and pregnant woman was fearful. There is still great cause for concern. Zika virus continues to spread at a fast rate. 

It is an illness that is caused from the bite of an infected mosquito. Most people do not show any symptoms at all. If illness does occur it is usually very mild - with fever and rash, body aches, joint pain, and red eyes.

Most people do not even know that that their illness is related to a mosquito bite. Most adults are never even sick enough to go to their health care provider. But we know that children get taken to the health care provider more frequently.  

But there can be very serious complications when Zika is contracted by pregnant women. This virus can be passed from a pregnant woman to her fetus. In some cases, the baby is born with a serious birth defect called microcephaly.

This means the head is smaller than normal, due to slowed brain growth. There may be developmental delays of varying degrees as well as other birth defects  associated with this as well. But every pregnant woman who contracts Zika does not have a baby with birth defects. That is very important to remember. 

Zika is not seen in very many places in the US. At this time only South Florida and one place in Texas. But, there are many places that are concerning for travel from the US. Because of this, protective measures should be taken to avoid travel to endemic Zika areas.

And you must protect yourself when you do travel to those areas. Because the concern is both for your own health and that you will bring the virus back and spread it here. It is not spread person to person but from a mosquito biting you and becoming infected and spreading it to others. 

Anyone, especially pregnant women or women who want to become pregnant should discuss travel with their healthcare provider prior to visiting these areas.  The CDC travel site can give guidance regarding which areas should be avoided and how to proceed with protection.

If a woman is exposed, she should discuss this with her healthcare provider immediately for testing. She and her partner should use protection during sex while traveling in these areas and on her return until she is cleared by her health care provider. It is known that Zika can be transmitted sexually from an infected person. 

The other mosquito related illnesses you may have heard of in the US is West Nile Virus.  This is present in most states in the US. If infected, most people have no symptoms. The majority with symptoms have a fever and some other symptoms such as rash, body aches, headache, joint pain, possibly nausea, vomiting and diarrhea. Most people recover very quickly. But some people have lingering fatigue and weakness for a few weeks.

Rarely, people will develop a serious infection of the brain covering or tissue called meningitis or encephalitis. These symptoms include headache, high fever, stiff neck, disorientation and worse neurological problems. About 10% of people with West Nile virus will die.

Because West Nile and Zika are viruses, there are not medications that treat them. There are no vaccines. There is just supportive care until a patient improves. 

Of course, outside of the US, other mosquito borne illnesses occur, such as malaria, dengue etc. If you are traveling outside the US, you should check the CDC travel advisory sites for what kind of protection you need for your family for mosquito borne illnesses. (And of course other illnesses as well)

Whenever you are traveling out of the country, you should check this site to find out what you should do ahead of time to protect your family.

Tick- borne illnesses also occur.  There are many different kinds of ticks and different ticks carry different kinds of diseases. Not all ticks live in the same parts of the country. Not all ticks are infected with disease. Just like not all mosquitoes are infected with disease. 

Not all diseases are common in the same parts of the country. So, just because you see a tick on your child, it doesn’t mean they are going to get a certain disease you may have heard of.  That disease may not be common in your part of the country.

Ticks live in wooded areas along the ground in tall grass, dead and decaying leaves, or the bottom of trees. They are present year round. They will attache to shoes or clothing when you brush by them, then walk up the body until it can get access to  skin.

Then the tick will embed its mouth into the skin.  It then starts feeding on the host’s blood. The longer a tick is attached, the more likely it is to transmit disease.

When a tick is engorged with blood, it swells up. They can get really large like a raisin. Some ticks are very tiny and some are larger, depending on the species.

Two of the most common tick-borne illnesses are Lyme Disease and Rocky Mountain Spotted fever

Ticks that spread Lyme disease are very tiny, immature ticks. Like a poppy seed. Their bite is painless and most people don’t know they have been bitten.

Lyme Disease symptoms include a flu - like illness with fever, headache, nausea, joint pain, dizziness and a characteristic bulls- eye like rash.  But not everyone has the rash.

Lyme disease is more prevalent in the Northeast and Upper Midwestern US. If you live or have been in these areas and have been bitten by a tick, be on the lookout for symptoms. But don’t panic. This is treatable condition with antibiotics and remember that not everyone who is bitten by a tick gets a disease. 

Rocky Mountain spotted fever is a rare, but serious and life threatening bacterial infection that occurs from being bitten by a tick that carried the bacteria. Early symptoms are vague with fever and headache.

It has a very classic appearing rash but it doesn’t appear until later, so the illness can be difficult to diagnose. It can progress  very quickly to a life threatening illness. The classic rash often begins on the palms of the hands and soles of the feet a few days after the fever begins.

This disease can have life altering complications but it is treatable .  This is a disease that is most common in the eastern half of the US but other places in the country as well.

So, how do you protect your family from mosquito and tick borne illnesses? I am going to give you 5 Steps to keep your family protected from Zika and other illnesses.

Step 1 -  Don’t make your home/yard inviting for mosquitoes and ticks

YARD
Mosquitos lay their eggs near standing water. So, you don’t want to make your home inviting for them.

Do not leave any standing water in your yard.

Once a week empty and clean out any birdbaths, planters, etc

Cover any standing water that cannot be emptied or removed with a wire mesh screen that is smaller than mosquitos

Keep areas that bugs congregate -  such as flowers beds, creeks, fish ponds etc - cleaned up.

Get rid of old tires and buckets that water can accumulate in.

Keep areas clear of garbage - keep cans covered, etc

When having picnics, keep outdoor foods covered and use fans to keep air circulating.

Ticks tend to be near the ground, in decomposed leaves, tall grass, bushes, fallen logs, lower parts of tree trunks, etc. Don’t give them a friendly habitat either. 

Clean up debris such as old leaves, decay, fallen logs

Keep the grass cut, and the bushes and trees trimmed.

HOME

Cover windows with fine mesh screens

Keep windows and doors closed

Use air conditioning if possible

If not possible, use mosquito netting over beds

Step 2. Protect the skin

Wear Protective Clothing when in woods or hiking in tall grass or wooded areas

Wear long sleeves and long pants.

Tuck pants into socks so that the legs and ankles aren’t bare.

Wear a hat to  keep ticks out of the hair and neck  

Give the ticks the least access to the skin.

Use mosquito netting over baby seats and strollers.

Don’t use perfumed soaps, lotions or sprays on yourself or children.

Step 3. Treat Clothing 

An excellent way to protect yourself from ticks, mosquitoes, ants, chiggers and other insects if you are going to be hiking or out in the woods often is to buy treated clothing or treat your clothing with Permethrin. Purchased clothing can last up to 70 washings. Or you can buy Permethrin and spray the clothing yourself. It will last 5-7 washes.

Read the directions on the product. One source says that spraying your shoes or boots can give you 70 x the protection from the ticks that cause lyme disease. Spraying shoes makes sense if the ticks are usually low to the ground. The permethrin kills on contact.

Always spray outside.

Do not use the permethrin on the skin.

Step  4. Use insect repellent

There was a time that this was discouraged with children. But even environmental groups are now saying that you have to weigh risks and benefits. And with the outbreak of potentially life threatening illnesses associated with tick and mosquitos, careful use of insect repellent is encouraged.  All of the pediatric organizations highly recommend use of insect repellents on children greater than 2 months of age when used with appropriate guidelines. 

Guidelines.

Do not use insect repellent as your first and only defense.

You always want to use a repellent that is approved by the EPA - that way you know that it has been looked at and approved for its safety and effectiveness.

If it is not approved then there is no way to know that there are any established safety protocols or any regulation of the quality of the product

Use the lowest concentration for the need at hand. There are different products with different effectiveness and strengths

Time

Insect repellents have concentrations that are based on the length of time in which they are effective for. Determine which you need based on how long you will be out. If you are going out in the backyard for a few hours, don’t use a concentration that will last all day.

High risk area

Are you in an area of high risk for a tick or mosquito borne illness?

Decide what product you need based on the bug borne illnesses in your area. If there is not a high degree of illness in your area, you may want to go with a lower strength product.

Age

No insect repellents should be used in babies less than 2 mos

CDC recommends that Oil of Eucalyptus not be used in Kids less than 3 years  (PMD)

Reactions

Test products first

Try a small patch test first to see if there is any reaction

If reaction occurs, discontinue

Try at home first to see if the product  is effective in your own backyard before trying in a higher risk scenario - such as the park or hiking where you cannot go back inside and get away from the biting pests

Pregnant and Nursing Mothers

All EPA approved insect repellents are approved for safety and effectiveness for pregnant women and nursing mothers

It is strongly recommended that pregnant mothers use insect repellant for protection of mom and fetus

Proper application

Apply Outside of clothes and to exposed skin only

Do not apply under the clothing

Use in a Lotion, pump or towelette form.  

Do not use aerosols  - minimize risk of inhaling the product.

Apply to your hands and rub on child's body and child’s face.

Do not apply to child’s hands.

Encourage child not to lick face or hands.

Keep out of the mouth.

Wash your hands well after applying.

Supervise children with these products.

Keep out of reach of children. Treat it as a poison or medication.

When you come in from outside, shower and wash off the product from the skin.

Wash the clothes. Do not wear clothes again that have been treated with insect repellent.

Types

Deet

Has the longest safety profile

Works by confusing the mosquito's senses and orientation.

Safe recommended concentration for children  is 7-30%  

7% is fine for backyard and recreational use and Zika and West Nile protection.

Use it according to the time outside

Use the lowest dose for length of time needed - few hours

Not greater than 20 - 30 % for longer protection

Use the 20 - 30% for Lyme disease protection.  

Concentrations are sold up to 100% but they are not recommended for children

Brands ( some examples)

Cutter Skinsations 7% Deet

Off! All Family 7% Deet

Off! Deep Woods Deet 25% pump

Repel 30% Deet wipes

Target Up and Up 7% Deet

Ben’s 30% Deet

Picaridin

A  chemical that closely resembles a compound found naturally in black pepper plants. It has been used in other countries for years. It works by forming a  barrier on the skin or clothes and repelling the insects from landing on the skin.  A fairly new compound in the US. The concentration makes a difference in length of time it is effective. The lower concentrations last for a few hours and the higher concentrations for longer term use.

Less irritating than DEET.  

May want to try it first while close to home, to monitor how effective it is on the child and family.

Has fewer reported irritation side effects than DEET.

Brands

Avon Skin So Soft with Picaridin

Cutter Advanced Wipes 5% Picaridin

Natrapel 8 hour 20% Picaridin

Off! Family care Picaridin 5%

Sawyer spray with 20% Picaridin 12 hour

Oil of Eucalyptus (PMD)

Is the only botanical product approved for use by EPA.

CDC says not for use in children less than 3 years

EPA considers this a biopesticide which is subject to more safety testing than botanical agents but less testing than chemicals such as DEET - is an oil extracted from the eucalyptus tree.  

( It is not the same as lemon eucalyptus oil - which is a botanical distilled from the leaves of the lemon eucalyptus tree and combined with other botanical substances. It has a very small amount of PMD in it )

Brands (remember do not use these on a child less than 3)

Off Botanicals wipes, lotion or spray

Cutter Lemon Eucalyptus

Repel Lemon Eucalyptus

Botanicals

Will likely say natural on their label

May contain ingredients use as geraniol, lemongrass, peppermint, citronella, soybean, or rosemary. They can be plant oils or synthetic replicas of the plant oils.

The EPA does not register these products because they don’t consider them to be a safety risk but they also do not monitor them for effectiveness.

But the concentrations of the oils can cause allergic reactions.

And there is no way to know if they are actually effective. So using them could put your family at risk for serious and even life threatening mosquito and tick borne illnesses.

If you are not in an area of high risk of mosquito or tick borne illness, then you may want to consider a natural product.  

Start with a patch test to check for sensitivity. If no reaction occurs, then test it at home to see how it works.

Do not use these products, if you are in a high risk  area for disease.

Brands

Cutter Natural

Burt’s Bees Natural

California Baby Natural Bug Blend Bug Repellent

Eco Smart Organic Insect Repellent DEET Free

Honest Company

Be very careful to read the labels.  Each of the name brands and most of the store brands have a natural brand, and a DEET brand and even a Picaridin brand as well. You have to read the labels to determine ingredients. The natural brand will often say DEET free or Natural on the label and will have plant based products. Do not use this product if you are in an area that is known to have mosquito or tick- borne illness carrying pests. Always do a test patch to test for allergy.

Products that have not been shown to be protective

Bug zapper - may actually attract bugs

Bug repellent wrist bands

Bird or bat houses do not decrease mosquito populations

Garlic or B1 capsules

Ultrasound machines

Step 5. Check the pet

Any time pet goes out,  check closely for any ticks

Remove when seen and be alert for illness.

Sometimes ticks will find their way onto a pet and transfer to the family

Step 6. Check your body

Each time you come in from a tick prone area such as the woods, take your family's clothes off and put them into the  dryer for 10 min to kill any ticks on them.

Then wash them.

Shower everyone, washing the hair and scalp well feeling for any bumps that do not belong.

 Inspect head, behind the ears, the groin, neck, buttocks.

Feel for any bumps that are not normal.

Embedded ticks are not usually painful.

Remove any ticks immediately. Call your healthcare provider to see if they want you to attempt this or if they want you to come in and have them do this. The longer the ticks are embedding in the body, the more likely they are to release their infection.  

Do not cover with vaseline or gas, nail polish remover, or light with a match or do any other home remedy that you may have heard will cause a tick to release.  

This causes them to release their contents into the body.

To remove a tick : Grab tick body with tweezers as close to the head at the skin as possible and pull out straight away from the skin and steady. The tick will hold on and it will be hard. Pull with steady pressure. Do not jerk, or twist. Just pull with slow steady pressure and the tick will let go. If you don’t think you can do this, go to your HC provider immediately. Once the tick releases,  wash the skin with soap and water. If any part of the tick looks like it has broken off in the skin, go to the healthcare provider. Observe daily.

Observe for any signs of infection or rash, but do not panic. Most tick bites are harmless.

There you have it.  6 Steps to Protect Your Family From Mosquito and Tick- borne Illnesses.  

We don’t like to apply chemicals to our children’s bodies. I never liked insect sprays but the alternative is to put our kids at risk for the discomfort of insect bites and the risk of significant and serious potential illnesses.

Minimizing the attraction for these bugs is the first line of defense.

Second is to dress appropriately when we know we will be exposed.

When necessary, use the insect repellents at the lowest concentration for the least amount of time needed for protection.

When exposure has ended, wash the clothing and shower to remove the chemical from the skin.

Inspect the body for any signs of ticks. Always be alert to any signs of mosquito and tick borne illness, especially in an area prone to disease. But don't over react! 

I will mention one more thing as an aside. Keep your little one's nails cut really short. They will surely get some bites here and there.

They itch.

They scratch.

We see a lot of secondary infections - like impetigo -  from infected mosquito bites.

Keep the nails short, keep their hands washed and  and wash the bites with soap and water. That will prevent most of those infections from occurring. 

I hope that this information will keep your little ones safe and healthy. Later this week, on Facebook,  we will discuss other insects that bite and ways to protect and treat those.

Don’t miss that information. If you have friends who can use this info, Make sure you share this information with them.