During the "dog days" of summer, families must be watchful for infections carried by mosquitoes and ticks, such as Lyme disease, West Nile virus, and insect bites.
Let's take a look at the signs and symptoms of these infections, how they are transmitted, and strategies to prevent exposure.
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Thousands of cases of Lyme disease have been reported since it was first recognized in 1975. A type of bacteria called a spirochete causes the infection. It is transmitted to humans by the bite of infected deer ticks, which are tiny insects about the size of a poppy seed.
Infected deer ticks have been found in many parts of the United States, especially the northeastern states, California, and closer to Chicago in Michigan, Minnesota, and Wisconsin. Deer ticks live in forests or grassy, wooded areas and are most active from late spring through early fall.
The first and most obvious symptom of a bite is a rash that resembles a bull's-eye with a red spot surrounded by a pink ring. The rash develops within the first few weeks after the person is infected.
It may expand over time and is usually not painful or itchy.
Many people will develop symptoms including fever, headache, swollen glands, fatigue and muscle or joint pain.
Lyme disease can be treated with a course of antibiotics resulting in a full recovery. If not recognized and treated, the infection can progress to more serious complications, including arthritis, meningitis, and paralysis of facial nerves.
Families spending time in areas where deer ticks are prevalent should follow strategies to help lower the chance of exposure. Whenever possible, stay on cleared paths to avoid the shaded, moist, grassy areas where ticks reside. Using insect repellent with DEET is also very effective. Wear enclosed shoes or boots, and keep arms and legs covered. A hat helps protect the scalp.
Wearing light colored clothing makes it easier to notice ticks. The most effective way to prevent infection may be doing a complete tick check after returning indoors. Humans are typically infected when the tick has been attached for more than 48 hours, so prompt removal of ticks is critical.
If ticks are found attached to the body, use a fine tipped tweezers to grasp the tick as close to the skin as possible. Try not to squeeze the body of the tick. Pull back slowly and the tick will usually release. Next, wipe the area with rubbing alcohol and apply antibacterial ointment.
West Nile virus
Mosquitoes typically contract West Nile virus by feeding on infected birds and then biting a human, which introduces the infection into the bloodstream.
While some infected individuals will remain asymptomatic, most will have just mild symptoms. These include fever, headache, nausea, body aches and fatigue. In a very small number of cases, less than 1 percent, of infected people will develop more severe symptoms such as meningitis, convulsions, paralysis and mental confusion.
There are no medications that can treat the West Nile virus infection. The symptoms typically resolve in a few days. As noted, the majority of people will have mild symptoms that require supportive care such as ibuprofen for fever and body aches, rest and fluids.
In more severe cases, patients may be admitted to the hospital for higher levels of support and monitoring.
Take measures to prevent exposure. Mosquitoes gather and lay their eggs in areas of standing water such as stagnant ponds, birdbaths and flowering pots. Avoid these areas, and consider removing them from your yard. Mosquitoes feed at dawn and in the early evening, so remain indoors during these times.
Insect bites, stings
Insect repellents along with clothing, timing and common sense will help to avoid bites and stings.
Consulting Registered Pharmacist Carter Black of Keefer's Pharmacy in Mount Prospect and Petranek's Pharmacy in Libertyville says that DEET is an effective insect repellent.
"DEET is safe for children above the age of 2 months and pregnant women. But do not apply it near the eyes, mouth or skin damaged with wounds or sores. Combination DEET with sunblock is not used for children because of potential overdose by reapplication," Black said.
"I prefer non-aerosol sprays or towelettes because inhalation can be dangerous. A little goes a long way, especially with children."
Another option is Picaridin, a plant-based repellent. Lemon citronella, Skin-So-Soft, BioUD and other repellents may be used if protection is not critical for disease-carrying insects.
Wristbands with high-pitched sounds or repellents and vapor belt clips do not have significant studies to back their claims.
It may sound like an old wives tale, but don't scratch your skin after being bitten. If the bite is opened, treat it like a cut with antibiotic ointment and a bandage. Black recommends products containing lidocaine gel to numb the bite.
Bee stings are treated differently.
"A bee sting must be monitored closely for infection. The stinger should be promptly removed if possible and swelling limited with an ice compress," Black said.
"For treatment of bee stings, I recommend hydrocortisone for inflammation and an oral antihistamine, and I prefer citrizine. I do not recommend diphenhydramine cream for bee stings, it can cause more problems."
A home remedy of a meat tenderizer poultice may be effective, as is baking soda or baking soda and vinegar. The sting should peak in less than 24 hours and start to decrease in symptoms. Nausea, vomiting and fever are danger signs.
"You should know if you are allergic to stings that cause difficulty in breathing, swelling of the mouth, etc. That condition requires an adrenaline injection in your possession at all times and a trip to the emergency room," said Black.
• Dr. Adam Aronson, MD is a pediatrician based in Skokie, Illinois. The advice contained in this article is for informational purposes only. Readers should consult with a physician to evaluate any illness or medical condition. Contact Dr. Aronson at (847) 676-5394 or www.kidsfirstpediatricpartners.com