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June 5, 2006

A University of Michigan Health Minute update on important health issues.

The buzz on treating summer insect stings and bites

U-M pediatrician offers prevention, treatment tips to take the sting out of summer

ANN ARBOR, MI – Buzzing bees, marching ants and swarms of mosquitos are just as much a part of summer as warm weather, blooming flowers and kids enjoying time off from school. And if your child has plans to spend the summer months outdoors playing, chances are he’ll encounter some insects along the way.

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For most children, the biting and stinging insects of summer are just minor annoyances – but for some, they can represent a serious problem, says Margie Andreae, M.D., associate professor, Department of Pediatrics and Communicable Diseases at the University of Michigan Medical School.

“The vast majority of people will only have a localized reaction to a bug bite or sting,” says Andreae. “However, about 3 percent of the population may develop an allergic reaction, including symptoms of a rash and hives that are distant from the site of the bite or sting that will require medical attention.”

To take the sting out of summer, Andreae offers tips to help treat insect bites and stings, and advice on how to prevent mosquito and tick bites.

5 tips for treating insect stings

  • Remove the stinger. The first thing to do when stung by a bee or wasp is to look at the site to see if there’s any remaining stinger. If there is, Andreae recommends that an adult use a firm object like a credit card to sweep across the site and pull out the stinger. Don’t squeeze or pinch the skin to remove the stinger. This will cause additional venom to be released into the bite.
  • Clean the area. Use soap and water to thoroughly cleanse the site of the sting before applying ice or hydrocortisone cream.
  • Apply ice. “Most people are going to develop redness and swelling at the site of the sting,” says Andreae. “A good approach to treating those reactions is to apply a cool compress or ice to the area.”
  • Add hydrocortisone cream. Adding hydrocortisone cream to the site of the sting will help relieve redness and pain.
  • Take a pain reliever and an antihistamine. “You also can use Benadryl in the oral form to control redness, swelling and irritation, as well as ibuprofen or Tylenol to relieve the pain,” says Andreae.

Should a severe allergic reaction occur – difficulty breathing or swallowing – Andreae says to call 911 and seek emergency care immediately.

Protecting your family against mosquito bites and West Nile Virus
Surprisingly, the most common insect to cause problems that bring children in for medical treatment are mosquitoes, Andreae says.

Health Minute Image“Mosquito bites generally cause a localized reaction in most children. But parents often mistake this reaction as something more severe, such as an infection, which brings them into the clinic for evaluation by a physician,” she says.

The incidence of a severe reaction to a mosquito bite, however, is extremely rare. If such a reaction were to occur, it would happen about three to four days after the insect bite happened – that’s the time when the bite should be healing and nearly gone, says Andreae.

West Nile Virus, which is transmitted by mosquitoes, also is a concern during the warm summer months, and can be most harmful to people over age 50.

“Approximately one out of 150 people bitten by a mosquito infected with West Nile Virus will develop a severe illness,” says Andreae. “Those who develop a severe illness will initially experience flu-like symptoms that will develop into severe symptoms of a headache, coma or even seizures.”

Fortunately, Andreae says there are several ways to protect yourself and your child against mosquito bites.

How to avoid summer insect bites

  • Use insect repellents with DEET. Most over-the-counter repellents now contain DEET, and are safe to use on children as young as 2 months old, and adults. “The concentration of DEET that’s most often recommended for children is 10 percent; up to 30 percent is safe for adults,” says Andreae. “The percent of concentration of DEET in a product is related to the length of time that it provides protection, not necessarily the strength or maximum protection against being bitten. For the product containing 10 percent DEET, it usually provides somewhere around two to three hours of protection against insect bites.”
  • Stay away from open beverages that contain sweetener. Sweetened beverages like soda and juice attract stinging insects.
  • Avoid areas with standing water. Standing water provides nice, moist breeding grounds for mosquitoes. “To keep your backyard safe, empty or cover pools at the end of the day, and don’t leave any potted plants outside that may contain standing water,” says Andreae.
  • Dress appropriately. Always wear shoes and dress in long pants and a lightweight long-sleeved shirt to cover skin and provide protection against biting and stinging insects.

Ticks and Lyme disease
People who live in the northeast and upper Midwest need to be on the look-out for ticks carrying Lyme disease this summer. Those at the greatest risk are people who spend a lot of time outdoors, especially in wooded areas.

About 80 percent of individuals with Lyme disease will develop a rash that looks like a bull's-eye near the bite. The rash is often accompanied by flu-like symptoms such as fever or headache, nausea and vomiting. Some people, however, may only develop flu-like symptoms and not a rash, notes Andreae.

“There’s a small number of people who will go on to develop secondary illness or complications from Lyme disease that most often affect large joints and cause pain and swelling,” says Andreae. “So any individual with a rash at the site of a known tick bite should by evaluated by a medical professional for possible treatment and testing for Lyme disease.”

For more information, visit these web sites:
UMHS Health Topics A-Z: Itchy or painful insect bites

UMHS Health Topics A-Z: West Nile Virus

UMHS Health Topics A-Z: Lyme disease

UMHS Health Topics A-Z: Bee or Yellow Jacket stings

KidsHealth: What to do when you’re bugged by bugs

American Academy of Allergy, Asthma & Immunology: Stinging insect allergy

 

Written by Krista Hopson

 

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