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This past mild winter was fantastic–right?? Unfortunately, your neighborhood ticks (carried by the flourishing “white footed mouse”, which ALMOST sounds cute…) and mosquitos thought so too.  As a result, this summer may be one of the worst yet for infections transmitted by insects, such as Lyme Disease, West Nile Virus, and even stranger ones like Dengue Fever.  As an ER doctor that trained in Connecticut (the first cases of Lyme Disease were discovered in Lyme, CT), Lyme was something that we always considered.  With recent weather patterns and increasing travel, these diseases are becoming even more common in the US.

Lyme disease is transmitted by a tick (Ixodes Scapularis–ok I just had to show off there and use that bit of knowledge that I had to memorize years ago!), when it bites a human. Once it infects the human, the bacteria cause a host of symptoms, starting with a rash (click the link for a picture) and then proceeding into a flu-like illness, with muscle aches, fever, chills, and lethargy (yes, pretty nonspecific symptoms).  Some patients may then progress to more severe and chronic forms of Lyme.  Treatment consists of an antibiotic for 2-4 weeks or more.

West Nile Virus and Dengue Fever are both viruses transmitted by mosquitos.  Due to the warmer weather and LOTS of rain, these are out in abundance–thus putting us all at higher risk.  Both of these can cause a range of illnesses, from mild/moderate flu-like illnesses to rare cases of severe illness and even encephalitis (infection of the brain).  Since these are viruses, antibiotics do not work–fortunately, aside from the few that become severely ill, most people fully recover.

For these conditions, I tell all of my patients that PREVENTION is the BEST strategy.  Follow these 9 steps:

  1. Use DEET to prevent ticks and mosquitoes.  The longer you are going to be outdoors, the higher the percentage of DEET you should use. If you’re just out for a short one-hour picnic, then 10-20% may be sufficient.  But, if you’re going for a several-hour hike, consider concentrations of 20-50%.  Avoid hands, eyes, and mouth.  When using on children, adults should apply it, and use concentrations of 30% or lower, according to the American Academy of Pediatrics. Make sure to wash the treated sites when you come in from the outdoors, to remove any excess.
  2. Use permethrin-containing products on your clothing.  Use permethrin to treat clothing, gear, boots, pants to give you extra protection.
  3. Wear long sleeved shirts and pants when hiking in the woods
  4. Look for (and either eliminate or avoid) areas of standing water, where the mosquitos will thrive, breed…and bite you
  5. Perform full-body checks of your skin and your family’s when you come in from the outdoors and throw clothes in the dryer for an hour on high heat to kill any ticks.
  6. In your backyard: clear tall grass and place a 3-foot wide barrier of wood chips or gravel around patios and play equipment to create a barrier.
  7. Key “dining” hours for mosquitoes = dusk and dawn.  When you’re out for your evening cookout, so are they–so don’t forget to protect yourself and your family
  8. Don’t forget your sunscreen! There are products that combine sunscreen and insect repellant in one. While it may be more convenient, I advise my patients to stick to two–sunscreen should be used broadly (especially on sensitive areas such as the face and hands) while DEET should be used only sparingly on these areas.  In addition, sunscreen often needs to be reapplied every 2-4 hours, while DEET does not.  So, stay safe by using each product the way it was intended (and safety tested!) to be used.
  9. If you become an insect’s lunch:
    1. Ticks: Remove a tick by using fine-tipped tweezers to grasp the tick as close to the skin surface as possible.  Pull upward with steady, even pressure (twisting or jerking will cause it to break).  After it’s removed, clean the site very well.  See the CDC website.
    2. Mosquitoes: After you’re bitten, the mosquito leaves behind dirty microscopic fragments (YUCK).  So be sure to wash the site WELL with water and gentle soap
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