Insect Protection Measures

If you don't get bitten by a mosquito, you probably won't get malaria. But if you don't get an insect bite, you also won't get yellow fever, filariasis, viral encephalitis, dengue, lyme disease, leishmaniasis, typhus, onchocerciasis, trypanosomiasis, or several other tropical and infectious diseases. Most of these diseases have no vaccination tactic so your only protection is to avoid insect bites that transmit the disease. This section deals with what must be done to reduce your risk of developing any and all of those diseases, and it must be done day and night to be effective. Insects to avoid: mosquitoes (day feeders), mosquitoes (night feeders), ticks, sand flies, fleas, tsetse fly, assassin/kissing bugs, black flies and chiggers.

Prevention requires a multifaceted approach. By practicing the following recommendations, you can achieve a very high degree of protection against insect bites:

1. Cover up bare skin, if possible, by wearing long sleeved shirts, hats and pants. Shirts should be tucked in. Boots should be worn and sandals avoided. Pants should be tucked into socks and boots. Avoid bright or dark-colored clothes.

2. Use insect repellents with DEET (N,N,-diethyl-meta-toluamide). Formulas containing 30% DEET are recommended to reduce potential for toxicity. The 95% formulas are no longer recommended. Ultrathon® (a 3M product sold in some of our pharmacies and available in many camping stores) is the new 30% DEET formulation in polymer. It has the advantages of being nonabsorbable, nonevaporating from the skin, and does not wash off easily with water or sweat. It can be used in children above age 3 and may be safe for younger children, but no studies have been done. The cream protects for 12 hours.

Minimize Potential for Adverse Reactions from DEET-Containing Repellents:

Do not inhale, ingest, or get repellents into your eyes. Never use repellent on inflamed skin or on wounds.

Avoid applying repellents to portions of children's hands that are likely to have contact with eyes or mouth.

Pregnant and nursing women should minimize use of repellents.

Use repellent sparingly: one application will last approximately 4 to 12 hours depending on the brand. Saturation does not increase efficacy. Wash repellent-treated skin after coming indoors. If a suspected reaction to insect repellents occurs, such as slurred speech, staggering gait, lethargy, or seizures, wash treated skin, and call a physician (take the repellent container with you).

3. Small mesh insect netting reduces insect access, but similarly reduces ventilation. Large netting, impregnated with permethrin, accomplishes protection while maintaining airflow through the bednet.

4. Avoid "smelly substances"-perfumes, colognes, after-shave, scented deodorants, and fragrant soaps.

5. Spray sleeping quarters with flying insect killers (Raid®, Black Flag®) 1 hour before going to sleep.

6. Use mosquito coils especially in nonscreened rooms.

7. Permanone® is a new permethrin cloth impregnating solution. In addition, a concentrated animal tick and flea repellent which can be diluted to the appropriate 5% permethrin strength can be obtained with difficulty and has not been officially approved by the FDA. Permethrin-treated clothing kills and repels ticks, mosquitoes and other insects and retains this effect after repeated laundering. Also, a permethrin containing shampoo (NIX®) and a prescription cream (Elimite®) are available.

8. Check bedding for ticks and other insects before retiring for the evening.