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Allergy & Asthma Advocate: Summer 2005
Summertime means mosquito time
By Stephanie S. Park, MD and Iftikhar Hussain, MD, FAAAAI
Baseball games, barbeques, and pool parties—the joys of summer are finally here! Unfortunately, summertime also means mosquito-time. There are over 2700 species of these pesky insects worldwide. In the United States, the three most common genera are the Aedes, Anopheles, and Culex. While mosquitoes are capable of carrying blood-borne diseases like malaria, West Nile encephalitis, and dengue fever, their bite is what gives them their notoriety.
Only female mosquitoes bite. Heat, light, sweat, body odor, lactic acid and carbon dioxide attract the female mosquito to your skin. She inserts the tip of her mouth into a tiny blood vessel, injects her saliva into your bloodstream, and then sucks your blood. It is thought that contact must last at least 6 seconds in order for a reaction to occur. Mosquito saliva contains chemicals that prevent your blood from clotting and proteins that evoke an immune response that we commonly witness as redness, swelling and itching.
A mosquito bite can cause a variety of reactions. People who have never been bitten before (primarily children) may not react at all. After being sensitized, they will typically develop a tiny, itchy red bump that appears hours to days after they have been bitten. Usually, these bumps will last a few days. Some people, however, have more serious reactions such as blistering lesions on the legs or larger hives accompanied by fever and joint swelling. At its worst, a mosquito bite can cause anaphylaxis—a potentially life-threatening condition characterized by throat swelling, generalized hives, faintness or wheezing. This reaction is rarely caused by mosquitoes and is more commonly associated with bee or wasp stings. If you suspect this reaction in yourself or anyone around you, seek medical attention immediately and use injectable epinephrine if available.
Treatment tips
Unfortunately, there is no real treatment for mosquito bites. Although there have been several efforts to develop allergy shots (immunotherapy) for mosquito bites, no reliable mosquito extract has been developed. Symptomatic treatment may be achieved with a few simple tips:
- Elevate the affected arm/leg and apply ice to reduce swelling and pain.
- Apply over-the-counter lotion like Calamine to the affected area.
- Clean blisters with soap and water without breaking them.
- If itching persists, try topical steroids or oral antihistamines.
- Consult a physician if the swelling progresses or the area appears infected.
- Carry an Epipen if there is any concern for anaphylaxis.
Tips to avoid mosquitos
Avoidance is still the best cure for mosquito bite. This is not an easy task. Here are some tips to avoid these pesky insects:
- Minimize outdoor exposure during peak mosquito time: dusk to dawn.
- Avoid standing near calm, shaded, humid areas and eliminate unnecessary reservoirs of standing water.
- Avoid bright clothing and heavy perfumes while outdoors.
- Wear clothing that covers most of your skin.
- Use insect repellents containing DEET. Read the label of your repellent! DEET will often be listed under the Active Ingredients as N, N-diethyl-meta-toluamide. Products with 6%-25% DEET should provide 2 to 6 hours of protection. There are side effects, including eye irritation, dry skin, and rash. Some people are allergic to DEET. It may also affect plastic, paint finish, and certain materials. Before applying to your entire body, use the repellent on a test area of skin to ensure tolerance. Use the lowest concentration that is effective for you and reapply as needed.
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