Don’t let the bugs bite: Prevention and treatment

Story highlights

Among the most common summertime bites and stings are those from fleas and bees

The more times you have been bitten by mosquitoes in your life, the less sensitive you are to it

Bug repellents can help prevent mosquito and tick bites, but make sure to apply them after sunscreens and lotions

CNN  — 

From family picnics to camping trips, summer is the time when we invade insect territory. And the bugs are ready for us: fleas, ticks and mosquitoes all thrive in warmer months.

As temperatures rise, “it switches from flu season to bite season; one stops and the other starts,” said Dr. Joe Sliwkowski, a family medicine and sports medicine doctor at CareWell Urgent Care in Framingham, Massachusetts.

Although we may never break free from the cycle of spray, swat and scratch, there are better ways than ever to prevent and treat bug bites. Simple foods such as garlic and basil may help fight the bite. And never scratch the bite, if you can help it, because that increases your risk of infection, Sliwkowski warned.

Buzz off, bugs! How to stay safe during insect season

We need all the help we can get to combat the insect world – it is estimated that their global population is a staggering 10 quintillion (that’s 10 with 18 zeros).

“If you add (the insects) up, it’s pretty scary, so we need to be aware they’re there and take precautions,” Sliwkowski said.

And next time you’re nursing a nasty bite or rash, try to keep in mind that insects have their place. Honeybees fertilize about a third of the world’s crops. And even the lowly mosquito is an important food for birds and fish, after it feasts on you.

What’s really eating you

Spiders may get the blame – unfairly – when you wake up with itchy pink bumps.

The truth is, these arachnids often avoid people, preferring to dine on insects rather than human blood.

The much more likely culprits are fleas, whose bites tend to occur in groups of three or four, often around your ankles, and can cause a red rash. “They tend to be more prevalent when it’s warm and dogs are out more,” Sliwkowski said.

It is more important than ever this time of year to treat your furry friends with flea and other pest repellents, he added.

Feel the burn

It’s bad enough that many insects – honeybees, fire ants, wasps, to name a few – release venom when they bite or sting that causes pain and swelling.

But for some people, the venom triggers an allergic reaction, which can either be localized to the sting site or spread throughout the body and create a life-threatening anaphylactic shock.

“The allergic reaction is very individualized,” Sliwkowski said. He has treated patients who developed welts the size of lemons where they were bitten. This type of localized reaction can usually be managed with over-the-counter antihistamines, such as Zyrtec, Sliwkowski said.

Call 911

Life-threatening allergic reactions to bug bites or stings are rare, occurring in fewer than 1% of children and about 3% of adults. But if you know that you may have this kind of reaction, “it’s critical that you carry an EpiPen at all times if you are in an outdoor area because bees can be anywhere,” Sliwkowski said.

Even if you are quick to jab yourself with an EpiPen after you are stung, you should still call 911 for help because the medication in the EpiPen (epinephrine) only gives temporary relief that lasts about 10 minutes, Sliwkowski said.

Rate your pain

How bad does it hurt? If it’s so bad that you can’t even answer this question, your sting might top the Schmidt Sting Pain Index, which ranks the pain intensity from different insect stings.

The most painful bite of all (level 4) is courtesy of the tropical bullet ant, which is fortunately found off the beaten path in the South American rainforest. The entomologist who developed the index, Justin Schmidt, described the kiss of this ant as “pure, intense, brilliant pain.”

Next time you are wailing about a fire ant or honeybee sting, remember that they rank only level 1 and 2 on the Schmidt Sting Pain Index.

Herbs, pills and creams can soothe the sting

Your backyard garden might be full of buzzing biters, but it may also contain a natural remedy for the pain.

“Basil has anti-inflammatory properties, so if my kids have bites I just take the leaf, crinkle it and rub it on the skin,” Sliwkowski said.

You can also soothe the pain and itching with over-the-counter medications such as Zyrtec even if you don’t have an allergic reaction.

“It is a little stronger than Claritin, but not so strong as Benadryl that (it) can knock you out,” Sliwkowski said. Even Preparation H hemorrhoid cream, which reduces inflammation, can be worth trying if you have some around your house, he added.

Mosquitoes’ viruses are worse than their bite

The good news when it comes to the maligned mosquito is that she (only females feed on your blood) is much less likely than a bee or wasp to trigger a serious allergic reaction when she bites. Instead of releasing venom, these insects inject an anticoagulant that helps keep the blood flowing.

Although the anticoagulant causes a mild allergic reaction, the more times you have been bitten by mosquitoes in your life, the less sensitive you are to it.

Of course, what mosquitoes can also give you are a couple of pretty serious diseases, malaria being the most famous. There were 2,000 cases of malaria in the U.S. in 2011, the largest number in 40 years, but nearly all of the infections were acquired overseas in areas such as sub-Saharan Africa.

The biggest bug-borne threat in the United States is West Nile virus, which peaks during late summer. Although most people who get infected do not experience any symptoms, about 20% develop fever, headaches, body aches and vomiting.

The Chikungunya virus has also been gaining a foothold in the Western Hemisphere, infecting 1 million people and killing 155 since it first appeared in the Americas in 2014. Infections can cause joint pain, fever and headaches, and in 20% to 30% of cases lead to arthritis and other chronic joint problems. There are currently no treatments for Chikungunya, and the Centers for Disease Control and Prevention recommends rest, staying hydrated and taking anti-inflammatory medications such as ibuprofen to reduce the symptoms.

Dengue fever is also emerging in the United States. Florida health officials detected an outbreak in 2010, which was the first time they had experienced cases since 1934. The mosquito borne illness causes rash, fever, bleeding and can be fatal. Most cases are among those who have traveled to the Caribbean or Central and South America. But like other mosquito borne diseases, mosquitoes can bite someone who is infected and then bite a healthy person, leaving them itching and ill.

Also of concern, Eastern equine encephalitis, or EEE, a rare virus that can cause inflammation of the brain. Fortunately, there are only a few cases in the United States. each year, in the Atlantic, Gulf Coast states, and the Great Lakes region.

The CDC recommends using bug repellents, such as Off!, that contain at least 20% DEET on exposed skin to reduce mosquito and tick bites.

Protect yourself from the sun, then from the bugs

In addition to DEET-containing repellents, the CDC recommends products such as Off! Botanicals, which has oil of lemon eucalyptus.

For his part, Sliwkowski recommends soybean oil and neem oil as natural insect repellents.

Your pet checklist for a healthy summer

Whatever repellent you use, it is important to apply it after sunscreens or body lotions. “You want (that) to be the top layer, it’s the scent you want on top,” Sliwkowski said.

Mosquitoes like beer, but not garlic

Although camping and beer may seem like the perfect pairing, you may have to forgo the latter if you want to avoid mosquitoes.

A small study found that mosquitoes prefer people who have kicked back some pints. It is possible this is because the insects, like other blood-sucking bugs, are attracted to the higher levels of carbon dioxide in the breath of beer drinkers.

On the other hand, a big bowl of garlicky pasta might be the perfect food to keep mosquitoes at bay. Although the research suggesting that garlic can repel mosquitoes is scant, it could be worth a try. “That’s what I’ve read over the years (and) it does seem to help,” Sliwkowski said.

Itsy-bitsy killer spiders

Even though it is rare to get bitten by a spider, there are a couple varieties in the United States that you should watch out for: the black widow and the brown recluse. Although the bites themselves are often painless, the aftermath can, in very rare cases, be deadly.

The black widow spider, which is most commonly found in fences, barns and other outdoor areas in the Southern and Western parts of the United States, is black with a signature red or yellow hourglass shape marking on its side. Its bite releases venom that causes chest pain and muscle cramps, usually within 30 minutes to an hour. These symptoms can usually be remedied with anti-venom or muscle relaxant. If you think you might have been bitten, you should call your doctor or a hospital right away and ice the area.

The brown recluse spider is most common in the Midwest and Southern states and hides away in secluded areas – think shoes, closets, the attic. Its bite often results in a red or white sore and fever and chills within a few hours. Although there is no medicine in the U.S. to treat brown recluse spider bites, you should relieve symptoms by icing the area or applying a cool wet cloth.

Tick trouble

A common summertime pest, especially in the Northeast and Midwest, is the ticks that carry Lyme disease, which causes fatigue, fever and headaches. “We see a tremendous amount of tick bites (in Massachusetts),” Sliwkowski said.

Although both adult and immature blacklegged (deer) ticks transmit the bacterium responsible for Lyme disease, the immature nymphs, which feed in the spring and summer, are the bigger threat because they are harder to spot and get rid of. A nymph is about as big as a poppy seed, whereas adults are the size of sesame seeds.

CDC: Lyme disease more common than we thought

If you can remove the tick within 36 to 48 hours, you should be home free, because it takes about that long for the Lyme disease bacterium to be transmitted.

But if you miss that window, you should get antibiotic treatment as soon as you notice the tick’s telltale bull’s-eye rash, Sliwkowski said. “Antibiotics work great when caught in the early stages,” he said.

Without treatment, Lyme disease can cause joint problems, damage the heart and lead to forgetfulness and other cognitive issues. You should contact your doctor right away if you have been bitten by a tick and start to experience symptoms, even if the symptoms subside.

Lyme disease is not the only tick-borne disease to worry about. There have recently been case reports of infections with Borrelia miyamotoi, which is related to the bacterium that causes Lyme disease. Although borrelia infections have some of the same symptoms as Lyme disease, such as fever and muscle aches, and can also be treated with antibiotics, infections do not cause bull’s-eye rash and arthritis.