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West Nile Virus and Insect Bite Prevention


Document Number: 258

West Nile Virus has been making the headlines recently due to the increasing number of cases being reported and identified in the United States. However, this virus is not exactly new. In fact, West Nile Virus was first identified in 1937 in the West Nile District of Uganda, and the first appearance in North America was back in 1999.

How is West Nile Virus Spread?
Infected mosquitoes spread West Nile Virus. Mosquitoes most commonly pick up the disease from infected birds, and go on to infect other animals while feeding on their blood. In a mosquito, the virus is found in the salivary glands, which mosquitoes use to anesthetize the skin of the animal on which they are feeding. Note: the virus cannot be spread by human-to-human contact.

West Nile Virus in Humans
In the bloodstream of humans, the virus multiplies and crosses the blood/brain barrier. When this happens, the virus can cause West Nile encephalitis, a serious condition resulting in the inflammation of brain tissue. However, it is important to note that most people who become infected have either no symptoms, or only mild symptoms. Also, if a person does contract the virus, a natural immunity is developed that is assumed to last all their life.

Prevention
While there is currently not a vaccine for West Nile Virus, the Center for Disease Control has advice for reducing risk of exposure. These include:

  • Stay indoors at dawn, dusk, and in the early evening.
  • Wear long-sleeved shirts and long pants when outdoors.
  • Spray clothing with repellents containing permethrin or DEET since mosquitoes may bite through thin fabric.
  • Apply insect repellent to exposed skin. An effective repellent will contain 35% DEET. Other effective mosquito repellents, as reported by the CDC in April 2005, are picaridin and oil of lemon eucalyptus.
  • Always read and follow manufacturers directions when using repellents, and avoid applying repellents to the hands of children.
  • Install or repair window and door screens so that mosquitoes cannot get indoors.
  • Vitamin B and 'ultrasonic" devices are not effective in preventing mosquitoes.

Reporting
An unusual number of dead birds in an area may indicate the presence of West Nile Virus. While there are over 110 species of birds known to have been infected, the virus tends to be somewhat more lethal to crows and jays. State and local health departments are responsible for investigating reports of dead birds.

For more information on West Nile Virus, please check out the Centers for Disease Control and Prevention website at: http://www.cdc.gov/ncidod/dvbid/westnile/index.htm

For a listing of State and Local Government Sites: http://www.cdc.gov/ncidod/dvbid/westnile/city_states.htm

For a fact sheet on using DEET insect repellents safety, please see: http://www.epa.gov/pesticides/factsheets/chemicals/deet.htm

For information on DEET alternatives, please see: http://www.cdc.gov/ncidod/dvbid/westnile/RepellentUpdates.htm

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Use clothing, repellents to fight off bugs
Warmer temperatures are a sure sign that summer is on the way. And with the warmer temperatures come those pesky, nuisance insects to ruin your outdoor activities. A single acre of land can easily accommodate more than 400 million insects that can sting, bite, chew or just generally annoy us enough to want to stay indoors.

Insects such as hornets, bees and fire ants use stingers, which penetrate the skin and inject venom. Bites from mosquitoes and black flies initially cause itching, but it’s the insect’s saliva that’s the main irritant. The saliva is highly acidic and can create swelling, welts and severe itching. Chiggers are chewers who tear small pieces of skin and secrete a liquid that dissolves skin cells. A close encounter with chiggers will leave you with one of the most itchy and painful of all insect wounds.

There are two options to fight off these insects. The first approach is to dress in loose pants and long-sleeved shirts. Mosquito netting is also a good idea for covering the face and neck. This full-body covering keeps insects away from the skin and prevents bites or stings.

A second option is to use insect repellent. The most commonly used repellents generally contain DEET (N, N-diethyl-m-toluamide), which was developed in 1946 by the U.S. military and made available to the public in 1957. Other repellents such as picaridin, also known as KBR 3023, and oil of lemon eucalyptus have been recently found to be effective alternatives to DEET for mosquito protection.

Although DEET works well as a repellent, it does have some shortcomings. In 1961, the New England Journal of Medicine reported a study on the effects of continuous exposure to DEET. The study indicated that DEET penetrated the skin and entered the bloodstream easily, and should therefore be used with caution. It found that some children generously treated with DEET for several weeks experienced seizures, convulsions and developed toxic encephalopathy. Adults, the study reported, experienced confusion, irritability, insomnia and other neurological problems when exposed to high levels of DEET.

Health effects
After completing a comprehensive reassessment of DEET, the Environmental Protection Agency (EPA) concluded that as long as users follow label directions and take proper precautions, insect repellents containing DEET do not present a health concern.

Rashes, blisters, skin and mucous membrane irritation, and numb or burning lips have occurred among people who applied products containing a high concentration (50 or 75 percent) of DEET and among those excessively exposed. Toxic encephalopathy and seizures have been associated with use in children. Subtle insomnia, mood disturbances and impaired cognitive function in adults has been associated with excessive application.

Suggestions for DEET Use
To prevent adverse reactions, it’s recommended that DEET-based products be applied sparingly or over clothing rather than directly on the skin. Another option is using products that have low concentrations of DEET.

Other suggestions for DEET based repellent use include the following:

  • Read and follow all directions and precautions on the product label.
  • Do not apply over cuts, wounds or irritated skin.
  • Do not apply to hands or near eyes and mouth of young children.
  • Do not allow young children to apply the product.
  • Use just enough repellent to cover exposed skin and/or clothing.
  • Do not use under clothing.
  • Avoid over-application.
  • After returning indoors, wash treated skin with soap and water.
  • Wash treated clothing before wearing again.
  • Do not spray aerosol or pump spray products in enclosed areas.
  • To apply aerosol or pump spray products to face, spray on hands first and then rub on face. Do not spray directly onto face.

Even with its shortfalls, an estimated 200 million people use DEET-based products and adverse reactions are extremely rare.

DEET Free Options

Two alternatives to DEET based repellents were announced by the CDC in an April 28th, 2005 press release. While the CDC still states that DEET is “highly effective” it does recommend products that contain either piraridin or oil of lemon eucalyptus as effective mosquito repellent options.

The release indicates that picaridin has been used for years in Europe, Australia, Latin America and Asia and “evidence indicates that it works very well, often comparable with DEET products of similar concentration. ”

According to the CDC, oil of lemon eucalyptus (also know as p-menthane 3,8-diol or PMD) is, “a plant-based mosquito repellent that provided protection time similar to low concentration DEET products in two recent studies. ”

A little planning and a few precautions can make a big difference when spending time outside this summer. So whether it’s work or relaxation, by dressing appropriately and having the right insect repellents on hand, you can be considerably more comfortable outdoors.

Click here for a selection of insect repellents.


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Please Note: The information contained in this publication is intended for general information purposes only. This publication is not a substitute for review of the applicable government regulations and standards, and should not be construed as legal advice or opinion. Readers with specific questions should refer to the cited regulation or consult with an attorney.

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