Tips to minimize risk of bug bites and related illnesses

While the image of a bug crawling on your arm or a creepy crawler snuggling up in your bed is enough to make you flinch, most bug bites are harmless and disappear on their own in a matter of days. Other insects, however, can spread disease and cause severe reactions that require medical attention.

At the American Academy of Dermatology's Summer Academy Meeting 2011 in New York, dermatologist Ronald P. Rapini, MD, FAAD, Josey professor and chair of the department of dermatology at the University of Texas in Houston, discussed the most common problems associated with insect bites and provided basic prevention tips to minimize your risk of bites and related illnesses.

"Prevention is the most important message when it comes to bug bites, and most bites can be avoided with some common-sense strategies," said Dr. Rapini. "The key is knowing which insects pose the biggest risk and when it is necessary to see a dermatologist for treatment."

Mosquitoes: The Summer Pests

In the United States, mosquitoes run rampant in the summer, and Dr. Rapini noted that they are the worst bugs for carrying diseases. While most mosquito bites resolve in a few days to a week without treatment, some people may experience an allergic reaction to a bite. In this case, a dermatologist may prescribe a cortisone cream, or in the case of severe allergic reaction, inject cortisone directly into the bug bite.

The possibility of contracting a disease is the biggest concern after being bit by a mosquito . For example, Dr. Rapini explained that in the United States, outbreaks of Saint Louis encephalitis virus, dengue fever and West Nile virus can be transmitted by mosquitoes and can cause serious illness.
In the case of Saint Louis encephalitis, most people infected with the virus will not become ill. However, those who do may develop a fever, headache, nausea or vomiting. In severe cases, inflammation of the brain can occur and, in rare cases, the virus can be fatal. Dr. Rapini explained that those affected with dengue fever will develop a high fever that can last for several days. With West Nile virus, birds carry the virus and mosquitoes that bite the affected birds can then transmit the virus to humans. Dr. Rapini noted that most symptoms of West Nile virus are mild and include a low fever and a headache or body aches that resolve on their own in a matter of days. In severe, rare cases, West Nile virus can cause brain damage, permanent muscle weakness or death.

To minimize the risk of mosquito bites and contracting a disease, Dr. Rapini recommends that insect repellents containing DEET be used when outdoors - especially at night. Insect repellents specially formulated for children will contain a lower percentage of DEET than adult formulas, making them safe to use for younger age groups. In addition, long-sleeved shirts should be worn to further protect the skin, and outdoor activities should be avoided if there are outbreaks of any mosquito-transmittable diseases in the community.

Bedbugs: Reputation Worse than Their Bite

As the name implies, bedbugs are tiny, nocturnal insects that like to prey on people in bed. Infestations commonly occur in hotels, where there is a continuous turnover of travelers who unknowingly may transmit bedbugs to the hotel or bring them home in their suitcase.

"It only takes one person to transmit bedbugs, and these insects - while generally harmless - can spread very quickly and be difficult to eliminate," said Dr. Rapini. "They like to hide in the cracks of a bed's wooden frame, under mattresses and even in wallpaper. When they bite, people may experience itching that can be hard to relieve."

Dr. Rapini explained that topical corticosteroids, such as hydrocortisone, are effective in reducing the itching and redness of bedbug bites, and warm compresses applied to the bites can help ease itching as well. Unlike other insects, bedbugs do not pose any serious health threats, and there is no evidence that they transmit diseases.

To avoid falling prey to bedbugs, Dr. Rapini recommends that suitcases be placed directly on a luggage rack away from the bed and should never be placed directly on the hotel floor. At home, clothes should be washed or dry cleaned immediately, and suitcases and items should be inspected for any signs of bedbugs.

Maggots: Travelers Beware

For travelers planning a trip to the jungles of Central America, Dr. Rapini cautioned that maggots known as dermatobia or the human bot fly can be transmitted to the skin via mosquitoes. In this area of the world, a bite from a mosquito can pass on the egg of a maggot that can burrow itself in the skin and make a hole where it will stay until it is removed.

"Maggots hate to have the hole in the skin covered, so the best way to get them out is to slap a piece of pork fat or meat over the affected area of the skin for a few hours," said Dr. Rapini. "The maggot is naturally drawn to the meat and will come out from under the skin and attach itself to the meat instead."

While not painful, Dr. Rapini added that a maggot holed up beneath the skin can be uncomfortable and should be removed.

Seek Treatment for Unusual Reactions to Bug Bites

"The best way to prevent a bug bite and an adverse reaction is to try to avoid bugs as much as possible and discourage young children from playing with them or picking them up," said Dr. Rapini. "While most bugs do not pose a threat to humans, the ones that do can cause an itchy rash or a nasty virus that can be hard to treat. If you experience an unusual reaction to a bug bite, see your dermatologist for proper diagnosis and treatment."