Pennsylvania physicians urge residents to take precautions against bug bites, bee stings

For many people, bug bites and bee stings aren't a big deal beyond a small irritation. But for some, it could mean the start of a painful - possibly long-term or even deadly - experience.

Despite their size, ticks, mosquitoes, and bees can pack a wallop. Every summer, reports appear about the havoc they can cause through Lyme Disease, West Nile Virus, and allergic reactions.

As such, Pennsylvania physicians are urging residents and guests to the state to take precautions as they hit the outdoors this summer, and know what to do if you have the misfortune of being bitten or stung.

"The old saying 'an ounce of prevention is worth a pound of cure' really holds true when it comes to bites and stings," says Karen Rizzo, MD, president of the Pennsylvania Medical Society and a practicing physician in Lancaster. "Simple things like checking yourself for bugs and wearing bug spray can make a difference in the long run."

Pennsylvania's Tick Threat

Of all insects, possibly ticks raise the greatest amount of concern in Pennsylvania, particularly in light of an April 2015 study released by the Pennsylvania Department of Environmental Protection (DEP). The study raised eyebrows when it indicated Lyme Disease is now a risk in all 67 Pennsylvania counties.

Before this study and according to statistics from the Centers for Disease Control and Prevention (CDC), it was well known that Pennsylvania had the highest number of confirmed Lyme Disease cases in recent years of all states. CDC data suggests there were nearly 5,000 confirmed cases of Lyme Disease in Pennsylvania during the 2013 calendar year.

The state DEP study prompted acting Pennsylvania Physician General Rachel Levine MD to offer advice on precautions the public can take. Among those recommendations are

• Avoid tick infested areas
• Wear protective clothing
• Use insect repellent
• Do a full body check after spending time outdoors

"If an individual develops signs and symptoms of Lyme disease after a tick bite, we urge them to seek medical attention," Dr. Levine says. "Early diagnosis and treatment of Lyme disease may prevent late-stage complications."

According to Paul Killian MD, president of the Pennsylvania Rheumatology Society, early symptoms within the first 30 days of a tick bite could include

• A red and expanding rash
• Fatigue
• Chills
• Fever
• Headache
• Muscle and joint aches
• Swollen lymph nodes

"This is something you want to catch early," says Dr. Killian, who practices in Monroeville. "A large percentage of patients who go untreated tend to face bouts of arthritis including severe joint pain and swelling. A small percentage may even develop chronic neurological issues such as shooting pain, numbness, or tingling in the hands or feet."

In 2014, Pennsylvania passed legislation to raise awareness of Lyme disease and increase prevention efforts. The new law created a task force at the Department of Health (DOH) to educate the public about Lyme disease and related tick-borne illnesses, and to collaborate with other key agencies.

Mosquitoes transmit diseases

Mosquitoes essentially use their mouthparts to puncture human skin and feast on blood. Most mosquito bites do little harm, possibly leaving the puncture area swelling, sore, and red.

However, if the mosquito is carrying a virus or parasite, then the victim could experience severe illness.

"Mosquitoes, particularly those in tropical environments, have been linked to some nasty illnesses including yellow fever and malaria," says G. Alan Yeasted, M.D., FACP, president of the Pennsylvania Chapter of the American College of Physicians. "Here in Pennsylvania, we don't see a lot of those diseases. Instead, we more often will associate mosquitoes with West Nile Virus."

According to the Pennsylvania's West Nile Virus Control Program, West Nile virus first appeared in Pennsylvania birds and mosquitoes in 2000. Typically, West Nile is a mild disease that mimics the flu and lasts only a few days. However, some cases - about one in 150 - can be severe, causing encephalitis, convulsions, paralysis, or death.

One of the keys in the fight against West Nile Virus is to make it difficult for mosquitoes to breed. Property owners play an important role. Mosquitoes tend to enjoy stagnant water. Eliminating stagnant water from locations like wading pools, clogged gutters, and other locations helps.

But, it can be tough to totally avoid mosquitoes, and Dr. Yeasted, who practices in Pittsburgh, suggests the following tips for patients:

• Take normal steps to prevent insect bites
• Wear appropriate clothing when outdoors
• Use mosquito repellent

Bee stings can cause an allergic reaction

Like ticks and mosquitoes, bees as well as wasps and hornets have the ability to cause little or a lot of harm. While many people will have a mild reaction to a bee sting, some may end up with an allergic reaction that could be life threatening.

According to Todd D Green, MD, FAAAAI, president of the Pennsylvania Allergy & Asthma Association, a severe allergic reaction could cause low blood pressure or swelling that could impact breathing.

"It's very important for a person having a severe allergic reaction to a bee sting to seek immediate medical care," says Dr. Green, a practicing allergist in Pittsburgh. "Even moderate reactions can be problematic."

Dr. Green says treatment for a bad reaction may include antihistamines, epinephrine, or in the worst of cases a breathing tube.

According to the US Department of Labor Bureau of Labor Statistics, between 2003 and 2010, of all insect bites, bees caused the most fatal injuries to workers.

Typically, people with known allergies to insect venom and food will carry an EpiPen to treat anaphylaxis shock.

In 2014, Pennsylvania passed House Bill 803 to make EpiPens more easily available in school settings. The law became effective just in time for schools returning from the December holidays. The new law allows schools to maintain a supply of EpiPens in a safe, secure location, and allows students who are having an allergic reaction to self-administer the injection. It also will allow schools to train employees to administer the injection. Physician organizations including the Pennsylvania Medical Society and Pennsylvania Allergy and Asthma Association supported the legislation.