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Bug Season calls for Precautions

Jun. 20, 2005, 2:01 PM

The great outdoors will keep children busy and active this season, but experts at the Monroe Carell Jr. Children‘s Hospital at Vanderbilt say parents would be wise to use a little precaution before play time to avoid insect-borne illnesses, typically caused by insect bites or stings.

“There are several diseases that are carried by mosquitoes and ticks, and we see a case at least every other week in the peak season of a child in Middle Tennessee made seriously ill as a result of a bite,” said Jake Nania, M.D., a pediatric infectious disease expert at Children‘s Hospital.

Mosquitoes carry viruses like West Nile that many people are aware of, but few people know that West Nile is less likely than some other viruses to seriously affect children. La Crosse and St. Louis encephalitis are two types of infections that cause swelling of the brain in children.

“Parents generally know something is wrong very quickly with these disorders because fever and headache progress to changes in mental function, confusion or disorientation and then even unconsciousness,” Nania said.

Treatment is mainly supportive. A child may need to be hospitalized for some time and even put on life support until the swelling from the infection subsides. There can be permanent damage and even death in rare cases. Prevention is as simple as using an insect repellant containing the ingredient DEET.

“The products that are made for children are actually a little too weak sometimes,” Nania said. “Research shows that the products with less than 10 percent DEET don‘t repel mosquitoes well enough or last long enough, while 10 percent to 30 percent should work for at least several hours and is quite safe for children older than 2 months old.”

If you use a 20 percent DEET repellant, you should use it just once during the course of the day without washing it off and even for infants older than 2 months, the product has been shown to be safe and effective.

DEET also repels ticks, which carry bacteria in their bodies that can cause other serious illnesses.

“We see Rocky Mountain Spotted Fever, Ehrlichiosis and Tularemia,” Nania said. “These infections can become very serious, and even fatal if they are not treated, but unlike the viruses mosquitoes carry, there are good antibiotic treatments for the tick-borne diseases.”

Nania said that Lyme disease, which is well-known in the North, is rarely seen in Tennessee.

“But a child with a tick bite that doesn‘t heal and gets crusted, black or ulcerated should be checked for Tularemia,” Nania said. “With Rocky Mountain Spotted Fever and Ehrlichia, you may not even notice the bite itself, but within a week or two, fever, headache and a rash, often on the wrists and ankles, are signs of the bacterial infection and need to been seen immediately by a doctor.”

One simple precaution parents can take to avoid tick-borne infections is to do a “tick check” every evening at bath time.

“If a tick is carrying bacteria, it won‘t transmit that to humans unless it has been attached for a prolonged period, or if you stress the tick too much in the removal process,” Nania said. “Use tweezers to grab as close to the skin as possible and pull with steady pressure until the tick detaches. Be careful not to crush ticks with bare fingers, as doing this can transmit infection to the person squeezing the tick.”

Media Contact:

Vanderbilt Children‘s Hospital

Carole Bartoo, 615-322-4747

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