Don't Scratch That Bug Bite

Florida’s sub-tropical climate virtually assures encounters with insects and spiders. According to www.floridanature.org, there are about 500 insects and spiders found only in our state. And while many insects play a vital role in breaking down decaying plants and animals, some can also be a nuisance for humans.

From mosquito bites to bee stings, hornets and fire ants, it’s good to know what’s bugging you. While some mosquitoes can transmit diseases, such as Malaria, experts say few cases are seen in our state annually. While also at a fairly low rate in Florida, ticks can cause Lyme Disease, which can have a disabling impact on joints and muscles. However, early detection is the key to treatment. That’s why it’s a good idea to make a thorough body inspection part of your routine when spending time outdoors - especially if you’ve been in thick, forested areas. Don't worry, there are other precautions you can take:

• Avoiding hiking in areas known to be hospitable to bees and hornets.
• Since eating meals outside can also attract insects,  using repellent on your skin and screened covers on food may prove helpful.  
• Standing water attracts insects, so it’s wise to keep all pots and buckets emptied, especially after a downpour. For more information on how to prevent mosquitoes from multiplying, check out this page on the Florida Department of Health's website.

If you are allergic to insect bites, it is always wise carry an emergency epinephrine kit. Signs of allergies can be life threatening and include:

• itching and swelling extending beyond the bite site
• chest discomfort or pounding
• difficulty breathing, speaking or swallowing
• feeling faint or dizzy

Philip Shenefelt, a physician at the James A. Haley Veterans Hospital in Tampa, Fla. is an expert in rashes and contact dermatitis. He is also an Associate Professor of Dermatology and Cutaneous Surgery at the University of South Florida. He reviewed the symptoms and treatment of some insect and spider bites, offering tips for prevention. 

MOSQUITOES

Mosquito bites are the most common. Shenefelt explained the female mosquito needs human blood to produce eggs. Mosquitos abhor high winds and are more prevalent at both dusk and dawn, making those ideal times to avoid hiking and paddling. Their bites resemble a round pink or red bump that itches. Because mosquitoes can carry the West Nile virus, Eastern Equine Encephalitis or Dengue Fever, repellent is an important defense.

“We don’t see much malaria,” said Shenefelt, “but there is a risk if global warming is real, “ he said. “Though generally a diagnosis you see in the tropics, climate changes could cause these infections to migrate northward and Florida is close by.”

Yellow fever, transmitted by mosquitoes, is endemic in South America and Africa. Once prevalent in the United States, a vaccination was developed in the late 1930s. However, in 2010, Dengue Fever cases were noted in Florida for the first time since 1934, in the Florida Keys, Miami, and a few  on Florida’s west coast. Though cases are relatively few, and likely contracted on overseas trips or brought in by travelers from foreign countries,  prevention is a key component in combatting these diseases.

Pets can also be bitten by mosquitoes, so heartworm prevention is an important strategy. Since there is a lot of standing water in our state, mosquitoes have an abundance of environments in which, to breed. With recent intermittent rains, Shenefelt notes we’ve seen slight increases in mosquito bites. The main uptick usually comes during Florida’s rainy season, beginning in June. The range of reactions to all insect bites runs the gamut from mild to severe, he said. Some barely react and others may have much stronger reactions.

“Those with asthma, hay fever or atopic dermatitis may get more itchy,” Shenefelt said, noting that hydrocortisone creams don’t seem to help.

He cautioned against scratching, no matter how great the urge. Scratching can introduce a secondary bacterial  infection and a more complicated set of problems.  

Treatment:

Wash the bite with soap and water, using over-the-counter cream such as Itch-X to counteract the itching. Placing an ice pack on the bite may also help control the discomfort and any swelling, according to some.  While it is unusual to have an allergic reaction to a mosquito bite, you should call a physician if you do.

Prevention:

The best way to avoid mosquito bites is to wear an insect repellent that includes DEET. Children can use products with up to 10 percent DEET, but layers may need to be replenished, due to absorption. Adults can use products with up to 50 percent DEET. Empty flower pots, barrels, and vessels that have standing water. Wearing long-sleeved shirts and long pants are best for repelling mosquitoes from your skin.

FIRE ANTS

Like many states, Florida has pesky fire ants, which are not native. While they do not bite, they sting, but this generally occurs if you have stepped on their nests. The material in their stinging venom causes formation of a pus pocket. Typically, bites occur  on feet ankles, legs and hands. The sting can last for days and victims may see slight redness at the site. 

Treatment:

Cleanse the area and keep it clean. An ice pack wrapped in a clean towel may lessen the sting, which can last for several days. Applying a triple antibiotic cream may help alleviate symptoms. Though unusual, be vigilant for signs and symptoms of an allergic reaction. 

FLEAS

When the weather turns warmer, tiny brown bugs called fleas, seem to proliferate. Dogs, cats and rabbits who have been outside, often have fleas in their coats and they may become itchy and start scratching. When indoors, fleas can jump from one person (or pet) to another and often live in carpeting. They are difficult to combat. 

Symptoms:

Flea bites feel itchy and tend to occur in groups of three or four bites resembling tiny red bumps.

Treatment:

Fleas are not repelled by DEET. Some people have luck using Eucalyptus oil or spray, which is actually available through a vendor. If you've been bitten by a flea, wash the bite with soap and water, use Itch-X and refrain from scratching, as this can lead to a secondary infection.

Prevention:

Small animals can be dipped in special flea-control shampoos, or they can wear a flea collar. There are also medications that both treat and repel fleas, though treatment may need to be repeated. Since the larvae of fleas can be embedded in carpets and rugs, they may need repeated treatments.. A professional exterminator can treat your home and yard with chemicals to both kill fleas and inhibit the hatching of egg. Be wary of incorrect information on the Internet, that has not been vetted. You can log on to www.emedicine.com for reliable, peer reviewed and accurate information.

Shenefelt offered this trick to test for the presence of fleas. Place a white pillowcase on your carpet and stand on it in your bare feet.  Within minutes, you may see tiny specks crawling- and that confirms the presence of fleas. You should also inspect your pets and outdoor animals daily. 

SPIDERS

Most spiders don’t bite, unless you invade their territory, and especially disturb their eggs,, according to Shenefelt. Black widow spiders are nocturnal and more of a threat at that time. They are often located in garages or other dark spaces, such as closets. A medium-sized spider has a body that is about one half-inch long. The southern black widow spider has a shiny, black, globular abdomen with a distinctive red hourglass symbol on the underside. Black widows can cause neurotoxin problems such as pain, muscle rigidity and in severe cases, breathing problems. If these occur, seek medical attention.

Brown Recluse Spider bites should be followed by a visit to the emergency room. While most bites turn out to be other spiders, it is worth a check, because the venom of brown recluse spiders is extremely potent and toxic to tissue. These venomous spiders, while not aggressive, can be found in dark, warm and dry environments such as attics, closets,  wood and tire piles, and will bite if disturbed. They have small, loosely organized webs, found mostly in corners. . The venom, comprised of enzymes, can  destroy cell membranes. You may see a black area on the victim, which is actually, necrosis of skin, fat and blood cells near the bite site. Initially, victims may not notice much, except for a stinging sensation.

After several hours, they may experience severe pain, relentless itching, nausea  vomiting, fever and muscular aches. Victims will also have an inflammatory response, which may lead to these life threatening  issues:

• a decreased red blood cell count
• the inability to form blood clots
• kidney problems
• coma
• death

A more common and far less threatening bite may occur from bedbugs, which are making a comeback with a vengeance. 

BEDBUGS

Adult bed bugs are reddish-brown, up to 3/8” long, and have a flat, oval-shaped bodies. Juvenile bed bugs, known as “nymphs”, are smaller and lighter, yet both  hide in a variety of places such as the seams of fabric and upholstery, between chair and couch cushions, and in bedskirts and curtains. They do not transmit diseases, but can be a nuisance.

Symptoms:

The bites appear as little red bumps that sometimes resemble a line. They can be itchy.

Prevention:

• Use a protective case around mattresses and box springs. Check it regularly for holes.
• Reduce clutter, so bedbugs have  fewer places to hide.
• Unload and unpack directly into your washing machine after a trip, and check your luggage carefully.
• In hotels, place suitcases on luggage racks, instead of the floor. Check the mattress and headboard for signs of bedbugs. Carry a protective cover for pillows and use it religiously. 

Treatment:

• Wash the bites with soap and water and use an anti-itch cream. Avoid scratching the bites, because that could lead to a secondary infection.
• Remove bedding and pillows and wash at high temperatures. Use high heat to dry the items.  

• Use zippered mattress, box spring, and pillow cases to trap bed bugs and help detect infestations.
• Vacuum frequently and reduce clutter to limit the places where bedbugs can hide.

TICKS

Lyme Disease is a bacterial infection carried by deer ticks. According to Shenefelt, Florida has had only 500 cases in the past decade. Yet Lyme disease is a bacterial infection and symptoms can be difficult to pinpoint since they mimic the flu. They include:

• A skin rash that often resembles a bulls-eye
• fever
• headache
• muscular pain
• stiff neck
• swelling of knees and other large joints

In the later stages of the disease, lab tests are used to confirm the diagnosis. 

Prevention:

Wear long pants and sleeves in fields and woods, get in the habit of performing self-inspections after hiking. Use pyrethrin spray (DEET won’t work) on your clothes and hat. Pyrethins are natural, organic insecticides. Do not wear the clothes until the pyrethin  has dried. It is heratening to know that according to emedicine.com, fewer than five percent of bites result in Lyme disease.

MORE RESOURCES: 

• Florida Poison Information Center, 1-800-222-1222 (staffed  24/7)
• Florida Department of Health
• Pinellas County Health Department
• U.S. Department of Health & Human Services
• American Association of Poison Control Centers
• Information on insect repellents from the Environmental Protection Agency. 
• National Pesticide Information Center (questions about DEET) 1-800-858-7378

Now that you know the symptoms and potential treatments, always be prepared.