Insect Bites

Itchy itchy scratchy scratchy, ooh I got one down my backy! – camp song

When our Cub Pack needed to enter a woody area to search for insects, the boys objected, “We can’t go in the woods. We might get ticks.” Scouting was founded over a hundred years ago to teach wilderness survival skills to clueless young boys from the cities. Now it seems the youth have gone from clueless to terrified of the great outdoors.

With picnic season resuming, families will venture (timidly?) outdoors once more and may, quite likely, encounter insects bites and stings. The advice used to be that you had nothing to worry about if you weren’t allergic to bee stings, etc. Today with West Nile Virus and Lyme disease the story is more complicated.

• West Nile Virus killed 44 people in 2008 (mostly adults over 50, rarely children) with some 2000 reported infections. A person is 1000 times more likely to die from the flu (36,000 deaths). So while “safe”, it’s no fun being bitten by a mosquito. Simple precautions include long pants and shirt sleeves and the use of insect repellant like DEET. The FDA recommends keeping kids' nails short so they don’t break the skin when scratching bug bites. A scratch with dirty nails could lead to a bacterial infection that will require treatment with antibiotics.
  
• Lyme disease is more common with 27,000 cases reported in 2007. Death is “rare” and I could find no numbers online for anyone killed. Lyme disease is easily treated with antibiotics if caught in the early stages but untreated can lead to extreme fatigue, joint or muscle pain, facial paralysis, heart damage, psychological disturbances, stomach problems, neurological disorders, blindness, and deafness. My wife and I and our dogs have all had Lyme. We spotted the bulls-eye shaped rash around the bite and took the antibiotics. We also ask for Lyme testing along with the traditional blood tests when we get a physical.

Lyme can also be prevented by daily full body tick checks. Early removal of a tick is important because a tick generally has to be on the skin for 36 hours to transmit Lyme disease. The ticks are very small and tricky to spot when not filled with blood. See How to Remove a Tick for more information.

Bottom Line
The most likely insect problem at a picnic will be a bee sting. Don’t use tweezers!. A bee will leave behind a stinger attached to a venom sac. Try to remove it as quickly as possible by scraping the skin with a credit card. If you pull with tweezers you might squeeze all the venom into the person you are trying to help. Wash the sting and apply an ice pack. Give acetaminophen or ibuprofen for pain (never aspirin with children.) No medical attention is needed UNLESS one of the following occurs:

• The person has a known bee allergy or has these symptoms:
• wheezing or difficulty breathing
• tightness in throat or chest
• swelling of the lips, tongue, or face
• dizziness or faintingnausea or vomiting
  
• The mouth region was stung. Oral swelling may block airways


• A large skin rash or swelling or pain persists from more than three days around the sting site. This could indicate an infection.