17 May 2007

Insect bite avoidance measures – an update for the summer months

In temperature regions of Europe and North America, the late spring, summer and early autumn are peak times of year for insect borne infections such as Lyme disease, Tick-borne encephalitis (TBE), and Babesiosis (transmitted by ticks), and West Nile virus (transmitted by mosquitoes).

Health professionals should stress the importance of insect bite avoidance measures to travellers visiting these regions. Travellers at particular risk for exposure to ticks are those undertaking outdoor activities, such as walking or camping in grassy and forested areas.

Bite avoidance advice:

• Wear loose fitting clothing that covers up skin as much as possible
• Apply insect repellents to exposed areas when outdoors. Repellents that contain DEET are considered the most effective.
• Manufacturer's instructions for repellents should be followed; they should not be applied to mucous membranes, open lesions or abraded skin
• Clothing may be treated with insecticide sprays.
• Travellers in grassy or woodland areas should wear long trousers and tuck the legs into their socks.
• Check clothes and skin for ticks on a regular basis. The larval form of Ixodes ticks, the species that transmits Lyme disease, Babesiosis and TBE, is tiny and difficult to see. Adult ticks, once they have fed and become engorged, may be the size of a coffee bean. Common areas for ticks to attach are at the hair-line, behind the ears, elbows, backs of knees, groin and armpits.
• Remove ticks as soon as possible by using a pair of tweezers or tick remover.  The tweezers should be placed as close as possible to the skin and then the tick removed slowly. Care needs to be taken not to squeeze the stomach contents of the tick into the site of the bite.
• Make sure that indoor accommodation is screened to prevent mosquitoes from entering
• Mosquito coils may be used in well-ventilated areas and can be useful for campers. A small piece of the coil lit under the table can be a deterrent when dining at outdoor restaurants
• Insecticide-treated netting can be placed around beds

Travellers should be advised to report symptoms upon return from travel, such as a non-specific flu-like illness, headaches, skin rash or fevers. Health professionals should familiarise themselves with the common signs and symptoms which may occur from diseases transmitted by insects. A detailed travel history should be included with any request for investigations.

Links

NaTHNaC Health Information Sheet – Insect bite avoidance.

http://www.nathnac.org/travel/misc/travellers_mos.htm

NaTHNaC Health Information Sheet – Tick-borne encephalitis.

http://www.nathnac.org/travel/factsheets/

Tickborneencephalitis.htm

HPA.Tick awareness

http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPA

web_C/1195733767621?p=1191942172156

NaTHNaC Health Information Sheet – Lyme disease

http://www.nathnac.org/travel/factsheets/lyme.htm

NaTHNaC Health Information Sheet – West Nile Virus

http://www.nathnac.org/travel/factsheets/west_nile.htm