Mother spraying daughter's leg with bug repellent Summer is a great time to explore the great outdoors with your kids, and there are loads of health reasons to get outside and enjoy nature. Unfortunately, tick and mosquito bites come as part of the package.

Both types of bugs carry diseases, and the Centers for Disease Control and Prevention (CDC) has issued an alert about the growing incidence of these illnesses. The number of cases in the U.S. has tripled since 2004. In the same period, nine new bug-borne diseases have been identified in the country.

There are several types of ticks, each of which can carry different diseases. Deer ticks carry Lyme disease, and Pennsylvania has more cases than any other state.

So in the face of this unsettling news, how can you protect yourself and your kids from tick and mosquito bites? And what should you do when you are bitten?

“Worry about bug bites shouldn’t keep you indoors,” says Michael Russo, MD, a specialist in pediatric infectious diseases at Children’s Hospital of Philadelphia (CHOP). “Just take some basic steps to reduce the risk of bites and practice good removal techniques if your child is bitten by a tick.”

Prevent bug bites

To prevent mosquito and tick bites, use insect repellent, Dr. Russo advises. When used as directed, repellents with up to 30 percent DEET are safe and effective for children and for pregnant and breastfeeding women.

Picaridin is another safe and effective repellent. The Environmental Protection Agency (EPA) offers an online guide to registered insect repellents, showing the active ingredient and its concentration percentage for each product.

After your child’s outdoor adventure, wash the repellent off with soap and water.

Extra tick precautions

Preventing tick bites requires some extra precautions. Ticks live in woods, brush and long grass. If you or your child will be in an area that might be home to ticks, wear enclosed shoes (not sandals) and long pants tucked into socks. Light-colored clothing can help you spot ticks before they crawl onto your skin. For extra protection, spray clothes — not skin — with permethrin, following the product’s instructions.

When you come back from a walk in an area with ticks, remove all clothes and do a careful tick check. Look behind the ears, along the hair and waistline, and behind the knees. Check your child’s back and have someone check yours.

Ticks can come indoors on a pet and climb onto you and your children. So if you have a dog or cat that goes outdoors, do a daily tick check on your pet. Ask your vet about the best way to keep your pet tick-free.

What to do if your child is bitten by a tick

If you find a tick fastened onto the skin, remove it with tweezers by grabbing near the head and pulling upward gently. Then flush it down the toilet. You don’t need to save the tick, but a picture of it on your cell phone can be useful to identify it if you need to seek medical care.

After the tick has been removed, clean the bite with warm water. Applying rubbing alcohol or first-aid ointment can help reduce the irritation that follows a tick bite.

Some skin reaction to a tick bite is normal. The spot will usually develop a small pimple-like bump for a few days. If you find and remove ticks promptly, within 36 hours, the chance of getting sick is minimal.

If a deer tick bite escapes notice for more than 36 hours, you’ll need to watch for signs of Lyme disease after you remove it. These include a rash spreading out from the area of the bite, or a fever. Signs of Lyme disease and other tick-borne illnesses appear a few days to two weeks after the bite.

“Don’t panic — most tick bites don’t lead to infections,” says Dr. Russo. “If you notice symptoms, call your primary care provider. Lyme disease and other tick-borne infections are easily and effectively treated with antibiotics.”

Other insect-borne illnesses

Other tick- and mosquito-borne diseases make news at times, but are less of a problem in our area.

  • West Nile virus is carried by mosquitos and can make people very sick, but it affects fewer than 30 people in Pennsylvania each year. That compares with close to 10,000 confirmed cases of Lyme disease each year in the state.
  • Zika virus poses a risk for pregnant women, but the mosquito that carries the disease lives only in tropical climates. If you are planning a trip, check the CDC website for current information about Zika virus and other travel-related infections.
  • Other tick-borne illnesses in our area include ehrlichiosis, anaplasmosis, babesiosis and Rocky Mountain spotted fever, though all are uncommon. Fever, rash and headaches are key symptoms of most of these diseases, starting a few days after a tick bite. As with Lyme disease, call your primary care provider if you see signs of illness following a tick bite.

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