I recently read an article comparing insect repellents published by The Medical Letter. I have decided to summarize that information, since insect season is fast approaching.
The CDC recommends insect repellents to prevent West Nile virus infections, as well as to protect against ticks which transmit Lyme disease.
DEET - the topical insect repellent with the highest documented effectiveness; varies in concentration of DEET between products. DEET is considered safe in children and infants over the age of 4 months, and the AAP recommends using formulations containing no more than 30% DEET in children. A long-acting formulation originally developed for the Armed Services contains 34% DEET and has been shown to be effective for 6-12 hours (Ultrathon lotion). Sawyer manufactures controlled release products in both 20% and 30% concentrations, and states that the 30% Liposome Controlled Release product protects up to 11 hours. DEET can cause side effects of skin rash and irritation; serious side effects are rare. DEET can damage clothes made from synthetic material, plastics and watch crystals. Obviously, one should wash hands well after applying.
Picaridin - pesticide used against flies, mosquitoes, chiggers and ticks; studies have shown 19.2% picaridin was as effective as Ultrathon with 34% DEET in preventing mosquito bites. Picaridin does not cause as many local reactions on the skin as DEET, and does not damage fabric or plastic.
IR3535 - Available in concentrations of 7.5% and 20% in combination with sunscreen (includes Avon Skin So Soft Bug Guard Plus IR 3535 and Bull Frog Mosquito Coast). Several studies found the 7.5% concentration to be ineffective, and the 20% concentration to be effective for several hours. The CDC does not recommend its use because of the included sunscreen, which would need to be applied more often for sun protection. IR3535 is effective for both mosquitoes and ticks.
Oil of Lemon Eucalyptus (OLE) - In studies against mosquitoes, may provide up to 6 hrs of protection; should not be used in children under age 3. Several sources suggest OLE may be effective against ticks as well, and I found one study that concluded that 30% OLE was as effective as 10-15% DEET in preventing mosquito bites.
Citronella - provide short-term protection against mosquitoes, and are probably not effective against ticks.
Essential Oils - including clove, geraniol and patchouli, provide limited and variable protection against mosquitoes.
Permethrin - A contact insecticide used commonly in head lice remedies, it is used on clothing, mosquito nets, tents and sleeping bags for protection against mosquitoes and ticks. It remains active for several weeks, through repeat laundering.
Wednesday, April 24, 2013
Monday, April 15, 2013
Roseola
It's April, and flu season (for the most part) is behind us. Starting in the Spring and Summer, another family of viruses visit us causing fevers and rashes, particularly in younger children. Most of these viruses belong to a larger group called Enteroviruses, though Roseola belongs to the herpes virus family.
Roseola, also called Exantema subitum, "Sixth's disease" or "Three day fever", typically affects children under the age of two. Roseola is caused by two human herpes viruses (predominantly HHV-6, and sometimes HHV-7) - these are not the herpes viruses that cause fever blisters or genital herpes.
Infection with Roseola viruses tends to occur more often in children between the ages of 6 months and 2 years. The infection begins with a sudden fever, which can be quite high (102-104 degrees). The abrupt rise in body temperature may cause a febrile seizure, but in most cases, the children otherwise appear normal, with no other associated symptoms. After a few days of daily fever (classically 5 days), the fever subsides THEN a red or pink bumpy rash develops. The rash begins on the trunk, may be more noticeable after a bath, and then spreads to the arms and legs. The rash is not itchy and may last several days.
Roseola is self-limited, there is no vaccine and no specific treatment is necessary. Tylenol (Acetaminophen) or Ibuprofen may be used to decrease your child's fever, and you should make sure your child is drinking plenty of fluids.
Here are pictures of the typical Roseola rash on the trunk:
Roseola, also called Exantema subitum, "Sixth's disease" or "Three day fever", typically affects children under the age of two. Roseola is caused by two human herpes viruses (predominantly HHV-6, and sometimes HHV-7) - these are not the herpes viruses that cause fever blisters or genital herpes.
Infection with Roseola viruses tends to occur more often in children between the ages of 6 months and 2 years. The infection begins with a sudden fever, which can be quite high (102-104 degrees). The abrupt rise in body temperature may cause a febrile seizure, but in most cases, the children otherwise appear normal, with no other associated symptoms. After a few days of daily fever (classically 5 days), the fever subsides THEN a red or pink bumpy rash develops. The rash begins on the trunk, may be more noticeable after a bath, and then spreads to the arms and legs. The rash is not itchy and may last several days.
Roseola is self-limited, there is no vaccine and no specific treatment is necessary. Tylenol (Acetaminophen) or Ibuprofen may be used to decrease your child's fever, and you should make sure your child is drinking plenty of fluids.
Here are pictures of the typical Roseola rash on the trunk:
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