July 2018: What to do about Insect bites and Stings

The Rural Pharmacist: What to do about Insect bites and Stings

-Henry Tempelman, Pharmacist & Owner

Summer is here! But so are the bugs. Big ones, little ones, furry ones, some of them sting, some of them make you itch. Many of us wish mosquitoes would fly far away to never bother us again, but insects are beneficial for our ecosystem. However, that doesn’t mean that we shouldn’t try keep our distance. Insects can carry a variety of diseases depending on where the insect lives in the world, although serious health consequences from insect stings are rare in Canada and usually result from anaphylaxis reactions.

            What kind of insects should we watch for in our area? Well, it’s no secret.. theses critters have likely introduced themselves to you already, whether or not you were looking for an introduction.

Mosquitos- Our unofficial regional mascot! Look for 1 of 3 ingredients in your insect repellant: Deet, Picaridin or plant-derived chemical such as Oil of Lemon Eucalyptus. Most commonly used, Deet has had some controversy about its safety, but when used properly it is safe to use in children older than 2. Avoid Deet in children less than 2 years of age and avoid spraying around their eyes or mouth or on their hands. The best way to protect a young child, or even an adult, is to cover skin with proper clothing or an elastic mosquito netting on a car seat/stroller. A deet concentration of 5%-10% is good for children and a concentration of 30% for adults typically offers a few hours of protection, but keep in mind the higher the deet concentration the higher the susceptibility to skin irritation.

            Picaridin (PiActive) at concentrations of 20% is deemed as effective as deet. Oil of Lemon Eucalyptus (Natrapel) has a more lax safety testing and shouldn’t be used in children under 3. Concentrations around 30% have proven to be effective in adults.

            Using sunscreen and insect repellant? Apply the sunscreen first and allow 20 minutes for it to absorb insect repellant application.

            Got a few mosquito bites? Try not to scratch to avoid wounds that can lead to an infection. Hydrocortisone cream, After-Bite or Calamine lotion offers effective itch relief.

Bee Sting/Wasp- The fuzzy bees are cute and honey is delicious. We love these little guys! ..until they sting. Following a sting, symptoms include pain for 1-2 hours, followed by 48 hours or more of swelling and itch. An oral antihistamine like Benadryl, Reactine or Claritin (or the generics) will help reduce the symptoms of itching and swelling of a sting. Oral Benadryl will cause more sedation than the other antihistamines while topical Benadryl is not recommended for the relief of itching due to a risk of contact dermatitis.  Consider regular doses of ibuprofen or acetaminophen to treat the pain associated with the sting.

An anaphylactic or allergic reaction could include trouble breathing , difficulty swallowing, change in heart rate or hives. This anaphylactic reaction can occur within minutes or up to 72 hours following the initial sting. Benadryl is a more effective antihistamine to treat anaphylactic reactions.  An Epi-Pen comes is very important and effective to temporarily reverse an anaphylactic reaction. If giving an Epi-Pen for anaphylaxis, be sure to get the treated person to the hospital because a second reaction is likely to occur within 4-6 hours of the initial reaction.  Be sure to let friends and family know about your Epi-Pen so that they know what to do if you need it. Don’t forget to regularly check the expiry date either! Good news: OHIP+ covers Epi-Pens now for people less than 25 years of age as of January 1st, 2018! Give us a call if you have any questions about coverage for your Epi-Pens!

Ticks- The tick population has been on the rise. These critters attach by the mouth and feed until engorged with blood and fall off. The most common reaction is a red papule and swelling at the site, which may progress to bruising, blistering or infection.

            The black-legged tick, or deer tick, can carry Lyme Disease. The tick must be attached for 36 hours to transmit the bacteria that causes Lyme Disease. Lyme Disease appears as a rash that appears as a bulls eye from 3-30 days after tick exposure. Common symptoms include flu-like symptoms, headache, lethargy and fatigue. If left untreated, the infection can spread over several weeks and lead to more severe symptoms of Bell’s Palsy, neck stiffness and joint pain. Antibiotic treatment for several weeks may be required to cure Lyme Disease.

            Check your animals or family members for ticks as they can pick them up in long grassy areas.  If you are removing a tick from an animal or human, use tweezers and pull gently. It may take up to a minute and you don’t want to break the head of the tick off under your skin! Our nurse in Kakabeka can also help you! You can pick up tick removal kits from the Thunder Bay District Health Unit and submit  the tick to the health unit for testing.

            Summer is a great time to enjoy the beautiful outdoors. Be sure to take proper precautions to avoid these pests. Don’t hesitate to call us at either of our convenient locations if you have any questions!