Using repellent to protect children from mosquito bites

Donya Betancourt, Pediatrician, drdonya@hotmail.com

Insects and mosquitoes are dangerous and annoying. They are dangerous because they transmit diseases like encephalitis (brain inflammation), malaria and dengue fever.

The most effective products for repelling insects contain the chemical N, N-diethyl-meta-toluamide, commonly known as DEET.

Moisture, warmth, carbon dioxide and odors produced by humans are all attractive to mosquitoes. Repellents work by blocking the receptors on mosquitoes' antennae, which normally hone in on these attractants.

DEET repels insects rather than killing them and remains the gold standard of repellents. For repellents to be 100 percent effective, all exposed skin must be covered with repellent. Mosquitoes will readily find and bite any area of untreated skin.

The repellents are available in various forms and concentrations. Products with a low concentration of active ingredients may be appropriate for situations where exposure to insects is minimal. A higher concentration of active ingredients may be useful in highly infested areas or with insect species that are more difficult to repel.

And where appropriate, consider nonchemical ways to deter biting insects such as screens, netting, long-sleeves and slacks. As we know, it does not take a high concentration of mosquito repellent with DEET to provide a effective deterrent to mosquitoes. Typically, a 25 percent to 30 percent concentration of DEET is sufficient for both adults and children. This will provide protection for about five hours, while a product with 5 percent to 7 percent DEET only lasts between one and two hours.

In general, use the lowest effective concentration of DEET to minimize the risk of side effects. A higher concentration of DEET generally lasts longer on your skin, but a concentration of more than 50 percent DEET is rarely necessary.

The Environmental Protection Agency (EPA) recommends the following precautions when using insect repellents:

* Read and follow all directions and precautions on the product label.

* Verify that the repellent is EPA approved. Products should have written on the label, "Apply repellents only to exposed skin and/or clothing as directed on the product label. Do not use under clothing."

* Never use repellents over cuts, wounds or irritated skin.

* Do not apply to eyes and mouth and apply sparingly around ears. When using sprays do not spray directly onto face, spray on hands first then apply to face.

* Do not allow children to handle the products and do not apply to children's hands, because children are likely to put their hands into their mouths. When using on children, spray product onto your hand and then apply to child's skin.

* Do not spray in enclosed areas. Avoid breathing in a repellent spray, and do not use near food.

* Use just enough repellent to cover exposed skin and/or clothing. Heavy application and saturation is generally unnecessary for effectiveness.

* After applying wipe or wash the repellent from your palms to prevent inadvertent contact with your eyes, mouth or genitalia.

* Once inside, wash treated area with soap and water

If you don't want to use a product that contains DEET, other products are available that can give you limited protection. Plant-based repellents generally show effectiveness for a shorter period of time, usually less than two hours.

But based on extensive toxicity testing, the EPA believes that the normal use of DEET does not present a health concern to the general population.

Here again we are faced with a situation where prevention is preferred to treatment. Repellents are poison and dangerous. Remember to check the container, read the label before using, follow instructions and most importantly, store all poisons in a locked utility cabinet out of the reach of children.