Insect bites

Sorting through the heap of photos from our vacation on the east coast last summer, I was stumped by what looked like a close-up of one of my kids’ limbs. Then I remembered our three-year-old son had been bitten several times by some kind of insect during a stroll through the brush. What I didn’t know was that my husband had been worried enough about the angry, red bumps to snap a photo. Luckily, nothing came of the bites, but it’s not always easy to know.

In rare cases, serious complications can arise from bug bites (see When It’s More Than a Bug Bite). But for most kids, run-ins with bugs cause nothing more than minor discomfort and aren’t reason enough to skip family hikes or playground time. Here are some tips for preventing, recognizing and treating bites and stings.

Flies and mosquitoes

Bugs that make a meal of our blood and leave their saliva behind include the blackfly, horsefly, deer fly and the dreaded mosquito. Though some of us especially attract these biters, there are ways to reduce the chances of being bitten.

Prevention Many things have been tried, but repellent (containing DEET or other Canadian-approved ingredients) is still the best way to keep mosquitoes at a distance, according to Robbin Lindsay, a Winnipeg research scientist with the Public Health Agency of Canada (see The Dirt on DEET).

You can also curb the local insect population by removing stagnant water from areas where kids play: Turn over backyard toys and wading pools, and clear out eavestroughs and gutters.

Move playtime indoors at peak mosquito times — dawn and early evening. Dress kids in light-coloured clothing that gives maximum coverage. Cover babies under two as much as possible, and use bug-proof netting for your stroller.

Treatment Itching and swelling are the main symptoms to manage when kids do get bitten. Try a soothing lotion such as calamine; if symptoms persist, talk to your doctor or pharmacist about an antihistamine.

Bees and wasps

Stinging bugs are the ones most kids learn to avoid early on — most likely because they’ve seen us quickly move away from them. But despite the anxiety they cause, bees and wasps don’t often sting people. When they do, it’s important to know that their stingers can be left behind and they should be removed as soon as possible to minimize exposure to the venom. You can remove a stinger by gently scraping the skin horizontally with the edge of a credit card or your fingernail.

Prevention To protect against bees and wasps, skip scented soaps and save bright-coloured clothing for indoor play. Leave pop cans out of your picnic basket — pack sippy cups and sports bottles instead — and don’t play near areas where stinging pests congregate (especially open garbage cans).

Treatment Stings will cause pain, swelling and itching. Symptoms can generally be treated with over-the-counter remedies such as ibuprofen or acetaminophen, and calamine lotion. Visit your doctor if a rash appears or the pain lingers longer than three days, as these can be signs of infection. A sting anywhere in the mouth requires careful attention, as it can lead to swelling that blocks the airways (see When It’s More Than a Bug Bite).

Ticks

Parks with known tick populations post warning signs in hot spots.

Prevention Repellent and proper clothing are the first line of defence against this lesser-known insect. Tuck pants into socks and make sure shirts and jackets have cuffs. Try to keep little wanderers on marked trails; that way they’re less likely to rub up against the brush where ticks make their homes.

If your family will be camping or hiking in wooded areas, it’s important to know where ticks live, what they look like (size of a sesame seed, reddish-brown in colour) and how to spot them (take off clothes and do a head-to-toe scan). There is a 24- to 36-hour grace period during which a tick can be removed before it transfers any bacteria (such as the one that causes Lyme disease).

Treatment If you find a tick on your child, remove it right away by graspng the head as close to the skin as possible and pulling it straight out. Then wash the area with soap and use a first-aid antiseptic on the bite. Visit the doctor if you think the tick was on your child for more than 24 hours, or if part of the tick remains after an attempted removal. It’s also a good idea to bring the removed tick with you to the doctor in case it needs to be tested or identified. If your child develops a rash of any kind (especially a red-tinged bull’s-eye rash) or complains of any flu-like symptoms, you should get medical attention immediately.

Spiders

Like bees and wasps, spiders inject their victims with venom. But it sounds worse than it is — of the thousands of species of spiders found in Canada, few are considered a serious health threat.

Prevention Spiders are not social creatures and often lurk in hard-to-see places. Keep an eye on sheds, woodpiles, storage areas or any places left undisturbed for long periods of time.

Treatment Most spider bites cause a mild reaction in children and can be treated at home with an antibiotic ointment and medication for pain.

When it's more than a bug bite

Allergies Children can have life-threatening anaphylactic reactions to insect bites, particularly bees and wasps, but it’s extremely rare. When a child is bitten or stung, especially for the first time, watch for symptoms such as swelling of the face or mouth, difficulty swallowing, shortness of breath, wheezing, dizziness, fainting and abdominal pain, which all require immediate medical attention.

West Nile Mosquitoes can carry this disease, but while kids are as likely as adults to be exposed to the virus (maybe more so, given the time they spend playing outdoors), they are less likely to develop health problems. When symptoms do occur, they are often flu-like and pass without incident, explains Robbin Lindsay, a research scientist at the Public Health Agency of Canada (PHAC). But, she adds, there have been rare cases of encephalitis (inflammation of the brain) and neurological disease reported in children as a result of exposure to West Nile virus.

Lyme disease Though rare, Lyme disease can be contracted through tick bites. It is often difficult to diagnose because its symptoms can mimic other health problems. In most cases, a rash develops at the site of the bite, followed by fatigue, chills, fever, headache, muscle and joint pain, and swollen lymph nodes. For more information, go to the PHAC website, phac-aspc.gc.ca, and click on Infectious Diseases.

The dirt on DEET

The Canadian Paediatric Society considers DEET, when applied in recommended concentrations, the most effective protection for children against bugs. Here are the amounts considered safe for children:

Children under 6 months No DEET — use protective clothing and netting
Children 6 months to 2 years 10% once a day in high-risk areas only
Children 2 to 12 years 10% DEET 3 times a day
Children over 12 years 30% DEET — reapply as needed

Other tips:
• Do not use DEET if pregnant or breastfeeding.
• Use repellent made for children.
• Apply sunscreen before repellent.
• Apply on top of clothing or exposed skin, not underneath clothing.
• Avoid spraying children’s hands, to prevent getting DEET in eyes or mouth.
• Do not apply to irritated or sunburned skin.

Source: Canadian Paediatric Society