A bite involves
biting with the insect's mouth parts and removing a drop of blood from
the human. A sting involves injecting a poison into the human from the
insect's stinger. The following three types of bites or stings are covered:
1) Bee and yellow jacket stings
2) Itchy or painful bites
3) Tick bites
BEE
AND YELLOW JACKET STINGS
Definition:
Your child was stung by a honeybee, bumblebee, hornet, wasp, or yellow jacket. Over 95% are from yellow jackets. These stings cause immediate painful red bumps. Although the pain is usually better in 2 hours, the swelling may increase for up to 24 hours. Multiple stings (more than 10) can cause vomiting, diarrhea, a headache, and fever. This is a toxic reaction related to the amount of venom received (i.e., not an allergic reaction). A sting on the tongue can cause swelling that interferes with breathing.
Home Care:
Treatment - If you see a little black dot in the bite, the stinger is still present (this occurs only with honeybee stings). Remove it by scraping it off. If only a small fragment remains, don't worry about it. Then rub each sting for 20 minutes with a cotton ball soaked in a meat tenderizer solution. This will neutralize the venom and relieve the pain. If meat tenderizer is not available, apply aluminum-based deodorant or a baking soda solution for 20 minutes. For persistent pain, massage with an ice cube for 10 minutes. Give acetaminophen or ibuprofen immediately for relief of pain and burning.
Prevention:
Some bee stings can also be prevented by avoiding gardens and orchards and by not going barefoot. Insect repellents are not effective against these stinging insects.
CALL OUR OFFICE
IMMEDIATELY if:
- Breathing or swallowing is difficult (call 911).
- Hives are present.
- There are 10 or more stings.
- Your child starts acting very sick.
DURING REGULAR HOURS if:
- Swelling of the hand (or foot) spreads past the wrist (or ankle).
- You have other questions or concerns.
ITCHY
OR PAINFUL INSECT BITES
Definition:
Bites of mosquitoes, chiggers, fleas, and bedbugs usually cause itchy, red bumps. The size of the swelling can vary from a dot to 1/2 inch. The larger size does not mean that your child is allergic to the insect bite. Mosquito bites near the eye always cause massive swelling. The following are clues that a bite is due to a mosquito: itchiness, a central raised dot in the swelling, bites on surfaces not covered by clothing, summertime, and the age of the child (i.e., she is an infant). In contrast to mosquitoes, fleas and bedbugs don't fly; therefore, they crawl under clothing to nibble. Flea bites often turn into little blisters in young children.
Bites of horseflies, deerflies, gnats, fire ants, harvester ants, blister beetles, and centipedes usually cause a painful, red bump. Within a few hours, fire ant bites change to blisters or pimples.
Home Care:
Itchy Insect Bites - Apply calamine lotion or a baking soda paste to the area of the bite. If the itch is severe (as with chiggers), apply nonprescription 1% hydrocortisone cream 4 times daily. Another way to reduce the itch is to apply firm, sharp, direct, steady pressure to the bite for 10 seconds. A fingernail, pen cap, or other object can be used. Encourage your child not to pick at the bites or they will leave marks.
Painful insect Bites - Rub the area of the bite with a cotton ball soaked in meat tenderizer solution for 20 minutes. This will relieve the pain. If you don't have any meat tenderizer, use a baking soda solution. Give acetaminophen or ibuprofen for pain relief.
Prevention:
Mosquitoes and Chiggers - Many of these bites can be prevented by applying an insect repellent sparingly to the clothing or exposed skin before your child goes outdoors or into the woods. Repellents are essential for infants (especially those less than 1 year old) because they cannot bat the insects away.
Bedbugs - The bed and baseboards can be sprayed with 1% malathion, but young children must be kept away from the area because this substance is somewhat poisonous. You may need to call an exterminator.
Fleas - Usually you will find the fleas on your dog or cat. If the bites started after a move into a different home, fleas from the previous owner's pet are the most common cause. Fleas can often be removed by bringing a dog or cat inside the house for 2 hours to collect the fleas (they prefer the dog or cat to living in the carpet) and then applying flea powder or soap to the animal outdoors. Careful daily vacuuming will usually capture any remaining fleas.
Precautions with Diethylduamide (DEET) Insect Repellents - Insect repellents containing DEET must be used with caution. DEET can be absorbed across the skin into the bloodstream and products with high concentrations can cause seizures or coma. Young children may also have reactions to DEET from licking it off the skin. To prevent harmful reactions, take the following precautions:
- Use DEET products formulated for children. These contain 10% or less DEET. Even adults don't need more than a 30% DEET concentration.
- Apply repellent mainly to clothing and shoes.
- To prevent contact with the mouth or eyes, don't put any repellent on the hands.
- Don't put any repellent on areas that are sunburned or have rashes because the DEET is more easily absorbed in these areas.
- Warn older children who apply their own repellent that a total of 3 or 4 drops can protect the whole body.
- Because one application of repellent lasts 4 to 8 hours, apply it no more than twice daily.
- If repellent is put on the skin, wash it off after your child comes indoors.
CALL OUR OFFICE
IMMEDIATELY if:
- The bite looks infected (yellow pus, spreading redness, red streaks).
DURING REGULAR HOURS if:
- Itching or pain is severe after treatment.
- You have other questions or concerns.
TICK BITES
Definition:
A tick is a small brown bug that attaches to the skin and sucks blood for 3 to 6 days. The bite is usually painless and doesn't itch. The wood tick (or dog tick), which transmits Rocky Mountain spotted fever and Colorado tick fever, is up to 1/2 inch in size. The deer tick, which transmits Lyme disease, is the size of a pinhead.
Home Care:
Tick Removal - The simplest and quickest way to remove a wood tick is to pull it off. Use a pair of tweezers to grasp the tick as close to the skin as possible (try to get a grip on its head). Apply a steady upward traction until the tick releases its grip. Do not twist the tick or jerk it suddenly because these maneuvers can break off the tick's head or mouth parts. Do not squeeze the tweezers to the point of crushing the tick; the secretions released may contain germs that cause disease.
If tweezers aren't available, use fingers, a loop of thread around the tick's jaws, or a needle between the jaws for traction. Tiny deer ticks need to be scraped off with a knife blade or the edge of a credit card. If the body is removed but the head is left in the skin, use a sterile needle to remove the head (in the same way that you would remove a sliver). Apply antibiotic ointment to the bite once.
Wash the wound and your hands with soap and water after removal. A recent study by Dr. G. R. Needham showed that embedded ticks do not back out with the application of a hot match or when covered with petroleum jelly, fingernail polish, or rubbing alcohol. We formerly thought that petroleum jelly, fingernail polish, or alcohol would block the tick's breathing pores and take its mind off eating. Unfortunately ticks breathe only a few times per hour.
Prevention:
Children and adults who are hiking in tick-infested areas should wear long clothing and tuck the end of the pants into the socks. Apply an insect repellent to shoes and socks (permethrin products are more effective than DEET products against ticks). During the hike perform tick checks using a buddy system every 2 to 3 hours to remove ticks on the clothing or exposed skin. Immediately after the hike or at least once daily, do a bare skin check. A brisk shower at the end of a hike will also remove any tick that isn't firmly attached. Because the bite is painless and doesn't itch, the child will usually be unaware of its presence. Favorite hiding places for ticks are in the hair, so carefully check the scalp, neck, armpit, and groin. Removing ticks promptly may prevent infection because transmission of Lyme disease requires 18 to 24 hours of feeding. Also the tick is easier to remove before it becomes firmly attached.
CALL OUR OFFICE
IMMEDIATELY if:
- You can't remove the tick.
- A fever or rash occurs within the 2 weeks following the bite.
- Your child starts acting very sick.
DURING REGULAR HOURS if:
- You think your child might have Lyme disease.
- You have other questions or concerns.
Adapted from Instructions for Pediatric Patients by Barton Schmitt (2nd edition, 1999) with permission from the author.
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