Category: First Aid and Safety

Dry Drowning – Hype or Hazard

Every day, about two or three kids drown in the United States.

And that’s why drowning is a leading cause of death for children and teens. In fact, it is the number two cause of unintentional death, right after motor vehicle traffic accidents. Not surprisingly, drowning is the number one cause of death for toddlers and preschoolers.

So, what are many parents afraid of?

Dry Drowning

Although the focus should be on making sure you learn CPR, fence off your pool, supervise your kids around water, and have them wear a Coast Guard approved life jacket around the water, some parents are overly worried about dry drowning instead.

“Parents are being unduly alarmed by media reports suggesting that children can die from drowning a week after swimming,” said Rebecca Parker, MD, FACEP, president of the American College of Emergency Physicians. “Some children can experience complications from swimming. For example, it is possible for a child to inhale water and develop an infection, such as pneumonia, which can become very serious and cause breathing problems. If a child has breathing problems at any time, the parent should take him or her to the emergency department. But there are no cases of completely normal, asymptomatic patients who suddenly die because they went swimming a few days ago. It’s also time to retire those incorrect terms, because it is inaccurate and incorrect to say a child was initially fine after a water event and then “dry drowned” a day or week later.”

Another story on The Today Show alerting parents to the dangers of dry drowning.
This story on The Today Show “alerting” parents to the dangers of dry drowning, ended up scaring many of them.

It isn’t hard to see why?

Although media reports of “dry drowning” deaths are rare, they are continuously shared on Facebook and other social media platforms, making it seem like they are much more common.

Still, it is important to note that what folks call dry drowning is often “delayed” drowning. Your child is not going to get sick simply because they coughed in the pool. They are going to have to cough, choke, and actually inhale some water to develop “delayed” drowning, which is rare.

Even though it is rare, you should still know about it though, right?

“You’ll want to keep a close eye on your child for about 24 hours following a close call in the water. Delayed symptoms of drowning include shortness of breath, difficulty breathing, coughing and/or chest discomfort. Extreme fatigue, irritability and behavior changes are also possible.”

Delayed Symptoms of Drowning: Know the Signs

Of course, but it shouldn’t be overblown to the point where you get panicked whenever your kids are in the water.

Or if you think more about dry drowning than you do about a much more common hazard – drowning.

What to Know About Dry Drowning Hype

Dry drowning is often a rare type of delayed drowning that occurs after a child inhales water and later develops what can become life-threatening symptoms, including fatigue, fever, coughing, and troubling breathing.

More on Dry Drowning Hype

Learn How to Spot and Treat Poison Ivy

You can probably spot poison ivy if you were looking out for it, right?

Leaves of three, let it be…

You know the problem though, right? Most of the time, you aren’t actually looking out for it.

Spotting Poison Ivy

It would be nice if we got a warning anytime we were going to be around poison ivy.

Poison Ivy Warning Sign
Our local YMCA used to have a sign warning kids to stay out of the surrounding woods.

Or if someone was nearby to point it out to us.

Poison ivy won't always be this easy to spot.
Poison ivy won’t always be this easy to spot.

That’s not usually going to happen, so you need to learn how to spot poison ivy if you want to avoid it.

What’s the first step in learning how to spot poison ivy? Understanding where poison ivy is likely to be growing.

Any “wild” area, especially along tree lines and fences, just off paths and trails, and around ponds and lakes, are likely places you will find poison ivy.

DSC_0362
Whether it is a tree line, fence, or edge of a path, you will likely find poison ivy growing nearby.
DSC_0358
Yup, there it is on one of the posts.
DSC_0366
Looks like a great place to go fishing… and get exposed to poison ivy if you aren’t careful.

If you really want to avoid getting a poison ivy rash when you are outside in an area that might have poison ivy plants, it is likely a good idea to wear long pants, a shirt with long sleeves, gloves, and boots. There are also products, like IvyX, that you can apply to your skin that are supposed to protect you from poison ivy oils.

Identifying Poison Ivy

While it is a good rule of thumb that you might run into poison ivy in a wild area, in some parts of the country, you might even encounter poison ivy in your own backyard. That’s why learning how to identify poison ivy plants is so important, especially if you or your kids have severe reactions to these plants.

This poison ivy plant is growing out of the edge of a lawn.
This poison ivy plant is growing out of the edge of a lawn. Photo by CDC/ Dr. Edwin P. Ewing, Jr..

What’s the key to identifying poison ivy? That’s right – think of the old adage – leaves of three, let it be.

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Birds eat the poison ivy berries and poop out the seeds, which is why you find these plants growing along tree lines… or in your garden.
Poison ivy plants use aerial roots to grab on to trees and fences.
Poison ivy plants use aerial roots to grab on to trees and fences.

There is a little more to it than that though. After all, other plants have three leaves. If you really want to be a pro at identifying poison ivy, you also need to know that with poison ivy:

These dead poison ivy plants on this tree could still trigger a reaction.
The dead poison ivy plants clinging to this tree could still trigger a reaction.
  • the middle leaflet has a longer stalk (petiole) than the other two
  • leaflets are fatter near their base, but are all about the same size, are green in the summer, and can be red in the fall
  • you can sometimes find poison ivy plants with clusters of green or white berries
  • their stems don’t have thorns, but do have aerial roots, which help them cling to trees and fences

Most importantly, understand that even a dead poison ivy plant or a plant without leaves can trigger a reaction.

Thinking about burning poison ivy? Don’t! Inhaling the smoke from a burning poison ivy plant can be deadly.

What about poison oak and poison sumac?

They look very similar (well, except poison sumac, which has 7-13 compound leaflets, instead of just 3), but unlike poison ivy, which grows as a vine, these other plants that can cause the same type of reaction grow as a low shrub (poison oak) or a tall shrub/small tree (poison sumac).

Avoiding Poison Ivy Rashes

If your kids are active and adventurous, it is likely going to be a little harder to avoid poison ivy than for kids who rarely go outside.

And even if they get good at spotting poison ivy, the next time they spot it, might be when they are climbing down a tree that is covered in it.

What can you do if your child is exposed to poison ivy?

  1. You can quickly cleanse the exposed areas with rubbing alcohol. How quickly? You have about 10 to 15 minutes to prevent a poison ivy reaction after an exposure.
  2. Next, rinse the exposed areas with cool water. Don’t use soap, since soap can move the urushiol around your body and actually make the reaction worse. It is the urushiol oil from the poison ivy that actually triggers your poison ivy rash.
  3. Don’t forget to scrub under your nails with a brush.
  4. Now, take a shower with soap and warm water.
  5. Lastly, put on disposable gloves and wipe everything you had with you, including shoes and tools, etc., with rubbing alcohol and water. And wash the clothes you were wearing. It is possible that urushiol that remains on these things could trigger another reaction if you touch them later.

Instead of rubbing alcohol, several over-the-counter  products are available, like Zanfel, IvyX Cleanser Towelettes, and Tecnu Extreme Poison Ivy Scrub or Cleanser.

You could even use a degreasing soap (dishwashing soap, like Dawn). One group of dermatologists has suggested that you could prevent a poison ivy rash after getting exposed by using a damp washcloth and liquid dishwashing soap, washing for three minutes with “repetitive, high-pressure, single-direction wipes under hot, running water.” Repeat this full body wash two more times within one to two hours of your exposure.

If these methods don’t work and your child gets a poison ivy rash, look for treatments to control the itching and inflammation, which will likely mean visiting your pediatrician for a prescription for an oral steroid (tapered over two to three weeks to prevent a rebound rash) and a steroid cream. In addition, other anti-itch treatments and home remedies can be helpful, including an oral antihistamine, calamine lotion, oatmeal baths, cold, wet compresses made with Domeboro powder packets (modified Burow’s Solution), etc.

Keep in mind that without treatment, poison ivy rashes typically linger for about three weeks. Fortunately poison ivy isn’t contagious, so you wouldn’t have to keep your child our of school for that long, but except for very mild cases, see your pediatrician for treatment if they have poison ivy.

What to Know About Poison Ivy

Learn to avoid poison ivy, so that you can avoid getting a poison ivy rash.

More on Poison Ivy

Choosing the Best Sunscreen for Babies and Kids

I know, we tell you that kids should get less time in front of screens and need more time outside playing.

And we tell you that they shouldn’t be tanned or get sunburned.

In addition to raising your risk of skin cancer, sunburns are painful.
In addition to raising your risk of skin cancer, sunburns are painful. Photo by Chelsea Marie Hicks (CC BY 2.0)

So what can you do?

Sun Protection

Use sunscreen!

But you are using sunscreen and your kids still get real dark and tanned?

Then make sure to apply it 15 to 30 minutes before your kids go outside, use enough to get good coverage, and reapply it every few hours.

Any other tricks?

Slip on clothes. Slop on sunscreen. Slap on a hat. Seek shade. And Slide on sunglasses to stay safe in the sun.
SLIP on clothes. SLOP on sunscreen. SLAP on a hat. SEEK shade. And SLIDE on sunglasses to stay safe in the sun.

You want to use sunscreen every time they go out, even if it is cloudy, and not just when they are going to be at the pool all day, limit exposure during the hottest parts of the day (10 a.m. to 4 p.m.), use sun protection clothing with a UPF of 15 to 50+, a hat, and sun glasses, and find shade when it is available.

Choosing the Best Sunscreen for Babies and Kids

Are there any tricks to choosing the best sunscreen for your kids?

Although I’m sure you can find a lot of buying guides that try and score or rate sunscreens, it is a lot simpler than that.

The best sunscreen is the one that you are actually going to use and:

  1. provides broad-spectrum UVA and UVB protection
  2. has an SPF of at least 15 to 30 (you can go higher, but get a minimum of 15 to 30)
  3. is water-resistant (even if your child isn’t going to be in the water, they will likely be sweating…)

For infants, or a child with eczema or sensitive skin, also make sure your child’s sunscreen is hypoallergenic and fragrance-free.

What else?

Do you want your child’s sunscreen to be tear-free and non-greasy?

Do you want sunscreen that comes in the form of a stick, gel, foaming lotion, lotion, dry touch lotion, wet skin sprays, spray, or continuous spray?

Do you want a kids’ brand, like Aveeno Baby, Banana Boat Kids, California Baby, Coppertone Kids, Coppertone Waterbabies, Neutrogena Wet Skin Kids, Neutrogena Pure & Free Baby, etc.?

There are plenty of options to help you get a sunscreen that you will actually use regularly. Personally, I like the dry touch lotions. They go on quick and easy, don’t leave a lot of left-over residue if you over apply, and don’t leave you feeling greasy afterwards.

I strongly dislike all of the spray sunscreens. What’s my beef with them? Ever see someone apply a spray sunscreen on their kids outside? If you have, then you have seen that the sunscreen doesn’t just end up on the kid. That’s also easy to see if you ever make the mistake of trying to apply spray sunscreen inside your home. It leaves a big greasy puddle on the floor. What does that mean? You likely aren’t applying as much sunscreen as you think you are when applying a spray sunscreen.

More on Sunscreen and Protecting Kids from the Sun

What else should you know about sunscreen and keeping your kids safe in the sun?

  • It is best to keep younger infants out of the sun, until they are about six months old, when you can start using sunscreen safely.
  • An SPF or Sun Protection Factor of 15 to 30 blocks 93 to 97% of UVB rays. Going up to SPF 50 only increases that to 98%. In theory, that is supposed to mean that it would take you 50 times longer to get a sunburn wearing SPF 50 sunscreen than if you were lying in the sun unprotected. Of course, even with SPF 50, your kids would eventually get a sunburn if you didn’t reapply their sunscreen every few hours.
  • On clothing, a UPF or Ultraviolet Protection Factor rating of 15 is considered good sun protection, but for excellent sun protection, look for a UPF of 50+.
  • The UV index forecast can help you figure out when you should avoid being out in the sun, especially when UV Alerts are issued for your area.
  • Many people only use about 25% of the amount of sunscreen that is needed to provide real protection and keep kids from getting a tan or a sunburn. How much do they need? You can use the teaspoon rule (half a teaspoon for each arm, a full teaspoon for each leg, a full teaspoon for their chest, abdomen, and back, and half a teaspoon for their face, head, and neck) or just use a palmful of sunscreen to cover your child’s body. Of course, that’s your child’s palm, not yours. And for older teens and adults, you should use about 5 to 6 teaspoons of sunscreen at a time to cover your entire body.
  • If you think that your child had a reaction to their sunscreen, try a sunblock with Zinc Oxide and/or Titanium Dioxide, or simply try another sunscreen that uses different ingredients. Apply a small amount to a small area of their body to see if they have a reaction before using it regularly though.
  • Sunscreen expires and becomes less effective after its expiration date. It also needs to be stored properly. Don’t use expired sunscreen or sunscreen that has been left in a hot car.
  • The ideas around “chemical-free” sunscreens, the need to avoid certain sunscreen ingredients, and that some sunscreens are safer than others is the same kind of hype that scares folks into thinking that they have to eat organic food, avoid GMOs, and that their are toxins in vaccines.

And remember that sunscreen is for everyone, not just people with light skin.

What to Know About Sunscreen and Sun Protection

Think about sun protection before your kids go outside, making sure you use a good amount of sunscreen every time they go outside, reapplying it often, and using other methods of sun protection too, including clothing, sun glasses, and shade.

More on Sunscreen and Sun Protection

News on the Latest Food Recalls and Foodborne Disease Outbreaks

It is not unusual for a food to get recalled.

Many have to do with undeclared eggs, gluten, peanut, or milk, things that can trigger food allergies, but some are because of potential bacterial contamination.

“When two or more people get the same illness from the same contaminated food or drink, the event is called a foodborne disease outbreak.”

CDC on Reports of Selected Salmonella Outbreak Investigations

And some lead to outbreaks that get people sick.

In fact, since 2006, there have been between four and fourteen multistate foodborne outbreaks each year, involving everything from ground beef and cantaloupes to sprouts and peanut butter.

The Latest Foodborne Disease Outbreaks

Do you remember hearing about any of these outbreaks?

Unfortunately, many people don’t know about these recalls and outbreaks until it is too late – when they are or someone they know gets sick.

That’s why it’s important to stay up-to-date on the latest food recalls and outbreaks, including:

  • Honey Smacks cereal has been linked to a Salmonella outbreak.
    Honey Smacks cereal has been linked to a Salmonella outbreak.

    an ongoing Salmonella outbreak that has been linked to recalled Kellogg’s Honey Smacks cereal that has gotten at least 73 people sick in 31 states.

  • an ongoing Salmonella outbreak that has been linked to pre-cut melons from Caito Foods in Indiana that has gotten at least 60 people sick in 5 states.
  • a resolved Salmonella outbreak that has been linked to recalled shell eggs from Rose Acre Farms’ Hyde County farm of Seymour, Indiana and has gotten at least 45 people sick in 10 states. Over 200 million eggs are being recalled that were sold in restaurants and stores (Target, Food Lion, and Walmart) in Colorado, Florida, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Virginia, and West Virginia.
  • an ongoing E.coi 0157:H7 outbreak that has been linked to romaine lettuce from the Yuma, Arizona growing region and has gotten at least 197 people sick in 35 states, including 5 deaths. Although there has been no official recall, we have been warned to not buy or eat romaine lettuce from the Yuma growing region (it is no longer being sold, but some product may still be in homes) or if you don’t know where it is from.
  • a resolved Salmonella outbreak that has been linked to recalled bulk packages of International Harvest, Inc. brand Go Smiles Dried Coconut Raw that has gotten 134 people sick in 8 states

If your child is sick and has eaten any of the foods listed in an ongoing outbreak, be sure to call your pediatrician or seek medical attention.

How can you avoid these outbreaks?

“Since 1996, there have been at least 30 reported outbreaks of foodborne illness associated with different types of raw and lightly cooked sprouts. Most of these outbreaks were caused by Salmonella and E. coli.”

Sprouts: What You Should Know

Although proper cooking and food handling can help keep your family from getting sick in some cases with these recalled foods, it likely won’t with others, such as when fruits and vegetables, that you eat raw, are contaminated with bacteria.

Got Salmonella? You might, if you eat these recalled eggs.
Got Salmonella? You might, if you eat these recalled eggs.

That’s why you have to be aware of food recalls and be sure that you don’t eat foods that have been recalled, especially if anyone in your family is considered to be at high risk to get sick (younger children, anyone with a chronic illness, anyone who is pregnant, etc.). Many experts suggest avoiding those foods that are at high risk of contamination for high risk people, including raw sprouts, uncooked and undercooked beef, pork, and poultry, eggs that aren’t pasteurized, and of course, raw milk.

Also be sure to seek quick medical attention if you have eaten them and get sick (diarrhea, vomiting, abdominal pain, and fever, etc.).

What to Know About Food Recalls and Foodborne Outbreaks

It is important to be aware of food recalls and foodborne disease outbreaks, whether they are caused by Salmonella, E. coli, or Listeria, so that you can take steps to avoid those foods and keep your family from getting sick.

More on Food Recalls and Foodborne Outbreaks

Updated June 15, 2018

Child Access Prevention Laws and Gun Safety

There are many types of gun violence that gun safety advocates are concerned about, including:

  • homicides
  • mass shootings
  • school shootings
  • suicide
  • unintentional shootings

The problem isn’t just gang-bangers killing themselves, as some people who try to minimize the gun violence problem try to claim.

The American Pediatric Surgical Association, in an editorial about Firearms, Children, and Health Care Professionals, does a good job in pointing this out.

They state that “the risk of firearm homicide, suicide and unintentional injuries is more than 5-fold greater in the United States than 23 other high-income countries considered collectively. Firearm-related injury and death are issues for all Americans, in all communities. The risk of dying by firearm is the same for residents of the largest cities as it is for the residents of the smallest counties and holds true for adult and pediatric patients alike. This parity in risk is due to the predominance of firearm suicides and unintentional firearms deaths in the rural counties and the predominance of firearm homicides in the urban counties.”

Gun Safety Laws

Many new and proposed gun safety laws will hopefully help to reduce gun violence, including:

  • universal background checks and the closure of the gun show loophole
  • mental health restrictions for gun purchases
  • limitations on access to high-capacity magazines and assault-style weaponry
  • repealing the Dickey Amendment, which restricts the CDC from doing research on gun violence
  • child access prevention (CAP) laws

And we need to make mental health services more readily available to those who need them.

The March For Our Lives and National School Walkout events in March are already pushing lawmakers to make changes to keep kids safe from gun violence.
The March For Our Lives and National School Walkout events in March are already pushing lawmakers to make changes to keep kids safe from gun violence.

Surprisingly, many of these gun safety laws are supported by most members of the NRA, even if they are strongly opposed by the NRA itself.

CAP Laws

Most gun safety advocates are pushing for stronger CAP laws as a way to decrease the number of children injured and killed by unintentional shootings.

CAP laws work to limit a child’s access to guns in and around their home.

All too often, a toddler, preschooler, or older child will find a loaded, unsecured gun under a bed, on a nightstand, or in a closet, etc., and unintentionally shoot themselves or another family member.

“The safest home for a child is a home without guns, and if there is a gun in the home, it must be stored unloaded and locked, with the ammunition locked separately.”

American Academy of Pediatrics

CAP laws are not just about accidental shootings though. Kids who get access to unsecured guns also use them in suicides and school shootings.

Studies have found benefits to CAP laws, including declines in unintentional firearm death rates in children, decreases in non-fatal gun injuries, and decreases in suicide rates among teens.

Current CAP Laws

While some states have some sort of CAP law on the books already, many others don’t.

In Texas, “A person commits an offense if a child gains access to a readily dischargeable firearm (a firearm that is loaded with ammunition, whether or not a round is in the chamber) and the person with criminal negligence and failed to secure the firearm (to take steps that a reasonable person would take to prevent the access to a readily dischargeable firearm by a child, including but not limited to placing a firearm in a locked container or temporarily rendering the firearm inoperable by a trigger lock or other means) or left the firearm in a place to which the person knew or should have known the child would gain access.”

However, many other states, including Alabama, Alaska, Louisiana, Maine, New Mexico, Ohio, South Carolina, Washington, Vermont, and Wyoming, don’t have any kind of laws that would prohibit allowing kids access to unsecured firearms.

Again, that is a surprise since even the NRA advises that it is a gun owner’s responsibility to “store guns so that they are inaccessible to children and other unauthorized users.” They also state that it is a basic gun safety rule to “always keep the gun unloaded until ready to use.”

Some other states have weak or limited CAP laws that simply make you criminally liable if a child or teen gets access to a gun and uses it in a felony. For example, in Oklahoma, it is “unlawful for any parent or guardian to intentionally, knowingly, or recklessly permit his or her child to possess any of the arms or weapons,” but only if they are “aware of a substantial risk that the child will use the weapon to commit a criminal offense or if the child has either been adjudicated a delinquent or has been convicted as an adult for any criminal offense.”

And no states have all of the features of a comprehensive CAP law, which most experts advise would:

  • define a minor as being under 18 years for long guns and under 21 for handguns (in some states, a minor is only those who are 13 years old and under when it comes to child access prevention laws)
  • require that all firearms be stored with a locking device
  • impose a criminal liability on people who negligently store firearms where a minor could gain access, even if the firearm is unloaded and the minor doesn’t gain access or use the firearm
  • impose civil liability for damages if a minor gains access to a firearm that was stored negligently and causes damage after firing it

California is getting close though and is often thought of as being a leader in gun safety laws. Their CAP law was amended in 2013 (the Firearm Safe and Responsible Access Act) to make it a misdemeanor to leave an unsecured gun where a minor could find it, even if they don’t, in addition to being a misdemeanor or felony if they find and use the gun. Gun dealers also have to post warning signs educating gun buyers about the state’s CAP law.

Proposed Gun Safety Laws

According to the Giffords Law Center to Prevent Gun Violence, there are pending gun safety bills in at least 23 states, including many bills that would strengthen background checks.

Still, only 27 states and the District of Columbia have child access prevention laws.

And there is currently no national CAP law.

A bill that was introduced in 2013, the Child Gun Safety and Gun Access Prevention Act of 2013 would have come close by amending the Brady Handgun Violence Prevention Act to make it “unlawful for any licensed importer, licensed manufacturer, or licensed dealer to sell, transfer, or deliver any firearm to any person (other than a licensed importer, licensed manufacturer, or licensed dealer) unless the transferee is provided with a secure gun storage or safety device.”

Another version of the bill that was far more broad would also “Prohibit keeping a loaded firearm or an unloaded firearm and ammunition within any premises knowing or recklessly disregarding the risk that a child: (1) is capable of gaining access to it, and (2) will use the firearm to cause death or serious bodily injury.” It would also have raised the minimum ages that young people could purchase and possess handguns and long guns.

The Child Gun Safety and Gun Access Prevention Act of 2013 never made it out of committee though. It’s not hard to imagine that by “by raising the age of handgun eligibility and prohibiting youth from possessing semiautomatic assault weapons,” the bill, introduced by Congresswoman Sheila Jackson Lee from Texas, could have prevented the latest school shooting at Stoneman Douglas High School in Parkland, Florida.

Hopefully stronger gun safety laws will now be passed in more states and we will see fewer unintentional shootings and other tragedies that occur when kids find unsecured guns or buy their own, including AR-15 style guns.

parkland-survivor

In addition to other measures to reduce gun violence, the American Academy of Pediatrics supports safe storage and CAP laws.

What to Know About Gun Safety Laws

As we see more and more gun violence, including school shootings, something has to be done to protect our kids and keep them safe.

More on Gun Safety Laws

What to Do If a Mosquito Bites Your Child

Mosquito bites aren't good, but you don't have to get panicked about them.
Mosquito bites aren’t good, but you usually don’t have to get panicked about them.

Depending on where you live, a mosquito bite can be just a nuisance or it can lead to a life-threatening disease. From Chikungunya virus to Zika, most parents have learned to fear mosquito-borne diseases and because they hear about them so much, fear or even get panicked over mosquito bites.

While it is good to prepared and learn to avoid mosquito bites, you likely shouldn’t be panicked.

But even if your kids aren’t at risk for a mosquito-borne disease, it’s no fun getting bit by mosquitoes. Mosquito bites are itchy, and even when bites don’t get infected, they can leave behind crusted scabs that kids continue to pick at, over and over again.

Still no reason for panic or fear – just good reasons to learn to avoid mosquito bites.

Mosquitoes and Mosquito-Borne Diseases

Diseases that can be spread from the bite of a mosquito can include:

  • Chikungunya – can develop fever and severe and debilitating joint pain 3-7 days after a mosquito bite from Aedes aegypti and Aedes albopictus mosquitoes in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans, Caribbean countries, and most recently, in Florida, Puerto Rico, and the U.S. Virgin Islands.
  • Dengue – can cause severe flu like symptoms, including fever, severe headache, eye pain, joint and muscle pain, rash, and bleeding, after a mosquito bite in one of at least 100 endemic countries, including many popular tourist destinations in Latin America, Southeast Asia and the Pacific islands. While there are cases in the US, it is important to keep in mind that “nearly all dengue cases reported in the 48 continental states were acquired elsewhere by travelers or immigrants.”
  • Eastern Equine encephalitis – a very rare disease, which is fortunate, as it is one of the most deadly of the mosquito-borne diseases. Transmission is in and around swampy areas, with most cases in Florida, Georgia, Massachusetts, and New Jersey.
  • Filariasis – spread by repeated mosquito bites over months to years, this disease is still found in at least 73 countries in parts Asia, Africa, the Western Pacific, and parts of the Caribbean and South America, these parasitic worms can grow and live in our lymph system
  • Japanese encephalitis – you can get a Japanese encephalitis virus infection after being bit by an infected Culex species mosquito in one of 24 countries in South-East Asia and the Western Pacific, especially if you are not vaccinated.
  • La Crosse encephalitis – rare, but can occur in the upper Midwestern and mid-Atlantic and southeastern states and can cause severe disease, including encephalitis, in children.
  • Malaria – although malaria was eliminated in the US in the early 1950s, we still see about 1,700 cases each year in returning travelers. That’s because malaria is a still a big problem around the world, from certain some states in Mexico to most of sub-Saharan Africa and South Asia.
  • St. Louis encephalitis – can occur in eastern and central states, starts with mild symptoms, but can very rarely (between 1 to 12 cases a year) progress to encephalitis (inflammation of the brain).
  • West Nile – has now been found in every state except Alaska and Hawaii, but up to 80% of people don’t develop any symptoms and only 1% develop severe symptoms, with folks over age 60 years most at risk. Although West Nile season peaks in mid-August, cases are usually reported from late summer through early fall.
  • Western Equine encephalitis – rare, but deadly, like Eastern Equine encephalitis, and is found in states west of the Mississippi River
  • Yellow fever – a vaccine-preventable disease, the Yellow fever virus is still found in tropical and subtropical areas in South America and Africa.
  • Zika – is mostly a risk during pregnancy as it can cause serious birth defects, including microcephaly, so there are warnings to avoid high risk areas, which in addition to multiple countries and territories around the world, includes Brownsville, Texas and previously included Miami-Dade County, Florida

Won’t a long list of diseases get parent’s panicked? Only if they skip the part about where the mosquitoes that cause those diseases are active.

What to Do If a Mosquito Bites Your Child

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 Do you know what to do if a mosquito bites your child? Photo by James Gathany

If a mosquito bites your child, don’t panic. There is no reason to run to your pediatrician or the ER and get tested for West Nile or Zika.

That’s not to say a mosquito bite couldn’t send you to the ER, but it would likely only be if your child was severely allergic, with the bite causing an anaphylatic reaction. Fortunately, most bites just leave little red bumps that go away in a few days if you don’t scratch them too much.

So the key treatment after a mosquito bite is classically about relieving the symptoms of itching. As with other itchy rashes, you can do this by:

  • applying an OTC anti-itch cream (hydrocortisone cream or calamine lotion) to the bite
  • taking an oral antihistamine, especially at night
  • applying a prescription steroid cream to help control itching

Also, keep your child’s finger nails short to minimize damage from scratching and wash the areas with soap and water to decrease the risk of secondary infections.

“Where you live, your travel history, and the travel history of your sex partner(s) can affect your chances of getting Zika.”

CDC on Know Your Zika Risk

In general, you should see your pediatrician if you have the symptoms of a mosquito-borne disease and have been in an area with risk of that disease.

Should you worry about dengue, West Nile, or Zika, etc?

  • Does your child live in an area where you can commonly find the mosquitoes that carry any of these diseases?
  • Did your child recently visit an area where you can commonly find the mosquitoes that carry any of these diseases?
  • Is your child a pregnant teen?
  • Is your teen sexually active?
  • Does your child have a chronic medical condition, such as cancer, diabetes, hypertension, or kidney disease?
  • Is your child a first- or second-generation immigrant from a malaria-endemic country who returned to their home country to visit friends and relatives?
  • Was your child at risk for a mosquito-borne disease and skipped taking preventative medications for malaria or skipped getting a Japanese encephalitis vaccine or a Yellow fever vaccine?

Again, see your pediatrician if your child had a mosquito bite and now has the symptoms of a mosquito-borne disease after being in an area with risk of that disease. This is especially important for anyone who is pregnant or with a chronic medical problem, as they might be at higher risk for severe disease. The elderly are more at risk too.

Preventing Mosquito Bites

Of course, whether you are traveling to the tropics or going for a walk in your neighborhood, your best bet is going to be trying to avoid mosquitoes and mosquito bites in the first place.

  • use insect repellent, which can protect your kids from tick bites too
  • wear long-sleeved shirts and long pants when possible
  • get rid of standing water around your home – places where mosquitoes can breed
  • make sure windows and doors have screens or are kept shut to keep mosquitoes out of your home
  • instead of insect repellent, consider using mosquito netting to cover your infant’s stroller or carrier when outside, and especially when in high risk parts of the world, using insecticide treated bed nets

And review travel advisories before planning a trip to see if you need to take any additional precautions to avoid a mosquito-borne disease.

What to Know About Mosquitoes and Mosquito Bites

Mosquito-borne diseases, like dengue, West Nile, and Zika, can certainly be serious, but you likely don’t need to panic your child has gotten one of them every time he or she gets a mosquito bite.

More About Mosquitoes and Mosquito Bites

What to Do If a Tick Bites Your Child

Lyme disease.

That’s usually what comes to mind when people find a tick on their child or if they simply think about tick-borne diseases.

It is important to know that there are many other diseases that can be caused by many different types of ticks though, from anaplasmosis to tularemia. And since these ticks and the diseases they transmit are fairly regional, it is easy to be unfamiliar with them if you don’t live in their specific habitats.

That can especially be a problem if, for example, you are from Hawaii, where tick-borne diseases aren’t a big issue, and you travel for a camping trip to Oklahoma and your child is bitten by a tick. Will you or your doctor know what to do if your child develops symptoms of Rocky Mountain spotted fever?

How To Remove a Tick

Fortunately, if you find a tick on your child, you can decrease their chance of getting sick if you remove it quickly. That makes doing daily full body tick checks important.

 

Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure.
Use tweezers to remove a tick, grabbing it close to the skin, and pulling it upward with steady, even pressure. A special tick-removal spoon can make it even easier!

How quickly?

At least 36 hours.

“Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.”

CDC on Preventing Tick Bites

After removing the tick, wash the bite area and your hands with soap and water and observe your child over the next few weeks for symptoms of a tick-borne disease.

Symptoms of a Tick Bite

Although some of the symptoms of tick-borne diseases are specific to the tick that bit your child, some other symptoms are common to all of them, including:

  • fever
  • headache
  • fatigue
  • muscle aches and joint pains
  • skin rashes
  • chills

Like spider bites, tick bites are usually painless. That often leads to a delay in actually figuring out that a tick has bitten your child, which makes it important to do frequent tick checks if they are doing anything that could expose them to ticks.

Many people are also surprised at how many different diseases can be transmitted by ticks, including:

  • Anaplasmosis – transmitted by the black-legged tick (northeast and upper midwestern United States) and the western black-legged tick (Northern California). May not cause a rash.
  • Babesiosis – transmitted by the black-legged tick (northeast and upper midwestern United States). Can cause severe hemolytic anemia.
  • Colorado Tick Fever – a viral infection that is transmitted by the Rocky Mountain wood tick (western United States, especially Colorado, Utah, Montana, and Wyoming). Can cause meningoencephalitis.
  • Ehrilichiosis – transmitted by the lone star tick in southcentral and eastern US.
  • Lyme disease – transmitted by the blacklegged in the northeastern U.S. and upper midwestern U.S. and the western blacklegged tick along the Pacific coast. Erythema migrans rash or Bull’s eye rash.
  • Powassan disease – a viral infection that is transmitted by the black-legged tick (northeastern United States and the Great Lakes region). Can cause biphasic illness, with children appearing to get better and then the symptoms reappearing again.
  • Rocky Mountain spotted fever – transmitted by the American dog tick, Rocky Mountain wood tick, and the brown dog tick in the U.S. Causing a classic petechial rash on the wrists, forearms, and ankles, which can then spread to the trunk.
  • Rickettsia parkeri Rickettsiosis – transmitted by the Gulf Coast tick in the eastern and southern United States.
  • STARI (Southern Tick-Associated Rash Illness) – “transmitted” by the lone star tick (central Texas and Oklahoma eastward to the the whole Atlantic coast). Children have an expanding “bull’s eye” lesion at the tick bite, like Lyme disease, but the cause is unknown.
  • Tickborne relapsing fever (TBRF) – spread by multiple soft ticks in the western United States which live in rodent infested cabins and can cause relapsing fever – 3 day episodes of fever, in between 7 days stretches in which a child might be fever free, over 3 to 4 weeks.
  • Tularemia – transmitted by dog ticks, wood ticks, and lone star ticks or by handling a sick animal, including wild rabbits, muskrats, prairie dogs, and domestic cats. Can cause an ulcer at the site of infection.
  • 364D Rickettsiosis – transmitted by the Pacific Coast tick in Northern California dn along the Pacific Coast.

And although it can be helpful to know about all of the different tick-borne diseases and their symptoms, you should basically just know to seek medical attention if your child gets sick in the few weeks following a tick bite.

What to Know About Ticks and Tick Bites

Of course, it would be even better to reduce your child’s risk of getting a tick-borne disease by avoiding ticks in first place, including limiting his exposure to grassy and wooden areas, wearing protective clothing, using insect repellent, treating your dogs for ticks, taking a shower within two hours of possibly being exposed to ticks, and doing frequent tick checks.

In addition to avoiding ticks, it is important to know that:

  • The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.
    The Vermont Department of Health advises that the best way to prevent tickborne diseases is to prevent tick bites.

    Tick activity is seasonal, with adult ticks most active in spring and fall, and the smaller nymphal ticks more active in late spring and summer.

  • Tick bites that lead to tick-borne diseases are often not noticed because they are usually painless and are often caused by nymphs, the immature, smaller forms of a tick. So while you might be thinking about a large, adult tick when you are asked about a recent tick bite, a nymph is tiny (about 2mm long) and might even be missed.
  • Testing (on your child), including antibody tests, can be done to confirm a diagnosis of most tick-borne diseases, but keep in mind that testing can be negative early on. You also shouldn’t wait for results before starting treatment in a child with a suspected tick-borne disease. Testing is usually done with either indirect immunofluorescence antibody (IFA) assay or enzyme immunoassay (EIA) tests.
  • It is usually not recommended that you have a tick that has bitten your child be tested for tick-borne diseases. Even if the tick was positive for something, it wouldn’t mean that it transmitted the disease to your child.
  • Experts don’t usually recommend that people be treated for tick-borne diseases after a tick bite unless they show symptoms. The only exception might be if the tick was on for more than 36 hours and you were in an area with a high risk for Lyme disease.
  • Although doxycycline, one of the antibiotics often used to treat tick-borne diseases, is often restricted to children who are at least 8 years old because of the risk of side effects, it should still be used if your younger child has Rocky Mountain spotted fever, ehrlichiosis, or anaplasmosis.

You should also know that most old wives tales about ticks and tick bites really aren’t true. You should not try to burn a tick that is biting your child with a match, paint it with nail polish, or smother it with vaseline, etc. Just remove it with tweezers and throw it away in a sealed bag or by flushing it down the toilet.

What to Do If a Tick Bites Your Child

Don’t panic if a tick bites your child. You have up to 36 hours to remove it, before it is can likely transmit any diseases to your child, like Lyme disease or Rocky mountain spotted fever.

More About Ticks and Tick Bites