Blood Suckers

Lately I've focused this column on consequences of all that time we're spending outdoors. In the Pediatric Emergency Department we've seen lots of related injuries and skin problems.  Now let's talk about wild beasts your kids might encounter, especially the deadliest animal known to man.  Causing the most fatalities world-wide every year, this animal kills far more people than sharks, snakes, hippos, crocodiles, lions, tigers, or bears.  Way more than murder hornets or killer bees.  This vicious scourge is that blood sucker, the mosquito. The mosquito kills so many people by transmitting disease when it bites.  Fortunately for us in the United States, it's bloated world-wide death toll is mostly from malaria, a tropical illness in Africa, Asia, and Latin America.  However, mosquitoes are beginning to spread other tropical diseases from the southern hemisphere to us, like Zika, Dengue fever, and Chikungunya.  Then there's diseases that mosquitoes already carry locally, like Eastern Equine Encephalitis and West Nile virus. Mosquitoes often hit and run before you know they've come.  They land, stab you with their needle-like nose, suck up blood while simultaneously injecting anticoagulant to prevent clotting in their nose, and lift off with a belly full of your blood, all within a minute.  Only after your body reacts to the anticoagulant, causing that ferocious itch, do you realize you've been a victim. In my practice, that itch does the most damage to kids.  They scratch those bites with dirty fingernails and cause localized skin infections.  I see West Nile or other encephalitises maybe once every five years.  I see infected mosquito bites daily. In spring I like a beer on my patio as the sun goes down, the temperature's the nicest, and unfortunately when mosquitoes are most active.  I spray repellent on myself and clothes and put out citronella candles.  I also keep my grass mowed, because long grass hides water that mosquitoes like to breed in.  I also make sure there's no standing water, like in gutters or buckets.  The one water feature in our yard, the birdbath, has a dripper fountain- mosquitoes don't lay eggs in rippling water.  Do the same with your yard and your kids.  And keep those nails clean and clipped. Another of nature's blood suckers is a hitchhiker, grabbing onto unwitting passersby.  This vampire doesn't have pale skin, slick hair, and pointy canines, or get rides with it's thumb out (who'd pick up that guy anyway?).  This horror movie happens on a tinier scale: the tick. To get out of the home, get some exercise, and get kids away from their electronic heroin, we're heading outdoors to woods and parks.  In spring, ticks are also hitting these places, clinging to bushes and grasses that we walk past.  As we brush by, the tick latches on to our clothes with hooks on it's legs.  It's swooped up and crawls to a hidey hole on the skin. Until recently, we didn't know how ticks actually sucked blood.  It certainly wasn't the lightning fast stab-and-run of the mosquito.  Ticks take hours before they get their "blood meal."  Then, in 2013, German scientists filmed the event.  Dr. Dania Richter of the Technische Universitat of Braunschweig is a researcher on how ticks transmit Lyme disease to humans. One day, as I imagine it, her team was lounging around the lab when she said, "Hey Franz (the actual name of one of her collaborators), let's film some ticks sucking blood!"  They got some high speed, high res cameras and mouse "volunteers," and made bug research history. Instead of the quick stab of the mosquito, it's a time-consuming process for ticks. They first cut into your skin with two tiny saws at the front of their heads.  Then they stick a fat harpoon between the saws.  Alternating thrusts of the saws and harpoon, they claw their way deeper until blood flows back into the mouth.  See it on Youtube! Ticks occasionally transmit diseases like Rocky Mountain Spotted Fever, Erhlichiosis, and Tularemia.  But mainly, they're just gross.  Prevent bites just like with mosquitoes: spray repellent on your skin and clothes, wear long sleeves and pants (if you can stand the heat), and keep yard grass short.  After hiking, when you shower off the dirt and sweat, check all your skin for ticks.  If you see one, pull it off with tweezers by the head, as close into your skin as possible.  You don't have to turn your skin into hamburger getting all those saws and harpoons out- they don't transmit disease themselves.