The Flying Menace

This week's guest columnist is Dr. John Giuffreda, a Family Practice resident at the University Hospital and Clinics here in Lafayette.  His column reminds me of when I was playing catch with my son.  When he went looking for a missed ball in some ivy, he stepped on a wasp nest.  Like a scene from the cartoons, he ran to the house trailing a cloud of wasps, yelling "Bees, bees, bees!!"  After we swatted them away and killed the ones that got inside, we counted 13 stings on his butt. We did everything Dr. Giuffreda talks about below, and my son did fine. Bugs bites and stings are usually no worse than a homework assignment- annoying but basically harmless.  Some crying after a sting (wasps, bees, fire ants), but that's it. Occasionally an insect bite can cause serious problems.  You should know when a simple ice pack can bring relief and when to visit your doctor, or the Emergency Department. Bee and Wasp Stings:  For most kids bee stings are a minor nuisance.  The area may swell, turn red, and be somewhat painful, but that's it. But bee and wasp stings can be real problems for people who are allergic.  A person can get a localized reaction (swelling, heat, or itching around the site) or a systemic allergic reaction, meaning that the venom affects the whole body. In the case of a systemic reaction the person may break out in hives.  Other more serious symptoms include wheezing, shortness of breath, rapid heartbeat, and swelling of the face, lips, tongue, or throat. More subtle symptoms include weakness, nausea and vomiting, or a feeling of dread.  If a kid has any of these symptoms, call 911 immediately.  If an Epipen is available use it right away.  It's rare, but severe allergic reactions to bee and wasp stings can be fatal if the person doesn't get medical help. Mosquito Bites: As you know, Louisiana is Mosquito Country, and mosquitoes hang out anywhere with still water.  Generally they are nothing to worry about.  They bite, you itch, end of story. But sometimes mosquitoes can give people diseases.  You have probably heard of West Nile Virus, which humans can get from mosquitoes.  The good news is that most kids, and any healthy person under age 50, who get West Nile virus get over it without symptoms and never know it.  Less than 1% of the people infected with West Nile become seriously ill. What To Do: For most bug bites and stings, antihistamines like benadryl lessen itching and swelling.  Acetaminophen (Tylenol) and Ibuprofen can ease pain. Use 1% hydrocortisone cream (over-the-counter) for itching too.  If it's a honeybee sting and you see the stinger, immediately scrape it out with your fingernail.  This lessens your kid's dose of venom. Wash the bite with soap and water and keep it clean. If it really bothers and you want more immediate relief than benadryl or Tylenol, ice can help.  Ice it for 10 minutes, every few hours or so.  If your child scratches and breaks the skin, you need to prevent infection.  Put on antibiotic ointment like Neosporin and again, keep the site clean and covered with a bandaid. Preventing Bites and Stings: Kids don't have to sit around and be a sample on the insect buffet.  Take some preventative steps: Avoid mosquitoes by staying away from still pools and ponds where they breed, especially in hot weather.  Pour out standing water from bird baths, buckets, old tires, etc.  Stay inside when mosquitoes are most active (dusk, night, and dawn). Use insect repellent when outdoors camping, hiking, or in the yard. DEET repellents on skin keep away mosquitoes and ticks.  Permethrin repellents are good to put on clothes. In wooded areas, tuck shirts into your pants and long pant legs into socks.  Make your kids wear shoes and socks outside, even if it's just for a minute. Bees, wasps, and ants can sting unprotected feet. Finally, don't swat at buzzing insects.  It just swirls the mosquitoes around and can make the real stingers- wasps and bees- feel threatened so they will be more likely to sting.  Just keep away... from the Flying Menace.