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ASK THE DOCTOR: DEET will repel infected insects
By Dr. JIM MITTERANDO
For The Patriot Ledger

Q. I am worried about the recent cases of Eastern Equine Encephalitis. Can I use a bug repellant with DEET on my 4-month-old daughter? Is DEET dangerous? What are other alternatives?

A. The South Shore has had four cases of EEE this year occurring in Duxbury, Halifax, Kingston and Plymouth. Both EEE and West Nile virus are rare but deadly infections spread by mosquito bites. There have been three human cases of West Nile Virus in Massachusetts in the past two years.

The Centers for Disease Control recommends DEET as the best insect repellant. DEET is safe for infants older than 2 months, children, adults, including pregnant and breastfeeding women.

People confuse DEET with DDT- the banned insecticide. DEET does not cause cancer and is safe when used according to the directions. DEET can be toxic if ingested. DEET has been widely used and tested for more than 50 years. DEET is a repellant not an insecticide.

DEET is available in concentrations from 5 percent to 30 percent. Higher concentrations of DEET generally last longer on your skin. The American Academy of Pediatrics recommends products up to 30 percent DEET for children.

Use repellants containing more than 20 percent DEET (Cutter Backwood or Off! Deep Woods) if you need more than four hours of protection. The ‘‘family'' products (Cutter All Family, Cutter Skinsations, Off! Skintastic intended for younger children contain 5 percent or 7 percent DEET products that protect 1 ½ to 2 hours.

For infants over 2 months use 5 percent or 7 percent DEET. Infants 2 months or younger should be protected with netting and clothing. Apply DEET or permethrin (Cutter Outdoorsman Gear Guard or Permethrin tick repellant) to insect netting or clothing when mosquitoes are quite abundant. Permethrin is an insecticide that kills insects that land on clothes.

When using insect repellant on a child:

  • Apply it to clothing and hair.
  • Do not apply repellant to children's hands since they tend to put their hands in their mouths.
  • Do not allow young children to apply insect repellant to themselves; have an adult do it for them.
  • Keep repellants out of reach of children.

Other tips:

  • Do not apply repellant to skin under clothing.
  • Do not apply DEET to cuts, wounds, irritated or eczematous skin.
  • DEET can damage plastics, synthetic fabrics, leather and painted or varnished.materials, so be careful not to get it on such things as eyeglasses, watch crystals, walls or furniture.
  • DEET does not damage nylon or natural fibers, such as cotton or wool.

DEET alternatives

People often inquire about non-DEET options because they may not like the odor or mistakenly think it may be dangerous.

  • Most DEET alternatives do not offer the same duration of protection, but picardin, soy bean oil and oil of eucalyptus can provide the equivalent protection as 5 percent DEET. Non-DEET repellants that are marketed as ‘‘natural'' or ‘‘herbal'' have not been as thoroughly studied as DEET, and may not be safer for use on children or pregnant women. In fact, the CDC advises against the use of most alternatives in young children since they have not been tested in this age group.

DEET Alternatives include

  • 7 percent picardin (Cutter Advanced ) - a chemical that has been used for years in Australia, Europe, Asia and Latin America recently available in the United States - can protect for 2 hours.
  • 2 percent soybean oil (Biteblocker for kids with soybean oil) provides roughly 1½ hours of complete protection. Safe for pregnant women and infants.
  • Oil of lemon eucalyptus, which is found in OFF! Botanicals, Repel Lemon Eucalyptus can last 1 to 2 hours. Not for use under age 3 years.
  • Citronella products (Herbal Armour or Natrapel) provide 20 minutes of protection - Most Skin-So-Soft products only provide maximum protection for 10 minutes.
  • Citronella candles are only somewhat more effective than ordinary candles in reducing mosquito bites and only half as effective as wearing insect repellant.
  • Wristband repellants do not provide protection.
  • Backyard bug zappers are not effective with mosquitos and mostly kill other insects.
  • Mosquito traps that emit carbon dioxide do attract and kill mosquitos but need further study to show they reduce mosquito populations and do not attract your neighbor's mosquitos into your yard.

Once bitten

Treat insect bites with cortisone creams to decrease inflammation and itch. Oral antihistamines - Claritin, Benadryl, Chlortrimeton and Allegra - can help reduce the itch and swelling. Avoid topical antihistamine (Benadryl) creams and numbing benzocaine sprays and creams because they can cause allergic skin reactions.

Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.

Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.

Copyright 2005 The Patriot Ledger
Transmitted Tuesday, September 27, 2005