West Nile I
The West Nile Virus is speading across the United States and I think it is imparative that we know as much as we can to protect ourself. Therefore, I am interrupting out current STD Series to bring you the latest information on the West Nile Virus.
This is information from the Centers for Disease Control.
Q. What is West Nile encephalitis?
A. "Encephalitis" means an inflammation of the brain and can be caused by viruses and bacteria, including viruses transmitted by mosquitoes. West Nile encephalitis is an infection of the brain caused by West Nile virus, a flavivirus commonly found in Africa, West Asia, and the Middle East. It is closely related to St. Louis encephalitis virus found in the United States.
Q. Where did West Nile virus come from?
A. West Nile virus has been commonly found in humans and birds and other vertebrates in Africa, Eastern Europe, West Asia, and the Middle East, but until 1999 had not previously been documented in the Western Hemisphere. It is not known from where the U.S. virus originated, but it is most closely related genetically to strains found in the Middle East.
Q. Historically, where has West Nile encephalitis occurred worldwide?
A. See the map describing distribution of flaviviruses, including West Nile virus:
Q. How long has West Nile virus been in the U.S.?
A. It is not known how long it has been in the U.S., but CDC scientists believe the virus has probably been in the eastern U.S. since the early summer of 1999, possibly longer.
Q. How many cases of West Nile encephalitis in humans have occurred in the U.S.?
A. In 1999, 62 cases of severe disease, including 7 deaths, occurred in the New York area. In 2000, 21 cases were reported, including 2 deaths in the New York City area. In 2001, there were 66 human cases of severe disease and 9 deaths. No reliable estimates are available for the number of cases of West Nile encephalitis that occur worldwide.
Please see CDC's current case count for information on 2002 cases in the U.S..
Q. I understand West Nile virus was found in "overwintering" mosquitoes in the New York City area in early 2000. What does this mean?
A. One of the species of mosquitos found to carry West Nile virus is the Culex species which survive through the winter, or "overwinter," in the adult stage. That the virus survived along with the mosquitoes was documented by the widespread transmission the summer of 2000.
Q. Do the findings indicate that West Nile virus is established in the Western Hemisphere?
A. The continued expansion of West Nile virus in the United States indicates that it is permanently established in the Western Hemisphere.
Q. Is the disease seasonal in its occurrence?
A. In the temperate zone of the world (i.e., between latitudes 23.5° and 66.5° north and south), West Nile encephalitis cases occur primarily in the late summer or early fall. In the southern climates where temperatures are milder, West Nile virus can be transmitted year round.
Q. How do people get West Nile encephalitis?
A. People become infected by the bite of a mosquitoes infected with West Nile virus.
Q. What is the basic transmission cycle?
A. Mosquitoes become infected when they feed on infected birds, which may circulate the virus in their blood for a few days. Infected mosquitoes can then transmit West Nile virus to humans and animals while biting to take blood. The virus is located in the mosquito's salivary glands. During blood feeding, the virus may be injected into the animal or human, where it may multiply, possibly causing illness.
Q. If I live in an area where birds or mosquitoes with West Nile virus have been reported and a mosquito bites me, am I likely to get sick?
A. No. Even in areas where the virus is circulating, very few mosquitoes are infected with the virus. Even if the mosquito is infected, less than 1% of people who get bitten and become infected will get severely ill. The chances you will become severely ill from any one mosquito bite are extremely small.
View enlarged image.
Q. Can you get West Nile encephalitis from another person?
A. No. West Nile encephalitis is NOT transmitted from person-to-person. For example, you cannot get West Nile virus from touching or kissing a person who has the disease, or from a health care worker who has treated someone with the disease.
Q. Is a woman's pregnancy at risk if she gets West Nile encephalitis?
A. There is no documented evidence that a pregnancy is at risk due to infection with West Nile virus.
Q. Besides mosquitoes, can you get West Nile virus directly from other insects or ticks?
A. Infected mosquitoes are the primary source for West Nile virus. Although ticks infected with West Nile virus have been found in Asia and Africa, their role in the transmission and maintenance of the virus is uncertain. However, there is no information to suggest that ticks played any role in the cases identified in the United States.
Q. How many types of animals have been found to be infected with West Nile virus?
A. Although the vast majority of infections have been identified in birds, WN virus has been shown to infect horses, cats, bats, chipmunks, skunks, squirrels, and domestic rabbits.
Q. Can you get West Nile virus directly from birds?
A. There is no evidence that a person can get the virus from handling live or dead infected birds. However, persons should avoid bare-handed contact when handling any dead animals and use gloves or double plastic bags to place the carcass in a garbage can.
Q. Can I get infected with West Nile virus by caring for an infected horse?
A. West Nile virus is transmitted by infectious mosquitoes. There is no documented evidence of person-to-person or animal-to-person transmission of West Nile virus. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any viral infection.
Q. How does West Nile virus actually cause severe illness and death in humans?
A. Following transmission by an infected mosquito, West Nile virus multiplies in the person's blood system and crosses the blood-brain barrier to reach the brain. The virus interferes with normal central nervous system functioning and causes inflammation of brain tissue.
Q. What proportion of people with severe illness due to West Nile virus die?
A. Among those with severe illness due to West Nile virus, case-fatality rates range from 3% to 15% and are highest among the elderly. Less than 1% of persons infected with West Nile virus will develop severe illness.
Q. If a person contracts West Nile virus, does that person develop a natural immunity to future infection by the virus?
A. It is assumed that immunity will be lifelong; however, it may wane in later years.
Prevention of West Nile Virus
Q. What can I do to reduce my risk of becoming infected with West Nile virus?
A. Here are preventive measures to take:
Apply insect repellent sparingly to exposed skin. An effective repellent for adults will contain at least 35% DEET (N,N-diethyl-meta-toluamide). DEET in high concentrations (greater than 50%) provides no additional protection.
Repellents may irritate the eyes and mouth, so avoid applying repellent to the hands of children.
Whenever you use an insecticide or insect repellent, be sure to read and follow the manufacturer's DIRECTIONS FOR USE, as printed on the product.
Spray clothing with repellents containing permethrin or DEET since mosquitoes may bite through thin clothing. Do not apply repellents containing permethrin directly to exposed skin. If you spray your clothing, there is no need to spray repellent containing DEET on the skin under your clothing.
When possible, wear long-sleeved shirts and long pants whenever you are outdoors.
Place mosquito netting over infant carriers when you are outdoors with infants.
Consider staying indoors at dawn, dusk, and in the early evening, which are peak mosquito biting times.
Install or repair window and door screens so that mosquitoes cannot get indoors.
To avoid helping mosquitoes breed in your environment, drain standing water. Routinely empty water from flower pots, pet bowls, clogged rain gutters, swimming pool covers, discarded tires, buckets, barrels, cans, and other items that collect water in which mosquitoes can lay eggs.
Note: Vitamin B and "ultrasonic" devices are NOT effective in preventing mosquito bites.
Q. What can be done to prevent outbreaks of West Nile virus?
A. Prevention and control of West Nile virus and other arboviral diseases is most effectively accomplished through integrated vector management programs. These programs should include surveillance for West Nile virus activity in mosquito vectors, birds, horses, other animals, and humans, and implementation of appropriate mosquito control measures to reduce mosquito populations when necessary. Additionally, when virus activity is detected in an area, residents should be alerted and advised to increase measures to reduce contact with mosquitoes.
Insect Repellent Use
Q. Why should I use insect repellent?
A. Insect repellents help people reduce their exposure to mosquito bites that may carry potentially serious viruses such as West Nile virus, and allow them to continue to play and work outdoors.
Q. When should I use mosquito repellent?
A. Apply repellent when you are going to be outdoors and will be at risk for getting bitten by mosquitoes.
Q. What time of day should I wear mosquito repellent?
A. Many of the mosquitoes that carry the West Nile virus are especially likely to bite around dusk and dawn. If you are outdoors around these times of the day, it is important to apply repellent. In many parts of the country, there are mosquitoes that also bite during the day, and these mosquitoes have also been found to carry the West Nile virus. The safest decision is to apply repellent whenever you are outdoors.
Q. How often should repellent be reapplied?
A. Follow the directions on the product you are using in order to determine how frequently you need to reapply repellent. As a general rule, repellents containing a higher concentration of active ingredient provide longer-lasting protection.
Q. How does mosquito repellent work?
A. Mosquitoes eat plant juices and flower nectar for energy. Female mosquitoes bite people and animals because they need the protein found in blood to help make their eggs.
Mosquitoes are attracted to people by our skin odors and carbon dioxide from our breath. When a mosquito gets close to a person, DEET and some other repellents jam the mosquito's sensors and confuse the mosquito so it is unable to land and bite the person successfully. DEET does not kill mosquitoes; it just makes them unable to locate us. Repellents are effective only at short distances from the treated surface, so you may still see mosquitoes flying nearby. As long as you are not getting bitten, there is no reason to apply more DEET.
Q. Which mosquito repellent works the best?
A. The most effective repellents contain DEET (N,N-diethyl-m-toluamide) which is an ingredient used to repel pests like mosquitoes and ticks. DEET has been tested against a variety of biting insects and has been shown to be very effective. Products that contain at least 35% DEET are the most effective for adults. There is no additional protection from products containing more than 50% DEET. (Fradin and Day, 2002. See Publications page.)
Q. Why does CDC recommend using DEET?
A. DEET is the most effective and best-studied insect repellent available. (Fradin, 1998) Studies using humans and mosquitoes report that only products containing DEET offer long-lasting protection after a single application.(Fradin and Day, 2002. See Publications page.)
Q. Are non-DEET repellents effective (e.g. Skin-So-Soft, plant-based repellents)?
A. Some non-DEET repellent products which are intended to be applied directly to skin also provide some protection from mosquito bites. However, studies have suggested that other products do not offer the same level of protection, or that protection does not last as long as products containing DEET. A soybean-oil-based product has been shown to provide protection for a period of time similar to a product with a low concentration of DEET (4.75%) (Fradin and Day, 2002. See Publications page.).
People should choose a repellent that they will be likely to use consistently and that will provide sufficient protection for the amount of time that they will be spending outdoors. Product labels often indicate the length of time that protection that can be expected from a product. Persons who are concerned about using DEET may wish to consult their health care provider for advice. The National Pesticide Information Center (NPIC) can also provide information through a toll-free number, 1-800-858-7378 or https://npic.orst.edu/.
Q. I'm confused. None of the products in the store says "DEET".
A. Most insect repellents that are available in stores are labeled with the chemical name for DEET. Look for N,N-diethyl-m-toluamide or, sometimes, N,N-diethly-3-methylbenamide.
Using Repellents Safely
Q. Is DEET safe?
A. Because DEET is so widely used, a great deal of testing has been done. When manufacturers seek registration with the U.S. Environmental Protection Agency (EPA) for products such as DEET, laboratory testing regarding both short-term and long-term health effects must be carried out. Over the long history of DEET use, relatively few confirmed incidents of toxic reactions to DEET have occurred when the product is used properly (From the National Pesticide Information Center [NPIC], EPA re-registration eligibility decision. See https://npic.orst.edu/factsheets/DEETgen.pdf .)
Q. What are some general considerations to remember in order to use products containing DEET safely?
A. Always follow the recommendations appearing on the product label.
Use enough repellent to cover exposed skin or clothing. Don't apply repellent to skin that is under clothing. Avoid over application.
Do not apply repellent to cuts, wounds, or irritated skin.
After returning indoors, wash treated skin with soap and water.
Do not spray aerosol or pump products in enclosed areas.
Do not apply aerosol or pump products directly to your face. Spray your hands and then rub them carefully over the face, avoiding eyes and mouth.
Q. How should products containing DEET be used on children?
A. No definitive studies exist in the scientific literature about what concentration of DEET is safe for children. The American Academy of Pediatrics has recommended that a cautious approach is to use products with a low concentration of DEET, 10% or less, on children. Some guidelines cite that it is acceptable to use repellents containing DEET on children over 2 years of age. Other experts suggest that it is acceptable to apply repellent with DEET to infants over 2 months old. Repellent products that do not contain DEET are not likely to offer the same degree of protection from mosquito bites as products containing DEET.
Parents should choose the type and concentration of repellent to be used by taking into account the amount of time that a child will be outdoors, exposure to mosquitoes, and the risk of mosquito-transmitted disease in the area. Non-DEET repellents have not necessarily been as thoroughly studied as DEET, may not be safer for use on children and are generally not as effective as DEET-containing products. Persons who are concerned about using DEET or other products on children may wish to consult their health care provider for advice. The National Pesticide Information Center (NPIC) can also provide information through a toll-free number, 1-800-858-7378 or https://npic.orst.edu/.
Always follow the recommendations appearing on the product label when using repellent.
When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears.
Do not apply repellent to children's hands. (Children tend to put their hands in their mouths.)
Do not allow young children to apply insect repellent to themselves; have an adult do it for them.
Do not apply repellent to skin under clothing. If repellent is applied to clothing, wash treated clothing before wearing again.
Using repellents on the skin is not the only way to avoid mosquito bites.
Q. Is DEET safe for pregnant or nursing women?
A. There are no reported adverse events following use of repellents containing DEET in pregnant or breastfeeding women.
Q. Are there any risks due to using repellents containing DEET?
A. Use of these products may cause skin reactions in rare cases. If you suspect a reaction to this product, discontinue use, wash the treated skin, and call your local poison control center. If you go to a doctor, take the product with you.
Repellents and Schools
Q. Should parents spray insect repellent on their children before they go to school?
A. Whether children spend time outside during the school day should determine the need for applying repellent. Because most schools in the United States have air conditioning, children's exposure to mosquitoes during the school day is not likely to be high. If children will be spending time outdoors (for example, in recreational activities, walking to and from school), parents may wish to apply repellent. Mosquito repellent containing DEET is the most effective in providing long-lasting protection from mosquito bites.
Q. Should children be given repellent to use during the day?
A. The age and maturity of the child should be taken into account before giving repellent to children for their own use. As with many other chemicals, care should be taken that DEET is not misused or swallowed. Parents should find out if a child will be outside during the school day, and should discuss proper use of the product with their children. Parents should also consult local officials to obtain policies and procedures specific to bringing repellent to school.
More information
Q. Where can I get more information about repellents?
A. For more information about using repellents safely please consult the EPA Web site: https://www.epa.gov/pesticides/citizens/insectrp.htm or consult the National Pesticide Information Center, which is cooperatively sponsored by Oregon State University and the US EPA. NPIC can be reached at: https://npic.orst.edu/ or 1-800-858-7378
This is information from the Centers for Disease Control.
Q. What is West Nile encephalitis?
A. "Encephalitis" means an inflammation of the brain and can be caused by viruses and bacteria, including viruses transmitted by mosquitoes. West Nile encephalitis is an infection of the brain caused by West Nile virus, a flavivirus commonly found in Africa, West Asia, and the Middle East. It is closely related to St. Louis encephalitis virus found in the United States.
Q. Where did West Nile virus come from?
A. West Nile virus has been commonly found in humans and birds and other vertebrates in Africa, Eastern Europe, West Asia, and the Middle East, but until 1999 had not previously been documented in the Western Hemisphere. It is not known from where the U.S. virus originated, but it is most closely related genetically to strains found in the Middle East.
Q. Historically, where has West Nile encephalitis occurred worldwide?
A. See the map describing distribution of flaviviruses, including West Nile virus:
Q. How long has West Nile virus been in the U.S.?
A. It is not known how long it has been in the U.S., but CDC scientists believe the virus has probably been in the eastern U.S. since the early summer of 1999, possibly longer.
Q. How many cases of West Nile encephalitis in humans have occurred in the U.S.?
A. In 1999, 62 cases of severe disease, including 7 deaths, occurred in the New York area. In 2000, 21 cases were reported, including 2 deaths in the New York City area. In 2001, there were 66 human cases of severe disease and 9 deaths. No reliable estimates are available for the number of cases of West Nile encephalitis that occur worldwide.
Please see CDC's current case count for information on 2002 cases in the U.S..
Q. I understand West Nile virus was found in "overwintering" mosquitoes in the New York City area in early 2000. What does this mean?
A. One of the species of mosquitos found to carry West Nile virus is the Culex species which survive through the winter, or "overwinter," in the adult stage. That the virus survived along with the mosquitoes was documented by the widespread transmission the summer of 2000.
Q. Do the findings indicate that West Nile virus is established in the Western Hemisphere?
A. The continued expansion of West Nile virus in the United States indicates that it is permanently established in the Western Hemisphere.
Q. Is the disease seasonal in its occurrence?
A. In the temperate zone of the world (i.e., between latitudes 23.5° and 66.5° north and south), West Nile encephalitis cases occur primarily in the late summer or early fall. In the southern climates where temperatures are milder, West Nile virus can be transmitted year round.
Q. How do people get West Nile encephalitis?
A. People become infected by the bite of a mosquitoes infected with West Nile virus.
Q. What is the basic transmission cycle?
A. Mosquitoes become infected when they feed on infected birds, which may circulate the virus in their blood for a few days. Infected mosquitoes can then transmit West Nile virus to humans and animals while biting to take blood. The virus is located in the mosquito's salivary glands. During blood feeding, the virus may be injected into the animal or human, where it may multiply, possibly causing illness.
Q. If I live in an area where birds or mosquitoes with West Nile virus have been reported and a mosquito bites me, am I likely to get sick?
A. No. Even in areas where the virus is circulating, very few mosquitoes are infected with the virus. Even if the mosquito is infected, less than 1% of people who get bitten and become infected will get severely ill. The chances you will become severely ill from any one mosquito bite are extremely small.
View enlarged image.
Q. Can you get West Nile encephalitis from another person?
A. No. West Nile encephalitis is NOT transmitted from person-to-person. For example, you cannot get West Nile virus from touching or kissing a person who has the disease, or from a health care worker who has treated someone with the disease.
Q. Is a woman's pregnancy at risk if she gets West Nile encephalitis?
A. There is no documented evidence that a pregnancy is at risk due to infection with West Nile virus.
Q. Besides mosquitoes, can you get West Nile virus directly from other insects or ticks?
A. Infected mosquitoes are the primary source for West Nile virus. Although ticks infected with West Nile virus have been found in Asia and Africa, their role in the transmission and maintenance of the virus is uncertain. However, there is no information to suggest that ticks played any role in the cases identified in the United States.
Q. How many types of animals have been found to be infected with West Nile virus?
A. Although the vast majority of infections have been identified in birds, WN virus has been shown to infect horses, cats, bats, chipmunks, skunks, squirrels, and domestic rabbits.
Q. Can you get West Nile virus directly from birds?
A. There is no evidence that a person can get the virus from handling live or dead infected birds. However, persons should avoid bare-handed contact when handling any dead animals and use gloves or double plastic bags to place the carcass in a garbage can.
Q. Can I get infected with West Nile virus by caring for an infected horse?
A. West Nile virus is transmitted by infectious mosquitoes. There is no documented evidence of person-to-person or animal-to-person transmission of West Nile virus. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any viral infection.
Q. How does West Nile virus actually cause severe illness and death in humans?
A. Following transmission by an infected mosquito, West Nile virus multiplies in the person's blood system and crosses the blood-brain barrier to reach the brain. The virus interferes with normal central nervous system functioning and causes inflammation of brain tissue.
Q. What proportion of people with severe illness due to West Nile virus die?
A. Among those with severe illness due to West Nile virus, case-fatality rates range from 3% to 15% and are highest among the elderly. Less than 1% of persons infected with West Nile virus will develop severe illness.
Q. If a person contracts West Nile virus, does that person develop a natural immunity to future infection by the virus?
A. It is assumed that immunity will be lifelong; however, it may wane in later years.
Prevention of West Nile Virus
Q. What can I do to reduce my risk of becoming infected with West Nile virus?
A. Here are preventive measures to take:
Apply insect repellent sparingly to exposed skin. An effective repellent for adults will contain at least 35% DEET (N,N-diethyl-meta-toluamide). DEET in high concentrations (greater than 50%) provides no additional protection.
Repellents may irritate the eyes and mouth, so avoid applying repellent to the hands of children.
Whenever you use an insecticide or insect repellent, be sure to read and follow the manufacturer's DIRECTIONS FOR USE, as printed on the product.
Spray clothing with repellents containing permethrin or DEET since mosquitoes may bite through thin clothing. Do not apply repellents containing permethrin directly to exposed skin. If you spray your clothing, there is no need to spray repellent containing DEET on the skin under your clothing.
When possible, wear long-sleeved shirts and long pants whenever you are outdoors.
Place mosquito netting over infant carriers when you are outdoors with infants.
Consider staying indoors at dawn, dusk, and in the early evening, which are peak mosquito biting times.
Install or repair window and door screens so that mosquitoes cannot get indoors.
To avoid helping mosquitoes breed in your environment, drain standing water. Routinely empty water from flower pots, pet bowls, clogged rain gutters, swimming pool covers, discarded tires, buckets, barrels, cans, and other items that collect water in which mosquitoes can lay eggs.
Note: Vitamin B and "ultrasonic" devices are NOT effective in preventing mosquito bites.
Q. What can be done to prevent outbreaks of West Nile virus?
A. Prevention and control of West Nile virus and other arboviral diseases is most effectively accomplished through integrated vector management programs. These programs should include surveillance for West Nile virus activity in mosquito vectors, birds, horses, other animals, and humans, and implementation of appropriate mosquito control measures to reduce mosquito populations when necessary. Additionally, when virus activity is detected in an area, residents should be alerted and advised to increase measures to reduce contact with mosquitoes.
Insect Repellent Use
Q. Why should I use insect repellent?
A. Insect repellents help people reduce their exposure to mosquito bites that may carry potentially serious viruses such as West Nile virus, and allow them to continue to play and work outdoors.
Q. When should I use mosquito repellent?
A. Apply repellent when you are going to be outdoors and will be at risk for getting bitten by mosquitoes.
Q. What time of day should I wear mosquito repellent?
A. Many of the mosquitoes that carry the West Nile virus are especially likely to bite around dusk and dawn. If you are outdoors around these times of the day, it is important to apply repellent. In many parts of the country, there are mosquitoes that also bite during the day, and these mosquitoes have also been found to carry the West Nile virus. The safest decision is to apply repellent whenever you are outdoors.
Q. How often should repellent be reapplied?
A. Follow the directions on the product you are using in order to determine how frequently you need to reapply repellent. As a general rule, repellents containing a higher concentration of active ingredient provide longer-lasting protection.
Q. How does mosquito repellent work?
A. Mosquitoes eat plant juices and flower nectar for energy. Female mosquitoes bite people and animals because they need the protein found in blood to help make their eggs.
Mosquitoes are attracted to people by our skin odors and carbon dioxide from our breath. When a mosquito gets close to a person, DEET and some other repellents jam the mosquito's sensors and confuse the mosquito so it is unable to land and bite the person successfully. DEET does not kill mosquitoes; it just makes them unable to locate us. Repellents are effective only at short distances from the treated surface, so you may still see mosquitoes flying nearby. As long as you are not getting bitten, there is no reason to apply more DEET.
Q. Which mosquito repellent works the best?
A. The most effective repellents contain DEET (N,N-diethyl-m-toluamide) which is an ingredient used to repel pests like mosquitoes and ticks. DEET has been tested against a variety of biting insects and has been shown to be very effective. Products that contain at least 35% DEET are the most effective for adults. There is no additional protection from products containing more than 50% DEET. (Fradin and Day, 2002. See Publications page.)
Q. Why does CDC recommend using DEET?
A. DEET is the most effective and best-studied insect repellent available. (Fradin, 1998) Studies using humans and mosquitoes report that only products containing DEET offer long-lasting protection after a single application.(Fradin and Day, 2002. See Publications page.)
Q. Are non-DEET repellents effective (e.g. Skin-So-Soft, plant-based repellents)?
A. Some non-DEET repellent products which are intended to be applied directly to skin also provide some protection from mosquito bites. However, studies have suggested that other products do not offer the same level of protection, or that protection does not last as long as products containing DEET. A soybean-oil-based product has been shown to provide protection for a period of time similar to a product with a low concentration of DEET (4.75%) (Fradin and Day, 2002. See Publications page.).
People should choose a repellent that they will be likely to use consistently and that will provide sufficient protection for the amount of time that they will be spending outdoors. Product labels often indicate the length of time that protection that can be expected from a product. Persons who are concerned about using DEET may wish to consult their health care provider for advice. The National Pesticide Information Center (NPIC) can also provide information through a toll-free number, 1-800-858-7378 or https://npic.orst.edu/.
Q. I'm confused. None of the products in the store says "DEET".
A. Most insect repellents that are available in stores are labeled with the chemical name for DEET. Look for N,N-diethyl-m-toluamide or, sometimes, N,N-diethly-3-methylbenamide.
Using Repellents Safely
Q. Is DEET safe?
A. Because DEET is so widely used, a great deal of testing has been done. When manufacturers seek registration with the U.S. Environmental Protection Agency (EPA) for products such as DEET, laboratory testing regarding both short-term and long-term health effects must be carried out. Over the long history of DEET use, relatively few confirmed incidents of toxic reactions to DEET have occurred when the product is used properly (From the National Pesticide Information Center [NPIC], EPA re-registration eligibility decision. See https://npic.orst.edu/factsheets/DEETgen.pdf .)
Q. What are some general considerations to remember in order to use products containing DEET safely?
A. Always follow the recommendations appearing on the product label.
Use enough repellent to cover exposed skin or clothing. Don't apply repellent to skin that is under clothing. Avoid over application.
Do not apply repellent to cuts, wounds, or irritated skin.
After returning indoors, wash treated skin with soap and water.
Do not spray aerosol or pump products in enclosed areas.
Do not apply aerosol or pump products directly to your face. Spray your hands and then rub them carefully over the face, avoiding eyes and mouth.
Q. How should products containing DEET be used on children?
A. No definitive studies exist in the scientific literature about what concentration of DEET is safe for children. The American Academy of Pediatrics has recommended that a cautious approach is to use products with a low concentration of DEET, 10% or less, on children. Some guidelines cite that it is acceptable to use repellents containing DEET on children over 2 years of age. Other experts suggest that it is acceptable to apply repellent with DEET to infants over 2 months old. Repellent products that do not contain DEET are not likely to offer the same degree of protection from mosquito bites as products containing DEET.
Parents should choose the type and concentration of repellent to be used by taking into account the amount of time that a child will be outdoors, exposure to mosquitoes, and the risk of mosquito-transmitted disease in the area. Non-DEET repellents have not necessarily been as thoroughly studied as DEET, may not be safer for use on children and are generally not as effective as DEET-containing products. Persons who are concerned about using DEET or other products on children may wish to consult their health care provider for advice. The National Pesticide Information Center (NPIC) can also provide information through a toll-free number, 1-800-858-7378 or https://npic.orst.edu/.
Always follow the recommendations appearing on the product label when using repellent.
When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears.
Do not apply repellent to children's hands. (Children tend to put their hands in their mouths.)
Do not allow young children to apply insect repellent to themselves; have an adult do it for them.
Do not apply repellent to skin under clothing. If repellent is applied to clothing, wash treated clothing before wearing again.
Using repellents on the skin is not the only way to avoid mosquito bites.
Q. Is DEET safe for pregnant or nursing women?
A. There are no reported adverse events following use of repellents containing DEET in pregnant or breastfeeding women.
Q. Are there any risks due to using repellents containing DEET?
A. Use of these products may cause skin reactions in rare cases. If you suspect a reaction to this product, discontinue use, wash the treated skin, and call your local poison control center. If you go to a doctor, take the product with you.
Repellents and Schools
Q. Should parents spray insect repellent on their children before they go to school?
A. Whether children spend time outside during the school day should determine the need for applying repellent. Because most schools in the United States have air conditioning, children's exposure to mosquitoes during the school day is not likely to be high. If children will be spending time outdoors (for example, in recreational activities, walking to and from school), parents may wish to apply repellent. Mosquito repellent containing DEET is the most effective in providing long-lasting protection from mosquito bites.
Q. Should children be given repellent to use during the day?
A. The age and maturity of the child should be taken into account before giving repellent to children for their own use. As with many other chemicals, care should be taken that DEET is not misused or swallowed. Parents should find out if a child will be outside during the school day, and should discuss proper use of the product with their children. Parents should also consult local officials to obtain policies and procedures specific to bringing repellent to school.
More information
Q. Where can I get more information about repellents?
A. For more information about using repellents safely please consult the EPA Web site: https://www.epa.gov/pesticides/citizens/insectrp.htm or consult the National Pesticide Information Center, which is cooperatively sponsored by Oregon State University and the US EPA. NPIC can be reached at: https://npic.orst.edu/ or 1-800-858-7378
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