It's cookout season and you're on the menu

Summer is the time for backyard barbeques, swimming at the pool, hiking in the woods and all types of outdoor activities. Unfortunately, humans aren’t the only creatures that love warm weather. Summer is also when ticks, mosquitoes and other biting insects come out in droves.

Let’s take a look at some of the common issues that arise from bug bites, when to seek medical care, and how to avoid getting bitten in the first place.

What’s eating you?

Bug bites are itchy, unsightly and potentially painful. But if the bug that bit you was carrying a disease, or if the bite gets infected, the result could be much worse. When it comes to spreading disease, the two main culprits in the Southeast are ticks and mosquitoes.

There are several species of tick in the Southeast. They can’t fly or jump, or even crawl very quickly, but what they lack in mobility they make up for in patience. Ticks will crawl up vegetation, extend their front legs, and wait for a host – like a deer, a dog or an unwitting hiker – to pass. When one does, they latch on and look for a good place to bite. Ticks are known to transmit numerous dangerous diseases, including:

• Lyme disease
• Rocky Mountain spotted fever
• Babesiosis
• Ehrlichiosis

The Southeast, with its warm and wet climate, is also home to dozens of mosquito species. Whereas ticks are happy to wait for you to come to them, mosquitoes can detect the CO₂ we exhale from over 100 feet away and will come swarming to meet you. Mosquitoes are also disease vectors, and can transmit:

• West Nile virus
• Zika
• Dengue fever
• Malaria

The first 48 hours

So, you’ve just been bitten. Maybe you removed a tick embedded in your leg, or you returned from a walk with mosquito bites all over your arms. How do you know if the bugs that bit you were carrying disease? What do you do now?

Most bug bites itch for a while and then quietly fade away. Within the first 48 hours of getting bitten, any localized redness, itchiness, or swelling you see is most likely just your body’s reaction to getting bitten. The best course of action is to leave it alone and let it heal on its own. If the itch is unbearable, you can treat it with over-the-counter, non-sedating oral antihistamines – like Zyrtec, Claritin, or Allegra – or use a topical corticosteroid such as hydrocortisone. The most important thing to remember is to avoid scratching the bite, which can lead to an infection.

“The most common reason we get people coming in for bug bites is the potential for secondary infection,” says Aleah Bartolomei, a certified physician’s assistant at Sentara Primary Care & Therapy Center in Town Center. “Treat the bite with over-the-counter anti-itch relief so you don’t scratch it open.”

When is a bite more than just annoying?

If things aren’t improving after the 48-hour mark, you might have cause for concern. Again, secondary infection is the most common problem that can elevate bug bites from an annoyance to something that requires medical attention.

“If you have a significant area of redness, pain to the touch, and/or a low-grade fever a few days after the bite, you should come in to be evaluated for a secondary infection,” says Bartolomei. Additionally, people who are immunocompromised, have diabetes, or are undergoing chemotherapy are more likely to have difficulty fighting off infection on their own.

Aside from infection, there’s also the risk that you’ve contracted one of the diseases listed above. The symptoms vary, but there are a few red flags to look out for. If you notice a rash, a red ring around the bite area, or flu-like symptoms – fever, chills, body aches – developing 48 hours or more after being bitten, you may have an insect-borne illness and should seek medical attention. If you’re unsure, err on the side of safety and let a medical professional examine your bites.

The best defense is a good…defense

The best way to avoid infections or insect-borne illness is to avoid getting bitten in the first place. Here are a few ways you can minimize the risk:

• Use an EPA-approved insect repellent when you venture outside, especially if you’re going to be in places where mosquitoes and ticks are more prevalent.
• Cover up with long sleeves and pants and try to wear clothes that have been treated with bug-repelling permethrin.
• Always check yourself and your pets for ticks when you come back from being outside.
• Use screens on windows, or close them and use air conditioning, to avoid getting mosquitoes in your home.
• Regularly empty containers such as birdbaths, flowerpots and gutters on your property to keep mosquito populations down.

“Prevention is the best medicine,” says Bartolomei, adding that if you’ve been bitten and are having any kind of unusual symptoms, don’t be afraid to visit your doctor. “Always be seen if you have any concerns!”

If you’re experiencing any symptoms or have concerns after a bug bite, contact your primary care provider or visit one of Sentara’s walk-in and urgent care locations.