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mosquito.jpgBy avoiding insect bites during your travels to tropical and subtropical regions, you can prevent the following diseases:

  • Malaria
  • Dengue fever
  • Yellow fever
  • Japanese encephalitis
  • Lyme disease
  • Tick typhus
  • Chagas disease

Care should be taken to protect yourself and your family from most bugs you might encounter. 

Tips to avoid bites and stings

Be aware

  • Learn about the feeding and nesting habits of insects at your destination and take extra precautions and/or minimize activities accordingly. Ask your hosts about seasonal or local pests to be on the lookout for.

Use insect repellant

  • Use an appropriate insect repellent. DEET (N,N-diethylmetatoluamide) has a long and safe track record and is very effective at sufficient concentrations. Hall Health Pharmacy sells DEET insect repellant.
    • The Centers for Disease Control and Prevention (CDC) suggest DEET strengths of up to 30-50%. Concentrations up to 30% are  considered safe in children 2 months and older.  Concentrations greater than 50% do not provide better protection, but may have longer lasting protection. We do not recommend concentrations greater than 50%.  When you purchase insect repellant, check the label for strength information.
  • Repellents containing Picaridin at 7-20% concentrations are also available, and compared to the products above, may be as effective, but need more frequent application.

  • When applying both insect repellent and sunscreen, always apply the sunscreen liberally first, wait 10 to 15 minutes if possible, then apply insect repellent.

Dress for success

  • Wear protective clothing such as long sleeves and pants whenever practical.  Shirts should be tucked in.  Foot wear that provides maximum coverage is ideal, including socks, (sandals are not recommended).  Avoid jewelry and bright or dark-colored clothes; the best colors are light green, tan and khaki.
  • Use permethrin on your clothes and gear.
  • Do not walk barefoot.

Insect proof your surroundings

  • When at the beach or pool, lie on a chair or, at the very minimum, on a blanket or long towel.  Do not lay clothes on ground since perspiration or other scents may attract insects.  Shake them vigorously before putting them back on.
  • Sleep in well-screened areas, air-conditioned rooms, or use bed (mosquito) nets.
  • Clothing and bed nets can be impregnated with permethrin insecticide.
  • Avoid using fragrance-containing products such as perfumes, colognes, after-shaves, scented soaps, shaving creams, hair sprays, etc.  Use only unscented hygiene products.

Insect behavior and habits

Mosquitoes

  • Species that carry malaria and Japanese encephalitis bite from dusk till dawn.
  • Species that carry dengue fever, chikungunya fever, and yellow fever bite during daylight hours.
  • Mosquitoes are most active right around dawn and right around dusk, so extra care at those times is necessary.

Ticks

  • Burrow into your skin.
  • Are carried on animals, but picked up by humans from brush, grass, trees.
  • Check your skin at least once daily for presence of ticks if in high risk areas. Armpits and hairline are common places for ticks.
  • Remove ticks with a slow steady tug, pulling perpendicular to the skin at the site of attachment of the tick, using tweezers or a tick remover, if available.

Fleas

  • Especially present on and around animals and in sand and soil.

Product information: What to buy

The following products are used to avoid bites and stings of insects, and thereby reduce the risk of contracting the diseases they carry.   They can be purchased in many pharmacies and outdoor supply stores (e.g., REI), including at Hall Health Pharmacy.  Some specific products are listed for your information.

Repellents for use on the skin

NOTE: Please note that these repellents are to be used only on exposed skin and not under clothing.

DEET repellent – DEET (N, N-diethyl-m-toluamide) is the most effective repellent against mosquitoes, chiggers, ticks, fleas, and biting flies.  Controlled release formulations have longer lasting effectiveness. Avoid contact with eyes, mouth, and synthetic materials. Toxic only if swallowed.

We strongly recommend DEET-containing repellents over all others, based on its proven safety, effectiveness, and ease of use. Look for a minimum concentration of 20% and a maximum concentration of 50%.

Other repellents

Picaridin – available for many years in Europe at 21% concentration. Higher concentrations provide longer duration of protection.

  • Cutter Advanced® sprays containing 7% and 15% picaridin are available.
  • Sawyer Go Ready® spray contains 20% picaridin

Higher concentrations provide longer lasting protection.

Newer repellents

  • Cutter Lemon Eucalyptus® spray contains Oil of Lemon Eucalyptus (PMD), approved by the EPA and CDC as a "biopesticide repellent"
  • Sawyer makes a DEET-free repellent containing IR-3535, another biopesticide repellent approved by the EPA and CDC.

Insecticide for use on clothing and nets

Permethrin is a synthetic chemical analogue of pyrethrum, which is the natural substance found in chrysanthemums. It effectively repels and kills insects. Permethrin is available in various formulations, as a spray for clothing, or as a liquid for “soaking” clothing or bed nets.

See manufacturer’s recommendations for application. Generally, permethrin is effective for 6 washings on clothing. If clothing is ironed after application, permethrin can last up to 12 washings. Some manufacturers offer travel clothing that is already treated with permethrin.

Mosquito nets

Locally, REI sells mosquito nets. Various companies sell mosquito nets and netting on the web. Here is a sampling, in no particular order, and without endorsement.

Military surplus stores also may stock mosquito nets.

Bee stings

Talk to your travel consultant at Hall Health or your personal health care provider if you are allergic to bee stings. The products discussed above may not be effective against bee stings and you should be appropriately prepared to manage a bee sting reaction.

Additional resources

 

Authored by: Hall Health Center Travel Clinic staff

Reviewed by: Hall Health Center Travel Clinic staff (AT), May 2014


woman doctor.jpgWhat is PID?

Pelvic inflammatory disease or PID is a serious infection of the fallopian tubes and uterus.  This infection, which may result in blockage or scarring of the tubes, is the most common preventable cause of infertility in women.  It is estimated that over one million women in the U.S.


What is a condom?

A condom (rubber, prophylactic) is a sheath worn over the penis. Condoms originally were designed to block the escape of sperm, but now have been shown to be effective in blocking entry and exit of bacteria and some viruses. Most condoms are made of latex but some, called "skin condoms," are made of sheep intestine. Only the latex condom should be used for disease protection because the AIDS virus, and possibly other disease agents, are able to penetrate the larger pores in the skin condom.


What are vaginal spermicides?

Vaginal spermicides are products such as foam, jelly, cream, suppositories or film that are inserted deep into the vagina on or near the cervix shortly before sexual intercourse.  Most of these products contain nonoxynol-9, a chemical that kills sperm on contact.  To be effective, a spermicide must be used every time intercourse occurs.

We recommend that vaginal spermicides always be used with condoms.


What every college student should know about HPV

  1. As many as 75% of sexually active people will have an HPV infection at some time in their lives.
  2. These HPV infections are usually asymptomatic and go away on their own.
  3. Some HPV infections are associated with abnormal Pap test results in women.
  4. Cervical cancer screening is recommended beginning at age 21.

What is emergency contraception?

Emergency contraception (also known as EC or the morning after pill) works to prevent pregnancy in the case of unprotected intercourse. For maximum effec­tiveness, EC should be taken as soon as possible after unprotected sex. However, EC may be taken within 72 hours (3 days) of unpro­tected intercourse.


What is Ortho Evra?

Ortho Evra or "the patch" is a birth-control patch. It contains the hor­mones norelgestromin and ethinyl estradiol, hormones similar to those used in birth control pills. Each contraceptive patch, which is thin, beige, flexible, and square, is worn on the body for 1 week at a time.

How does the contraceptive patch work?

Once applied to the body, the hormones are absorbed through the skin into the blood stream. Like the birth control pill, the patch works by suppressing ovulation.  It also causes changes to the cervical mucus and to the endometrium (lining of the uterus) that further reduce the chances of becoming pregnant.

How effective is the contraceptive patch?

Like the pill, the contraceptive patch is 99% effective when used correctly.

When do I start wearing the patch?

You may apply your first patch during the first 24 hours of your menstrual period.  No back-up birth control method is needed.

Or you may wait until the first Sunday after your period be­gins.  A non-hormonal method of birth control (such as con­doms or a diaphragm) is needed for the first 7 days. 

Where should the contraceptive patch be applied?

You can apply the patch to your abdomen, buttock, upper outer arm, or upper torso (but not the breasts).  You can wear it in the same location each week.  However, you should apply each new patch to a new spot on the skin.  To ensure effective­ness, you should not write on the patch or alter it in any way.

How should the contraceptive patch be applied?

You should apply the patch to clean, dry skin with no redness, irritation, or cuts. To make sure that the patch sticks properly, you should avoid using creams, lotions, oils, powder, or makeup on or near the site where the patch is to be applied.

Please refer to the patient package insert for specific instruc­tions in applying the patch.

Check the contraceptive patch every day to make sure that it is still sticking firmly.

How is the contraceptive patch removed?

To remove a used patch, simply lift one corner and quickly peel back. Because a used patch still contains some active hormones, you should fold the patch in half so that it sticks to itself before you throw it away.  If a small ring of adhesive is left on your skin (which may occur if certain clothing has rubbed against the patch), you can remove it by rubbing a small amount of baby oil on the area.

Will I be able to do all of the same activities I was doing before I began wearing the contraceptive patch?

Yes.  There is no need to alter daily activities while using the patch. Bathing, showering, swimming, exercising, or moisture due to wet or humid weather should not affect your contracep­tive patch.

What if I forget to change the contraceptive patch?

If you are more than one day late in putting on your first patch:

  • Apply the first patch of your new cycle as soon as you remember.
  • You will now have a new start day and a new Patch Change Day.
  • You must use backup birth control for one week to avoid becoming pregnant.

If you forget to change your patch during week 2 or 3:

  • And you are 1 or 2 days late, remove the used patch and apply a new one.
  • Apply your next patch on your normal Patch Change Day.
  • No back up birth control is needed.

If it has been more than 2 days past your last Patch Change Day:

  • Remove the used patch and apply a new patch as soon as you remember.
  • You will have a new Day 1 and a new Patch Change Day.
  • You must use back up birth control for 1 week to avoid becoming pregnant.

If you forget to take your patch off during week 4:

  • Take the patch off as soon as you remember.
  • Start your next cycle on your normal Patch Change Day.
  • No backup birth control is needed.

Can I change my Patch Change Day?

Yes. If you wish to alter the Patch Change Day,  follow these instructions:

  • Complete the current cycle.
  • Remove the third patch on the correct day.
  • Select a new Patch Change Day by applying a new patch on the desired day during the patch-free week.
  • Do not let more than 7 consecutive days go by without a new contraceptive patch.

Does the contraceptive patch cause side effects?

Except for possible minor skin reactions when the patch is placed, adverse events are similar to those associated with oral contraceptives.  The most common side effects are breast symptoms, headache, application-site reactions, nausea, cramps, and abdominal pain.  The patch is not associated with significant changes in weight.

Are there any risks associated with use of the contraceptive patch?

The patch contains hormones similar to those in birth-control pills.  Most side effects associated with the patch are not seri­ous, and those that are serious occur infrequently.  Serious risks, which can be life–threatening, include blood clots, stroke, and heart attack, and are increased if you smoke ciga­rettes. Cigarette smoking increases the risk of serious cardio­vascular side effects, especially if you are older than 35 years. Women who use hormonal contraceptives are strongly advised not to smoke. Some women should not use the patch, includ­ing those who have had blood clots (this does not mean blood clots in your menstrual flow), certain cancers, or a history of heart attack or stroke, as well as those who are or may become pregnant.

In November 2005, Ortho Women’s Health updated the information it provides to clinicians and patients.  The current patient information/warning states: “Hormones from patches applied to the skin get into the blood stream and are removed from the body differently than hormones from birth control pills taken by mouth. You will be exposed to about 60% more estrogen if you use ORTHO EVRA than if you use a typical birth control pill containing 35 micrograms of estrogen. In general increased estrogen exposure may increase the risk of side effects.  However, it is not known if there are differences in the risk of serious side effects based on the differences between ORTHO EVRA and a birth control pill containing 35 micrograms of estrogen.”

NOTE: The patch does not protect against HIV infection or AIDS or other sexually transmitted diseases.

What are the danger signs?

Call the clinic immediately or consult your private doctor or local Emergency Room if you experience ANY of the follow­ing:

  • Severe headache
  • Visual changes (flashing lights in the eyes, blurring and/ or partial loss of vision)
  • Numbness or tingling in the face, an arm, leg, hand or foot
  • Pain in the chest, shortness of breath, or coughing up blood (these symptoms may indicate possible clots in the lungs)
  • Severe leg pain (possible clot in the leg)
  • Crushing chest pain or heaviness
  • Severe abdominal pain

These symptoms may be warning signs of a blood clot, heart attack or stroke.

Who needs to know I am using Ortho Evra?

There are some drugs that may interact with Ortho Evra (and other hormonal birth control methods) possibly making the birth control method less effective in preventing pregnancy or causing an increase in breakthrough bleeding. If you are ill or need medical care, tell your health care practitioner that you are using Ortho Evra. If surgery is anticipated, it may be advisable to discontinue Ortho Evra one month before the surgery. Please discuss this with your surgeon and clinician.

Please note also that women who are using a hormonal method of birth control and also use some form of St. John’s Wort have reported pregnancies and breakthrough bleeding.

What if I want to become pregnant?

The contraceptive patch is a reversible form of birth control.  As with other forms of hormonal contraception, you may experience a delay in becoming pregnant after you stop using the patch, especially if you had irregular menstrual cycles before you used it.  Your clinician may advise you to postpone trying to get pregnant until you begin menstruating regularly on your own.

Other important information

Be sure you have available at all times a non-hormonal method of birth control such as condoms, diaphragm or spermicides.

If you do not know what to do about mistakes in using your patch, use a backup birth control method every time you have sex and contact your health care provider.

Individual replacement patches are available from your pharmacist.

For detailed information, read carefully the information sheet that is included with your prescription for Ortho Evra or you may access the web site for Ortho Evra at www.orthoevra.com

Additional resources

If you have any questions and are a UW student or established Hall Health patient, you may call one of our Consulting Nurses for further information.

 

Authored by: Hall Health Center Women's Health Clinic staff

Reviewed by: Hall Health Center Women's Health Clinic staff, January 2014


What is genital herpes?

Genital herpes is caused by the herpes simplex virus (abbreviated as HSV).  It is very common--about 1 in 4 women and 1 in 8 men have genital herpes. There are two types of the virus:


youngwoman2.jpgWhat is a UTI or bladder infection?

A urinary tract (UTI) or bladder infection occurs when bacteria gain access to and multiply in the bladder.  Bacteria infect the bladder by way of the urethra, a small, short tube that opens near the vagina.  The placement and size of the urethra make bladder infections very common in women.  Men rarely develop bladder infections because their urethras are longer.


medium_young woman_1.jpgWhat is yeast?

Yeast vaginitis is an infection caused by a fungus called Candida. It is one of the most common vaginal infections.


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