By avoiding insect bites during your travels to tropical and subtropical regions, you can prevent the following diseases:
- 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
- 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.
- 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.
- 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.
- 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.
- Sawyer’s Controlled Release® (20% DEET) lotion
- 3M Ultrathon® (34% DEET) lotion is another controlled release formulation.
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%.
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.
- 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.
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.
- Sawyer’s Permethrin® solution or spray (available at Hall Health Pharmacy)
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.
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.
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.
- Check out the Environmental Protection Agency’s online tool to find an insect repellent that’s right for you.
- Schedule an appointment with Hall Health at least 4 weeks prior to your departure date to discuss how to protect yourself from insects.
Authored by: Hall Health Center Travel Clinic staff
Reviewed by: Hall Health Center Travel Clinic staff (AT), May 2014