The summer arrives along with the desire for walks in the countryside, mountain weekends and picnics on the meadows. In spring and summer, a beautiful day outdoors can become a torment due to insect bites. Mosquitoes, bees, ticks, sandflies, and wasps may require prompt intervention, and not only for those who are allergic. “The first thing to do is to recognize if there has really been a puncture, or check for redness, edema and itching. It is very important to observe the lesion and verify the presence of a prick in the sting, is it whole or not – explains Dr. Stefano Ottolini, doctor of the Emergency Medicine Unit of the Humanitas hospital. If there is a more or less generalized erythema, fever, headache, a sense of breathing difficulty, tachycardia, it is always better to go to the emergency department”. Here’s how to deal with the bite of an insect.

 

Ticks

 

In some mountain areas and meadows, especially where the grass is high, you can find the woods tick. The activity of ticks is closely linked to the values of temperature and humidity and, although there are some exceptions, in general their activity is concentrated in the warm months and in places close to stables, kennels of animals and pastures. Even very small in size, some ticks are as large as a pinhead; their bite is painless because they emit a substance containing anesthetic principles that can make it difficult to realize that you have been bitten. Typically, their bite prefers the area of the head, neck, behind the knees, and hips.

 

To prevent the tick bite and locate “the host”, it is advisable to:

 

• Walk on the given paths

 

• Wear light-colored, long-sleeved clothing and long trousers in socks or boots.

 

• Use a light-colored tablecloth or towel that allows you to see the insects (in this case, move away from the area) for picnics on the lawns.

 

• Check your skin also using a magnifying glass when returning from places at risk.

 

The tick bite is not in itself dangerous for humans, but it can convey infections (tick-borne encephalitis, Lyme disease, rickettsiosis, tick-borne recurrent fever, tularemia, tick-borne meningoencephalitis, ehrlichiosis) that can be dangerous in children and elderly people. They can be treated with specific antibiotic therapy; in case of a tick bite, it is advisable to contact the first aid station.

 

What to do and not to do in case of a tick bite

 

Disinfect the skin, grasp the tick with thin tip tweezers, as close as possible to the surface of the skin. Pull gently with a slight twist. Currently, specific extractors can be found on the market that allow the tick to be removed with a rotating movement. After extraction, disinfect (avoid iodine dyeing) the skin again, and burn the tick.

 

Do not crush the tick in order to avoid regurgitation, which would increase the possibility of transmission of pathogens.

 

Do not touch the tick with bare hands in an attempt to remove it; hands must be protected (with gloves) and then washed.

 

Use a sterile needle for the extraction of the rostrum (the buccal apparatus of the tick), which can remain inside the skin, or contact the emergency room where antithetanal prophylaxis can also be performed.

 

Never use alcohol, benzene, acetone, trieline, ammonia, oil or grease, or arrogant objects, matches or cigarettes to remove the tick. In fact, the suffering induced can cause the regurgitation of infected material

 

At the end of each extraction operation, whether partial or complete, check that there are no residues and that the extraction has been completed.

 

In the next 30-40 days from bite, signs of infection may appear such as a reddish halo on the skin that tends to widen or fever, headache, weakness, joint pain, enlarged lymph nodes: contact your doctor immediately when symptoms appear.

 

Bees, wasps and bumblebees

 

Although they may seem similar, in reality only wasps are attracted to our food (in particular fruits, sweets and sugary drinks) and, if annoyed, can sting even several times, without dying, as opposed to what happens to bees. In case of multiple stings or inside the nose, mouth, or eyes, or severe reactions, go to First Aid.

 

To avoid irritating wasps, bumblebees and bees, and reduce the risk of being stung, it is advisable to:

 

• Not get too close to beehives.

 

• Move away slowly and do not scream if a bee or a wasp approaches.

 

• Avoid scents, lacquers and creams that are too sweet and fragrant.

 

• Not leave cans and sweet foods open: wasps can sneak inside a drink and could sting your tongue, lips or the inside of the mouth (go immediately to the emergency room).

 

• Not walk barefoot in the meadows to avoid treading on wasps or bees

 

• Dress in light colors: better white and green, as well as long-sleeved t-shirts and long trousers, for trips to woods and meadows, or for gardening.

 

In case of puncture, the reactions may be non-allergic (swelling, which may increase in the 24 hours following the puncture, intense burning, itching and pain in the affected area) or allergic (same symptoms but generalized hives type, difficulty breathing, chest pain, reduction in blood pressure). In case of a known allergy to bee, wasp or bumblebee sting, immediately take antihistamine drugs, which should always be kept with you, and in the most severe cases, go to First Aid.

 

Bee or wasp puncture: What to do

 

Disinfect the affected area with hydrogen peroxide or euchlorin.

 

Scrape off the sting with a needle, a blunt blade, or a plastic card (e.g. a credit card). Avoid tweezers because you could squeeze the poison left inside into the sting of the wound.

 

Apply ice or immerse the area in cold water to reduce pain and slow down the absorption of poison

 

Keep the affected part stationary

 

A cortisone cream can then be applied.

 

 

Horseflies

 

Their sting is very painful, more so than that of bees, and can take several days to heal and, most likely, infections could develop. For this reason, it is best to pay close attention to your sting and be able to recognize its symptoms such as redness, swelling, inflammation and strong itching, which are much more intense than the sting of a mosquito or bee. In allergic individuals, horsefly bites can trigger an allergic reaction with redness and swelling of the lips and eyes, shortness of breath, weakness and dizziness.

 

What to do in case of a horsefly bite

 

• Wash the affected area with antibacterial soap and water.

 

• Dry it by padding the puncture with a clean, dry paper towel.

 

• Do not scratch the skin to avoid worsening the situation, even in case of severe itching.

 

• Apply a handkerchief soaked in warm water to the skin helps to relieve the pain.

 

• Apply ice to block swelling.

 

In case of pus on the puncture site, avoid do-it-yourself methods and consult your doctor for specific therapy. Only in case of allergic reaction, immediately contact the Emergency Department.

 

Sand flies and mosquitoes

 

Both insects are activated when the sun goes down, and sandflies are quite common in the Mediterranean areas. Compared to mosquitoes, the proximity of the sand fly is not anticipated by any buzzing and their sting is able to transmit infectious diseases to humans, such as the known Leishmaniasis, but also encephalitis and meningitis. The sand fly preferably pricks the lower part of the body, such as ankles and feet, because it does not fly, while the mosquito can reach every area of the body. Redness, pain and intense itching can be alleviated by “after bite” creams or by creams with a low concentration of cortisone, in the case of hives.

 

Sand fly sting: What to do

 

Seek medical attention or first aid if necessary:

 

The occurrence of diffuse erythema: this could be the occurrence of an allergic reaction.

 

Fever and flu-like symptoms with chills, muscle pain, headache and neck pain: these could be symptoms of encephalitis or meningitis.

 

How to avoid the bites of mosquitoes and sand flies?

 

Use special repellents for sand flies and mosquitoes sprayed directly on the skin and clothes.

 

In the evening, prefer light long-sleeved dresses and pants

 

Ventilate rooms and do not keep shutters closed during the day: sand flies love warm, dark and humid places. Air and light are disturbing elements

 

Avoid marsh or lake areas with waterlogging