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Treating and Preventing Mosquito Bites in Children

With the deluge of rain we have been having, mosquitoes have also made their presence known. Mosquitoes lay their eggs and molt in still water, and we have had an abundance of that lately. As a result, we have had multiple visits for mosquito bites and the subsequent reactions.

Mosquitoes belong to the Order Diptera, which includes the true flies. Not all flies bite, but biting flies use their mouthparts and lack stingers. Everyone tends to react allergically to mosquito bites, experiencing redness (flare), hives (wheal), and itching. Some individuals exhibit more vigorous reactions, with pronounced swelling and redness. The challenge lies in determining whether the bite has become infected.

Ordinary mosquito bites typically flare and itch for 3 to 7 days. It is important to note that symptoms worsen when scratched, so the primary focus of treatment is supportive care to prevent itching. Cool compresses can help reduce swelling and may alleviate itchiness. Traditional remedies like calamine and oatmeal lotions/washes have been used for years, with some evidence suggesting their efficacy and no reported harm. Antihistamines have the strongest medical evidence for alleviating symptoms and breaking the scratch-itch cycle.

The risk of secondary infections from mosquito bites is generally mild to moderate. However, with children playing outdoors and scratching with dirty fingernails, the risk is not zero. Mosquito bites should not initially cause pain. If a mosquito bite hurts right away, it might not be a mosquito at all but rather a bee, wasp, or ant sting (Order Hymenoptera). These insect bites tend to be painful initially and then itch later. Both mosquito bites and insect stings typically result in wheals and flares. If a mosquito bite starts to hurt, particularly if there is a linear spread of redness up the extremity or swollen lymph nodes, it is concerning for infection, and the child should be seen by a healthcare professional. However, this is usually not an emergency unless accompanied by muscle pain, soreness, or fever. Most infected bites and stings can be managed supportively over the course of a day or weekend, with a follow-up appointment the next day.

Infections resulting from mosquito bites are usually treated with oral antibiotics. The most used antibiotics for such infections are amoxicillin, cephalexin, clindamycin, and Augmentin. These infections typically clear up within 5 to 7 days and rarely require additional interventions.

Other common problems often mistaken for mosquito bites include other insect bites and hair follicle infections, commonly caused by Staphylococcus aureus. These infections are frequently misdiagnosed as "spider bites." However, in this area, there are only two spiders capable of envenomating, namely the black widow and the brown recluse. Spider bites are quite rare, whereas staph infections are much more common.

If you have suspected bites or stings, we welcome you to send us photos for evaluation. Please note that the nurse line phone may not always be manned or checked daily, especially on weekends or holidays. Therefore, we recommend calling the front desk instead. Prevention of mosquito bites is strongly advised as the most effective measure. Babies aged 2 months and older can use DEET of 20% or less, and children who no longer explore their environment with their mouths (typically 3 to 5 years of age) can use a "Deep Woods" preparation. It is advisable to avoid products with 100% DEET, as these are only available at specialty stores. We hope you find this information helpful for you and your family. Enjoy your summer!

Toddler > Health

Treating and Preventing Mosquito Bites in Children

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