Mosquito wars: Why do some kids get bitten more than others?

The Pediatric Insider

© 2014 Roy Benaroch, MD

“I have three children. But it’s only the middle one who gets bitten by mosquitoes! We’re outside for 20 minutes, and he’s covered with big itchy welts. They never bite the rest of us. I’m beginning to wonder what is wrong with him?”

I’ve wondered this myself—why are some people more mosquito-attractive than others? I’ve got some theories:

1.  Some kids play more in the shade where mosquitoes lurk.
2. Some kids are less sensitive to mosquitoes on their skin, so they don’t slap them away before being bitten.
3. Some kids have a bigger reaction than others, so bites are more noticeable. (The welts you see are an allergic reaction to, essentially, mosquito spit. Like any other allergy, some people are more sensitive to others. It’s possible some people get bitten and don’t react at all.)
4. Some children are just plain tastier. Mmmm, say the mosquitoes.

So what can you do about it? For families who have one or more bite-attracting kids, you need a good mosquito bite prevention and treatment plan for the summer.

 Prevention

Mosquitoes are more than an itchy nuisance. Though uncommon, serious diseases such as West Nile Encephalitis, dengue fever, and now chikungunya fever can be spread by mosquito bites in the USA. The itchy bites can be scratched open by children, leading to scabbing, scarring, and the skin infection impetigo. Prevention is the best strategy.

Try to keep your local mosquito population under control by making it more difficult for the insects to breed. Empty any containers of standing water, including tires, empty flowerpots, or birdbaths. Don’t let gutters or drainage pipes to hold water. Mosquitoes are “home-bodies”—they don’t typically wander far from their place of birth. So reducing the mosquito population in your own yard can really help.

There are yard sprayers either applied professionally or as a home job to reduce the local mosquito population. I have no personal experience with these products, and couldn’t find much in the way to independent assessments on the web. There’s no reason to think they wouldn’t work—but I’m kind of leery about the idea of spraying chemicals all over the place when there are simpler options. Still, for very sensitive people or heavy infestations, this might be a good idea.

There are also devices that act as traps, using chemicals or gas to attract the mosquitoes from your yard. Again, I don’t have much independent confirmation that these work, but they ought to be environmentally friendly and safe. If any of you visitors have used either these traps or the yard/mister sprays, let us know how well they worked in the comments.

Biting mosquitoes are most active at dusk, so that’s the most important time to be vigilant with your prevention techniques. Light colored clothing is less attractive to mosquitoes. Though kids won’t want to wear long pants in the summer, keep in mind that skin covered with clothing is protected from biting insects. A T-shirt is better than a tank top, and a tank top is better than no shirt at all!

Use a good mosquito repellent. The best-studied and most commonly available active ingredient is DEET. This chemical has been used for decades as an insect repellant and is very safe. Though rare allergies are always possible with any product applied to the skin, almost all children do fine with DEET. Use a concentration of about 10%, which provides effective protection for about two hours. It should be reapplied after swimming. Children who have used DEET (or any other insect repellant) should take a bath or shower at the end of the day.

Two other agents that are effective insect repellants are picaridin and oil of lemon eucalyptus. These have no advantage over DEET, but some families prefer them because of their more pleasant smell and feel. (Picaridin, oddly, smells like Fritos.) Other products, including a variety of botanical ingredients, work for only a very short duration, or not at all.

Treatment

No matter what you do, occasional bites are going to happen. To minimize the reaction to mosquito bites, follow these steps:

1. Give an oral antihistamine like Benadryl, Zyrtec, or Claritin (do NOT use topical Benadryl. It doesn’t work, and can lead to sensitization and bigger reactions.) For kids who get bitten a lot, it makes sense to just give an oral antihistamine daily, before the bites.
2. Apply a topical steroid, like OTC hydrocortisone 1%. Your doctor can prescribe a stronger steroid if necessary.
3. Apply ice or a cool wet washcloth.
4. Reapply insect repellent so he doesn’t get bitten again.
5. Have a Popsicle
6. Repeat all summer!

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Tags: mosquitoes, pests

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