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Summer 2014 - Pests & Poison

If your family likes to spend time together outside, the summer is a good time to brush up on everyone’s knowledge of pests and poisons.

A Executive Medical Director for Primary Care and Urgent Care at WakeMed Physician Practices and Fellow of the Academy of Wilderness Medicine, shares tips to prevent health problems and what to do when you encounter some of the more common pesky problems that come up frequently in the summer.


To keep insects away, Dr. Casey suggests putting a flea collar in the bottom of sleeping bags.

Minimize Pesky Problems
Regardless of the concern, many things can be avoided with a little added precaution. Remember these quick tips for keeping the fun in your summer:

  • Wear bug repellent and protective clothing in wooded areas – a repellent with DEET helps with both mosquitoes and ticks.
  • Adults should check each other and their kids for ticks after time outdoors.
  • Jump in the shower when coming in from a day of play.

Tiny & Troublesome Ticks
Some ticks carry pathogens that cause disease in humans. It’s tough to know if a tick you find poses a problem. Even experts have difficulty identifying a specific tick species within a group. “The most important thing about ticks is knowing how to properly remove them and when you need to come in to be seen,” said Dr. Casey. “We have already started seeing tick bites this spring.”

If you find a tick, don’t panic. If it is loosely attached or is flat, it has probably only been on someone for a short amount of time. After removing the tick (see removal tips on page 7), Dr. Casey recommends monitoring the site and watching for symptoms for approximately 1-2 weeks. If nothing appears or symptoms do not develop, there is probably nothing to worry about.

“Remember, a small amount of redness without rash can be a body’s initial, normal inflammatory response to the tick bite,” said Dr. Casey. “However, if you develop a rash, significant redness or the area looks worse over time, get it assessed by a doctor.”

Other symptoms of concern include headache, joint aches, muscle aches and fatigue. If any of these occur and are new, get checked by a doctor. A trip to the emergency room is only necessary if symptoms progress rapidly, which is rare.

“If you do need to see the doctor and are able to bring in the tick at the time of your visit, it might be helpful for identifying the type,” said Dr. Casey. “However, keep in mind that the tick won’t necessarily be identifiable nor analyzed for specific diseases.”

Tips for Tick Removal
Avoid trying removal techniques that involve matches, nail polish remover, gasoline, etc. “Burns and other risks outweigh the benefits for most of these methods,” said Dr. Casey. They might even irritate the tick more, which could cause them to regurgitate pathogens into the wound.”

  • DO use fine-tipped tweezers.
  • DO wear gloves if available.
  • DON’T use your fingers.
  • DO grab the tick at the part that is stuck in your skin.
  • DON’T grab the tick around its bloated belly.
  • DO gently pull the tick straight out until it lets go of your skin.
  • DON’T twist and turn the tick.
  • DON’T crush it because you are expelling its pathogens.
  • DO consider putting the tick in a jar or sealed bag and place it in a freezer for possible identification later.

Note: Try to remove the entire tick. If most of it is removed, you generally do not need to have it checked unless other symptoms develop.

“It is normal to see a small crater or indention in the skin after tick removal,” said Dr. Casey. “Clean the area with basic soap and water. You can use peroxide initially to clean the area and add antibiotic ointment.”

“If the area itches a lot, use a topical or oral Benadryl® (diphenhydramine),” said Dr. Casey. “Make sure the dosage is appropriate for children.”

Learn more - Ticks - Removing a Tick
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Uh-oh, Mosquitoes!

Uh-oh, Mosquitoes!
Nobody enjoys it when mosquitoes decide to crash the party and ruin an enjoyable outdoor experience. They can be a real pain! Even worse, they can transmit viruses.

“The very best thing to do is wear protective clothing and use a repellent with 10 to 30 percent DEET when there is a high chance that you’ll be around mosquitoes,” said Dr. Casey. “Alternate products that don’t have DEET are less effective but can be used.”

Three Most Effective Repellents

  • DEET*
  • Picaridin – DON’T use Picaridin on children younger than 3
  • Oil of Lemon Eucalyptus** – DON’T use on children under 3.

*According to the American Academy of Pediatrics, this is also safe for kids age 2 to 12 with a maximum application of three times per day (less than 2 years old, one time per day). You can apply repellent with DEET to children as young as 2 to 3 months.

**This oil contains a chemical that repels mosquitoes. It is less potent than DEET and picaridin and does not last as long after applied.

Dr. Casey recommends applying repellents only to exposed areas of skin and wash with soap and water after done. Some clothes are made with a repellent.

Don’t Invite Mosquitoes
Families should also eliminate sources of water where mosquitoes can breed around the home. Children can help by looking for things that might be holding water.

Common Breeding Areas:

  • Toy Buckets
  • Empty Planters
  • Bird Baths
  • Watering Cans
  • Tires
  • Roof Gutters

Poison Ivy!

Itchy Poison Ivy
If you’ve ever had an annoying poison ivy rash, you know that it’s something you don’t want mixed into your summer plans.

Most people know to watch for and avoid ‘leaves of three’ so it’s easy to assume the problem is with the leaves. The oil is the real problem so exposure to either the leaves or the vines can cause a problem.

“It’s not really contagious,” said Dr. Casey. “The concern is when the skin comes in contact with the oil so it is important to wash everything it may have touched.” If you think you’ve been exposed, Dr. Casey recommends showering as soon as possible after exposure. Parents should help children wash thoroughly with basic soap and water. Adults can shower and use soap or a powder laundry detergent to help neutralize the oil.

If new areas of concern are appearing days later, think back to everything you were wearing or using on the day of exposure. Gloves, clothing, garden tools, shoes and all other possible sources of the oil should be washed in hot water. If you slept before realizing you were exposed, wash your sleepwear, linens and towels.

TIP: Your pet might even be a source of spreading the oil. Give them a good wash if you suspect they came in contact with the oil.

Mild cases of poison ivy rash do not need medical attention. “There is no proven effective treatment to treat poison ivy,” said Dr. Casey. “Calamine lotion, hydrocortisone and other topical products will only temporarily help relieve itching.” See a doctor if you have very severe or widespread rashes. Prescription products can help with symptoms.




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