The mosquitoes that carry EEE can bite any time day or night, the highest frequency is the early evening. Schools in high-risk areas have canceled nighttime athletic contests. There is insecticide spraying in hish risk towns, but this disease very high case-fatality rate, so it falls to individuals to protect themselves. The following is a combination of advice from me and the CDC.

Use Insect Repellent

The EPA and CDC recommends insect repellents with one of the active ingredients below. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breastfeeding women.

  • DEET (My recommendation is Ultrathon from 3M, which lasts approximately 12 hours, and is similar to the military preparation which has been tested around the world..)
  • Picaridin (known as KBR 3023 outside the US)
  • IR3535
  • Oil of lemon eucalyptus (OLE)
  • Para-menthane-diol (PMD)
  • 2-undecanone

Tips for babies and children

  • Always follow instructions when applying insect repellent to children.
  • Do not use insect repellent on babies younger than 2 months old.
    • Instead, dress your child in clothing that covers arms and legs.
    • Cover strollers and baby carriers with mosquito netting, especially permethrin-treated cloth.
  • Do not use products containing oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD) on children under 3 years old.
  • Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin.
    • Adults: Spray insect repellent onto your hands and then apply to a child’s face.

Tips for Everyone

  • Always follow the product label instructions.
  • Reapply insect repellent as directed.
    • Do not spray repellent on the skin under clothing.
    • If you are also using sunscreen, apply sunscreen first and insect repellent second.

Natural insect repellents have never been adequately tested.

Permethrin treated clothing will kill or disable a mosquito in seconds. It is the choice of the military around the world, as well as permethrin-treated mosquito nets. If you’re in a high-risk area designated by your Department of Health, consider all these recommendations.

You still need insect repellent on exposed skin. Spraying cuffs, collars, had brims, can facilitate stopping mosquitoes.

Wear long-sleeved shirts and long pants

  • Use permethrin to treat clothing and gear (such as boots, pants, socks, and tents) or buy permethrin-treated clothing and gear.
    • Permethrin is an insecticide that kills or repels mosquitoes.
    • Permethrin-treated clothing provides protection after multiple washings.
    • Read product information to find out how long the protection will last.

If treating items yourself, follow the product instructions.

  • Do not use permethrin products directly on the skin. But a search of the medical literature reveals almost no cases. beyond a transient irritation. I sprayed my left forearm for a month and nothing happened:)

Take steps to control mosquitoes indoors and outdoors

  • Use screens on windows and doors. Repair holes in screens to keep mosquitoes outdoors.
  • Use air conditioning, if available.
  • Stop mosquitoes from laying eggs in or near water.
    • Once a week, empty and scrub, turn over, cover, or throw out items that hold water, such as tires, buckets, planters, toys, pools, birdbaths, flowerpots, or trash containers.
    • Check indoors and outdoors.

Prevent mosquito bites when traveling overseas

  • Choose a hotel or lodging with air conditioning or screens on windows and doors.
  • Sleep under a mosquito bed net if you are outside or in a room that does not have screens.
    • Buy a bed net at your local outdoor store or online before traveling overseas.
    • Choose a WHOPES-approved bed net: compact, white, rectangular, with 156 holes per square inch, and long enough to tuck under the mattress.
    • Permethrin-treated bed nets provide more protection than untreated nets.
      • Do not wash bed nets or expose them to sunlight. This will break down the insecticide more quickly.
    • For more information on bed nets, visit CDC’s page on insecticide-treated bed nets.
    • For more information on traveling overseas, visit Travelers’ Health.
James Katz MD

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