Mosquito Allergy: Sometimes More Than Just a Nuisance

More water means more mosquitoes

I’ve noticed that everyone lately is complaining about Mosquito bites. It seems Hurricane Irene brought with her more than just damaging floods. The excess water everywhere is a breeding ground for mosquitoes. Normally, mosquitoes wouldn’t be a major topic of discussion, but with West Nile virus being reported in our area, and some unusually severe reactions that I have seen in my New York City allergy practice , I think it’s worth being aware of some facts:

1. Mosquitoes come out more in the evening, so if you are taking an after dinner stroll wear long sleeve shirts, pants and socks—don’t give the mosquitoes much skin exposure. Using citronella candles or mosquito coils can help a little to repel the insects.

2. If you are going into a grassy outdoor area like a park, be sure to use insect repellent. The most proven effective repellent is DEET in concentrations of 10-30% and can be used safely in children older than 2 months.

What to use and not use:

If you get some very itchy bites Don’t use Benadryl spray or cream! You are much better off using over-the-counter cortisone cream and applying ice to the area so there is less swelling. You can take an oral antihistamine like Claritin, Allegra or Zyrtec to decrease the itching, and even Ibuprofen (Advil or Motrin) can stop some of the swelling and itching.

Another over-the-counter remedy is to use After Bite. If you use it immediately, it greatly reduces itching and swelling.

Reactions can sometimes be severe

There is allergy testing for Mosquitoes, but it is rarely necessary because most bites aren’t severe and resolve with the above treatments. However, this past year I had 2 cases of severe allergic reactions to mosquito bites. One was in a small child, his mother brought in photos how severe the swelling was in the boy’s leg after the mosquito bite. He couldn’t walk for a few days afterwards. Another strong reaction occurred in a college student who was bitten behind her knee. Her knee swelled up so much she also had difficulty walking. In both of these cases, if I had spoken to the patient early enough (they were both new patients I had not yet seen) I would have prescribed oral prednisone to make sure the swelling didn’t become severe enough to cause inflammation in the deeper tissue. If someone’s job put them in increased exposure to mosquito bites and these kind of reactions, I would consider desensitization with mosquito extract.

And lastly, if you do get several mosquito bites and develop a fever, Call your doctor immediately to be tested for West Nile virus!

The good news: Fall is on the way and the mosquitoes will be leaving town soon!

Dean Mitchell,M.D.

The Allergy Detective

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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