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About Applegater. (Jacksonville, OR) 2008-current | View Entire Issue (Sept. 1, 2008)
Applegater September-October 2008 19 EARL’S PEARLS Summer in the Applegate: Bites and stings BY EARL SHOWERMAN, M.D. Yellow jackets, colonial wasps, bees, mosquitoes, flies, spiders and ticks abound in the Applegate and their stings and bites can pose a variety of medical problems. Most of the time bug bites swell up and itch for two to four days, and then gradually resolve. First aid for most stings and bites includes washing the area thoroughly. For stings, you also can apply a small amount of meat tenderizer or baking soda paste to the area for a short period to degrade the toxins; I also have found that chewing a leaf of plantain and applying it as a poultice keeps the swelling down. Keep the area clean and don’t scratch it when it itches. Itching and swelling also can usually be reduced by antihistamines and applying cortisone cream to the bite area several times a day. Bug bites and stings rarely get infected or cause you to become seriously ill, nor do they usually require a tetanus booster. However, if the area near a bite becomes more swollen, red, or painful over several days, you will probably need to start antibiotic medicine right away. Honeybee, wasp, yellow jacket, and hornet stings can cause two types of reactions: local and generalized or allergic reactions. Only about 5% of the population is allergic to these stings, but a severe local reaction can be a cause for concern. Local reactions cause immediate pain and progressive redness, swelling, heat and itching around the sting. Swelling and redness may even spread to involve larger areas, but even bad local reactions will clear up in one week. Ice packs, antihistamines, or mild pain medicines may be used to help reduce the swelling, discomfort and itching. Generalized reactions occur when you have an allergy to the insect venom. They also can develop if you are stung many times by a colony. Allergic reactions can cause a wide variety of symptoms: hives, a red rash, itching or swelling in areas not near the sting, hoarseness, tightness in the chest, breathing problems, dizziness, fainting, stomach pain, vomiting, or diarrhea. Allergic reactions usually occur within a few minutes of the sting. They can be life threatening and require immediate medical attention. Adrenalin shots, antihistamine medicine, and even IV fluids may be needed to treat these reactions. Anyone who has had an allergic reaction to an insect sting has a high risk for a similar or worse reaction if stung again, so it may be important to carry a kit with an injection of adrenalin (epinephrine) when venturing outdoors. If you are stung and use your kit, you should go to your doctor’s office or the nearest ER right away since more than one injection may be needed. Allergy desensitizing shots are effective in preventing reactions, but require years of treatment to work. To reduce the risk of stings, avoid brightly colored clothing, strong perfume, hairspray, or scented lotions during the summer because these attract insects. Avoid leaving food or garbage exposed and do not walk barefoot. Put yellow jacket traps out 15 minutes before barbecueing outdoors and eliminate wasps’ nests when possible. Tick bites in our area do not usually cause any serious problems when the tick is removed right away. There are a variety of ways to remove a tick, which can usually be accomplished by grasping it directly with tweezers as close to the skin as possible and pulling it straight out. If the mouth or head parts break off and are still in the skin, you will need further attention to remove these parts. Do not use hot matches to try to get the tick to back out; you might burn yourself in the process. Tick bites often cause a large area of redness, swelling, and pain around the bite, but this usually clears up in two to three days with mild pain medicine and cool compresses. Some ticks are carriers of serious infections including Lyme disease. Symptoms of tick- borne diseases include any unusual rash, especially a circular rash around the tick bite, fever, flu symptoms, eye irritation, headache, fatigue, swollen glands, joint and muscle aches and pains, or muscle weakness. A special blood test is usually needed to confirm the diagnosis of Lyme disease. Antihistamine and antibiotic medicines may be needed to reduce symptoms and treat infection from tick bites. You can guard against tick bites by being careful not to brush against plants and trees along trails and walks. Wear protective clothing and spray an insect repellant to all exposed areas plus boot tops, pant legs and shirt cuffs. You should use tick repellent (Permanone) or mosquito repellents containing 30% DEET applied to the skin for protection in high-risk areas. Check yourself regularly, especially around the hairline, armpits and waist. Also, check your pets after exposure to tick-infested areas. Finally, I would like to mention swimmer’s itch, a condition I have personal experience with from swimming in the late summer in Applegate Lake. Swimmer’s itch is a benign condition that causes scattered itchy red pimples to develop on the skin within days of being exposed to lake water, and usually takes about a week to resolve without treatment. The medical term is “cercarial dermatitis” and it is caused by an allergic- type reaction in the skin to a microscopic parasite that is carried by mammals, migratory birds and snails. These parasites do not cause any serious illness, and the itching can be relieved by antihistamines and topical cortisone medicine. I have now come to believe that the honker flock that winters over at the lake each year is why I find myself scratching in August. Earl Showerman, M.D. 541-899-8721 Correction: Copy was inadvertently omitted from Dr. Showerman’s article, “Poison oak: prevention and treatment,” which appeared in the July-August 2008 issue of the Applegater. Following is the corrected sentence with the missing copy in boldface. The Applegater sincerely regrets the omission. “You can also prevent the poison oak oil from adhering to your skin and causing a reaction by washing unprotected skin with soap and water within 30 minutes after contact with the plant. Technu and Zanafel are commercially available cleansing agents that will help remove the plant oil up to 4-8 hours after contact and Ivy Block or Ivy Shield are barrier creams that can be applied prior to exposure will help prevent an outbreak if you bathe within 8 hours of contact.” “We hope that, when the insects take over the world, they will remember with gratitude how we took them along on all our picnics.” —Richard Vaughan “Nothing seems to please a fly so much as to be taken for a currant; and if it can be baked in a cake and palmed off on the unwary, it dies happy.” —Mark Twain “God in His wisdom made the fly. And then forgot to tell us why.” —Ogden Nash Loyal Readers Please support our advertisers. They help us bring the Applegater to you.