As summer approaches and experts predict a further spread of West Nile virus, federal health officials are recommending DEET-based repellents to help prevent mosquito bites and the national organization for pediatricians has issued new guidelines to help protect families from insect- and tick-borne disease. DEET is the active ingredient in the most widely used personal insect repellents.
The federal Centers for Disease Control and Prevention last year began recommending the use of DEET-based repellents to help prevent mosquito bites and potential infection from the diseases they sometimes carry, particularly West Nile virus. The CDC says DEET-based repellents are the most effective and "are very safe when used according to the directions."
The American Academy of Pediatrics recently has released new guidelines on protecting children from West Nile virus that include using insect repellents. The AAP now says DEET-based repellents should be used when necessary to protect against insect- and tick-borne disease and advises that products containing up to 30 percent DEET can be used on children. The previous guidance was to use products with no more than 10 percent DEET.
The AAP experts note that West Nile virus causes illness less often in children than in adults, for unknown reasons, and that there is no vaccine available to prevent the disease. In the latest issue of AAP News, Stanford T. Shulman, M.D., FAAP, says preventing West Nile means using common-sense measures to avoid mosquito bites. He recommends that children wear long sleeves and pants when possible, that they avoid being outside at dawn and dusk when mosquitoes are most active, and that adults apply repellent on children as needed.
The AAP's Committee on Environmental Health provides guidance on using DEET, also in the June AAP News, stating: "DEET-containing products are the most effective mosquito repellents available. DEET also is effective as a repellent against a variety of other insects, including ticks. It should be used when there is a need to prevent insect-borne disease."
The committee suggests applying DEET-based repellents on children two months of age or older. This is the first time the Academy has provided guidance on ages of children and DEET usage. The pediatric group offers additional advice, such as, "Apply DEET sparingly on exposed skin; do not use under clothing."
Product labels provide further information on proper use, says Susan Little, an industry spokesperson with the Consumer Specialty Products Association. As with any product, she says, it is essential to read and follow label directions when using DEET-based repellents. The CSPA provides consumers with extensive information about using these repellents, plus other steps to prevent insect and ticks bites, through a Web site (http://www.deetonline.org), brochure and toll-free phone line: 1-888-No-Bites (662-4837).
Helping to avoid exposure to West Nile virus is not the only reason to use DEET-based repellents, says Jerome V. Murphy, M.D., a pediatric neurologist.
"There are two reasons to prevent mosquito bites in children," says Dr. Murphy. "First, they cause discomfort. When children scratch the affected areas, the skin gets further irritated and can even result in infections. Even more importantly, mosquitoes can carry disease agents that can cause West Nile, equine encephalitis, La Crosse encephalitis and other serious illnesses."
DEET-based repellents can also help prevent tick bites, says Dr. Murphy, noting that ticks carry numerous diseases, particularly Lyme disease and Rocky Mountain spotted fever. Both sickened record numbers of Americans last year. The CDC received reports of 18,181 Lyme disease cases in 2002, and experts say that many more cases are unreported. The number of Rocky Mountain spotted fever cases reported to the CDC jumped from 697 in 2001 to 975 in 2002.
Experts Predict West Nile Spread to Continue This Summer
Forty-one U.S. states have reported human cases of West Nile virus, which first appeared in New York City in 1999. The disease will spread farther this summer, according to experts including Jonathan F. Day, professor of medical entomology at the University of Florida. He says states with few West Nile cases so far--particularly North Carolina, Texas, Wisconsin, Minnesota and the Dakotas--could see a significant increase this summer, and California could see its first human cases as migratory birds return north, after having become infected while they wintered in Central America and Mexico.
A specialist in mosquito-borne diseases, Day says several major metropolitan areas in the East might see their first serious outbreaks of West Nile. "Along the northeastern corridor, from Washington to Philadelphia to Boston, there's been an extremely wet winter and spring," Day says. "This favors mosquito production and that could translate to a big West Nile virus problem later this year.
"We also know that West Nile virus made it to Wyoming and Colorado, right up to the foothills of the Rocky Mountains, so people in that region are definitely at risk," Days says.
Consumer Confusion Leads to Label Addition
Consumers will find it easier to readily identify personal-use insect repellents containing DEET, thanks to a recent regulatory decision permitting the word "DEET" to be included on product labels. Previously, by law, DEET-based repellent labels could only refer to DEET by its cumbersome scientific names, primarily N, N-diethyl-m-toluamide. But in a decision last fall, prompted mainly by the rapid spread of West Nile virus, the U.S. Environmental Protection Agency approved adding "DEET" to labels.
"This step, which will certainly aid consumers, is one that repellent industry officials had advocated for years," said Susan Little of the CSPA. Companies that manufacture and market DEET products are modifying labels and putting stickers and hangtags with "DEET" on containers of repellents already produced for this year's mosquito season. Also, companies are preparing new point-of-sale advertisements, brochures and other collateral information.
Scientific research, including a study published in the New England Journal of Medicine last July, demonstrates that DEET is the most effective personal-use insect repellent available. It has been studied extensively by scientists and healthcare professionals since its introduction in 1957. The industry estimates that about one-third of Americans use DEET-based products every year.
The Consumer Specialty Products Association (http://www.cspa.org) represents the interests of the consumer specialty products industry, which provides households, institutions and industrial customers with products that help provide a cleaner and healthier environment.
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