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Our 11-year-old son seems to be especially attractive to mosquitoes, especially when he goes on class trips in nature areas. He has come back more than once with mosquito bites near his eyes and on his lips, and they become very swollen. Is this dangerous and what can be done to reduce his suffering from mosquito bites? V.S., Karmiel
Dr. Giora Gotsman, a pediatric and infectious diseases expert at Meir Medical Center in Kfar Saba, comments:
Female mosquitoes, which do the biting, seek blood to promote incubation of their eggs. They produce and inject into the skin of their victims a protein to keep the blood flowing, but this substance causes irritation and scratching and may cause an allergic inflammatory reaction. There are differences in the way various people react to mosquito bites.
In some cases, especially in children, swelling can be very significant, especially if the location is near the eyes, ears and lips. Swelling can be so bad that the victim's eyelids close or the outer ear or lip gets very large. Such occurrences are very scary, but they don't always require treatment beyond an ointment or gel that alleviates the itching and pain until the swelling goes down. Often, swelling, redness and local heat are suspected of involving an infection, so the doctor may prescribe antibiotics. A simple mosquito bite can develop into an infection because it itches and the victim scratches. This requires that antibiotics be given. But in most cases, in which there is no infection, pain or fever, antibiotics are not necessary.
You can minimize your son's exposure to mosquito bites by giving him mosquito repellant to take along on his class trips, to wear long sleeves and long pants and to sleep under mosquito netting.
I am a 40-year-old woman who, for as long as I can remember, has fallen asleep as a passenger during inter-city driving. As a result, I never drive inter-city and always have somebody else behind the wheel. I get enough sleep at night and fall asleep easily in bed. Is this normal? What causes it? Someone told me that being lulled to sleep while in a car has to do with having low blood pressure, which I have. Is this true?
Prof. Peretz Lavie, a leading sleep medicine expert at the Technion-Israel Institute of Technology's sleep lab in Haifa, comments:
There are many reasons for falling asleep at the wheel. Most of them are related to disturbed sleep at night rather than to low blood pressure. The leading cause of excessive daytime sleepiness is sleep apnea syndrome, which entails cessation of breathing during sleep. In most cases, the patient is not aware that he suffers from disordered breathing during sleep, so the only way to reach a diagnosis is a sleep examination at a sleep medicine clinic.
The Technion sleep clinic in Jerusalem will be happy to consult on this case. We do not know of a syndrome in which people do not suffer from sleep apnea and do get enough sleep but automatically fall asleep while they are passengers in a moving car. In many cases, there is an underlying disorder. It may be restless legs syndrome or idiopathic hypersomnia. There is no way to reach a conclusion in such cases without an examination in a sleep lab.
I never used to suffer from pollen allergy as a child, but this changed suddenly after I received about 30 units of blood following a 1972 car accident. More than 30 years later, I still suffer from such an allergy today. Could there be a connection?
Prof Meir Shalit, head of the allergy unit at Hadassah University Medical Center in Jerusalem's Ein Kerem, replies:
Most probably, there is no connection between the blood transfusion and your allergy. People can spontaneously develop allergies as adults, even though they never had them as children.
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