(photo credit: Courtesy)
For some reason, mosquitoes seem to find my four-year-old son delicious, and he
is regularly bitten in the summer, even though we try to protect the house with
window screens. I think most of the problem is when he is outdoors. One of the
bites even ended up as an infection for which he needed medical
How does a mosquito bite turn into an infection, and what can
be done to prevent this complication – and insect bites in general?
Dr. Adi Klein, head of the pediatric emergency department at Hillel Yaffe
Medical Center in Hadera, replies:
High temperatures and humidity – along with
bodies of standing water – are the perfect conditions for the spread of
mosquitoes in our region, and among the main sufferers are young children and
infants. In the past month, more than 30 children have arrived at our emergency
room with infected mosquito bites. They usually develop a fever and inflamed
lymph glands. They need intensive treatment, but all of the children are in good
Even when the local authorities spray against mosquitoes, many
survive, and during trips, while sleeping at night, at picnics or at the sea,
it’s hard to avoid them.
Children are much more sensitive to mosquitoes
than adults. There are chronic skin conditions such as “asthma in the skin,”
which is actually a form of atopic dermatitis, also known as eczema, which
involves a predisposition to being overly sensitive to allergens. Skin sores can
quickly become infected. Children with even a local sensitivity and not in skin
all over their body can react significantly with redness, swelling and
Often, the mosquito bite creates an allergic reaction, and
sometimes there is an infection. One can try to differentiate between the two
according to the time difference: An infection develops only about 24 hours
after the bite. But as redness, swelling and itchiness are also a reaction to
allergy, determining the cause can be confusing.
It’s natural to scratch
itchy skin, but this causes infectious bacteria on the surface of the skin to
penetrate it. These microbes are naturally found on the skin and cause no
problems there, but when they penetrate lower layers, they cause a local
infection and significant swelling and redness.
If the infection spreads
through the body, the patient can end up in the hospital.
In addition to
ordinary bacteria, another type, called Streptococcus group A, can spread
quickly and cause infection in the soft tissues. This can cause the child’s
condition to deteriorate rapidly.
Mosquitoes cause most bites, but other
insects, including ticks and flies, can also cause problems. If a patient is
hospitalized, blood tests and cultures are taken find out what bacteria are
involved. If the child was in contact with a dog, it may be that he was infected
by a tick.
When a young child suffers a mosquito or other insect bite the
first thing to due is to apply anti-histamine cream. Make sure the child’s
fingers and nails are clean to avoid infection from scratching. If the situation
requires going to the hospital, it will usually require anti-allergy medications
and oral antibiotics, but if the child can’t take enough pills orally to
overcome the infections, intravenous infusions are necessary.
exposure to mosquitoes, for example by wearing long-sleeved, light clothing and
anti-mosquito preparations, installing screens and eliminating standing water
(even in a pail), is the best way to deal with the problem.
I am a
71-year-old man who had a heart condition and suffered from hypertension. I get
medication for the high blood pressure. I am going on vacation next month to a
fancy hotel with a luxurious spa. I was wondering whether I can safely use the
Jacuzzi and sauna or not. I.T., Beersheba Judy Siegel-Itzkovich comments: The
Hebrew-language Israeli Journal of Family Practice had an article not too long
ago by Dr. Nir Livyatan, a family medicine specialist from the Haifa and western
Galilee regions, which dealt with this issue. He wrote that bathing in very warm
water or being in a place of intense heat, like a sauna, can cause the blood
vessels to expand and the blood pressure to drop. Theoretically at least, using
a Jacuzzi or sauna could cause problems in heart disease and hypertension
One study he cited showed that one can stay in a Jacuzzi for up
to 10 minutes without risk, even if suffering from these chronic conditions and
taking medications for them. Another study stated that 15 minutes in a Jacuzzi
could be considered safe for such patients if they were fit enough to exercise,
while a third said that hypertensives or heart patients who are stable can use a
The American Heart Association has issued an advisory
saying that hot tubs and saunas “pose no risk to healthy people as long as they
are not misused.
People with high blood pressure should tolerate saunas
well as long as they are not experiencing a hypertensive crisis...
your doctor has told you to avoid moderate exercise, you should also be careful
when considering hot tubs and saunas. People with high blood pressure should not
move back and forth between cold water and hot tubs or saunas. This could cause
an increase in blood pressure. Drinking alcohol and using a sauna isn’t a good
combination either, so don’t mix the two.”
Thus Livyatan concludes that
10 or 20 minutes in a Jacuzzi is safe for people with stable coronary disease
and blood pressure. If patients are told by their doctors to avoid moderate
physical activity, he recommends avoiding hot tubs and saunas.
case, consult your doctor about your individual case.
Rx for Readers
welcomes queries from readers about medical problems. Experts will answer those
we find most interesting.Write Rx for Readers,
The Jerusalem Post, POB
81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-
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