While you may be relishing your time outdoors in the glorious summer, dining al fresco with the family on the patio, picnicking on the beach or just nabbing a burger or a hot dog at a curbside stand, some familiar, pesky critters at the same time may be munching on you.
Bug bites, merely annoying for most of us, can be medically perilous to some who encounter the wrong creepy crawler or experience a severe allergic reaction. When those bites go beyond a bothersome itch, it's important to know what to look for, how your body may react and if this might be the time to see your doctor.
An Inconvenient Truth
While most bites or stings just cause swelling and a bothersome urge to scratch, more than two million Americans are allergic to stinging insects, which include honeybees, yellow jackets, wasps, hornets and fire ants. Many of these individuals also may experience life-threatening reactions. More than 500,000 Americans visit emergency rooms every year because of insect stings or bites, and reactions to these are known to cause at least 50 deaths per year.
If you experience one of these strong allergic reactions to an insect bite or contact, you could develop anaphylaxis, which is a severe whole-body allergic reaction to a protein from the bug. This can result in coughing or difficulty breathing or swallowing; a feeling of throat fullness; swelling of the lips, tongue, eyes, palms of hands and soles of feet; confusion; lightheadedness or dizziness; fainting; nausea; diarrhea; palpitations, slurred speech; wheezing; abdominal pain; stomach cramps; anxiety; hives and circulatory collapse (shock). This life-threatening condition occurs after your immune system gets sensitized from an exposure to the venom of a bee or other insect sting. When your immune system encounters this toxin again, tissues in various parts of the body react -- perhaps overreact -- by releasing histamine and other substances that may cause your airway to restrict and your blood vessels to dilate if you're hypersensitive to stings.
You should seek prompt treatment for this reaction, and if you think someone is suffering an anaphylaxis due to a bite or sting, you need to help him or her seek immediate emergency medical care, by calling 911. If you know the person in distress has a history of such allergic reactions, oftentimes they will carry an emergency kit with them. You may need to help them find the kit and inject the medicine they have on hand. Be careful with oral medications for them if they're experiencing difficulty swallowing or breathing. While waiting for medical personnel, help the patient avoid shock -- have them lie flat, raise their feet about 12 inches, and keep them comfortable. Although anaphylaxis can be life threatening, it can be treated, and individuals recover from it. But act swiftly.
Because someone who has suffered one allergic reaction to one bite or sting has a 60 percent chance of experiencing another similar reaction if bitten or stung again, be sure, if this describes you, to discuss an action plan for yourself with your doctor or allergist. Those at-risk may carry a physician-prescribed, self-administered epinephrine (adrenaline) kit, also known as an EpiPen®. It carries epinephrine, a hormone and neurotransmitter that increases heart rate, constricts blood vessels, dilates air passages and stimulates the nervous system. These measures all can be key if you experience a major allergic reaction. But you must talk with your physician about the autoinjector; you need to ensure it's readily available, on hand, and replaced before its expiration date, or it might not help you when you need it the most.
Taking a Bite Out of Confusion
Even if you're not severely allergic to bug bites or stings, you may want to take a look at these photos from WebMD to help you determine the severity of the nip that annoying insect took of you. [Warning, click here with care; as is the case with all medical images, some may be unsuitable for the queasy.]
Mosquitoes: While most mosquito bites are little more than a bother, the bugs are notorious carriers of disease and pathogens. Malaria, of course, is a global scourge linked to these blood-sucking pests. It's not seen in California, where the main, mosquito-related bane is West Nile virus, or West Nile fever. This skeeter-borne disease can cause abdominal pain, diarrhea, fever, headache, lack of appetite, muscle aches, nausea, rash, swollen throat and lymph nodes, and vomiting. More serious forms of the disease can cause confusion, lack of consciousness or coma, muscle weakness, neck stiffness, and weakness in one arm and leg. If you suffer any of these symptoms after coming into contact with a mosquito, it's important to seek medical care immediately. The state takes the threat of West Nile virus sufficiently seriously and has set up a website with warning information. If you're a gardener or a swimming pool owner, you also can do your part to curb infestations by ensuring that your property is free of mosquito breeding areas -- a neglected pool or yard water feature can create misery, or worse, for an entire neighborhood.
Tick Bites: Ticks really get under our skin. And once a tick attaches itself to your body, it can burrow in, feasting on your blood and transmitting disease. Tick-borne ailments include Lyme disease, an inflammatory affliction spread by a bite that can cause body-wide itching. It has been found in all but two counties in California, and the signs and symptoms of a Lyme infection include chills, fever, a general ill-feeling, headache, light-headedness or fainting, muscle pain or a stiff neck and a typical "bull's eye" rash. Babesiosis is a disease caused by a parasite most often carried in deer ticks. Babesiosis cases have cropped up in California and can appear very similar to malaria, causing fever, chills, headache, nausea, muscle pains, fatigue, anemia, shortness of breath, anxiety and panic. Between 2001 and 2008, researchers noted a 20-fold increase in babesiosis in the Lower Hudson Valley in New York. If you feel ill and spot a tick on your body and experience any of the symptoms just described, seek medical care. If you see you've been bitten and the tick is still on you, follow these steps to get rid of the pest, as recommended by the American Academy of Family Physicians.
Bee, Wasp Stings: As long as you don't experience facial swelling, tightness of the throat or other anaphylactic symptoms, that white, swollen bump with a red dot in it -- your new bee sting -- probably won't pose big problems. Remove the stinger, apply a cold compress and consider an over-the-counter antihistamine for itch relief. You should always use care, though, about contact with these usually beneficial bugs. In particular, Africanized bees, also known as killer bees, have become prevalent in California since entering the state in 1994. Because Africanized bees defend their colonies more than others in their species, they are more easily disturbed; they can launch concerted stinging attacks, which can make them life threatening, especially to babies, children, the elderly, those allergic to stings and pets. As with aggressive wasps or yellow-jackets, Africanized bees aren't going to let up once disturbed, so you need to remove yourself, pronto, from their area; race to shelter, even if it means a few soldiers follow. Eliminate them, and then check to see how much harm you've suffered, tend to your wounds and decide, especially if you're reaction-prone, whether you need medical care. Because you simply may stumble into or on bee hives or yellow-jacket nests while gardening or working outdoors, take precautions: wear gloves, proper footgear and protective clothing in light colors.
Red Fire Ants: Although red fire ants are new to California, they've been discovered in many residential and commercial neighborhoods in Orange, Los Angeles, Riverside, San Bernardino and San Diego counties. Don't mess with their nests, and watch out if they're marching or swarming nearby. A red fire ant sting can look like puss-filled hives all over your body. A single red fire ant can bite and sting numerous times, causing immediate burning and itching; over time, a white pustule will appear at the bite site. Cold compresses, antihistamines and over-the-counter pain relievers can help. But because many red fire ant stings can be toxic, it's important to seek emergency care if you notice them crop up on your body.
Spider Bites: While many spider bites might just appear to be the work of a mosquito, if you look close you may notice distinctive, red fang marks accompanied by redness, tenderness and shooting pain. That may mean you've encountered a black widow, the most common harmful spider in California. With venom reported to be 15 times stronger than a rattlesnake's, a black widow bite requires immediate emergency care and anti-venom. With venom just as deadly, brown recluse spiders are another eight-legged creature to be wary of in the Golden State. The venom of a brown recluse spider is more deadly than that of a rattlesnake. But unlike a rattlesnake, bites by a brown recluse can appear harmless at first. Then, two to eight hours later, victims experience symptoms that include severe pain at the bite site, severe itching, nausea and vomiting, fever and muscle pain. If you think you've been bitten by a brown recluse, get medical attention quickly. Fortunately, it is very rare for a person to die from either a black widow or a brown recluse spider bite.
Scorpions: Scorpions thrive in warm, dry climates and live in the deserts around us. Some inflict stings no more serious than those of ants or bees. A scorpion attack may cause redness, swelling and burning that can disappear after 30 minutes. But other stings (such as from a bark scorpion, common in the California deserts adjacent to Arizona) can be deadly. Symptoms of a bark scorpion bite include vomiting, profuse sweating, itching, respiratory paralysis, convulsions, muscle twitching, swelling and pain. If stung by a scorpion, get medical care fast.
Sand Flies or Sand Fleas: Sandflies are tiny, biting bugs that mostly are irksome and are commonly found along the beaches of California and Florida. A sandfly bite often leaves red, itchy bumps -- itchier than mosquito bites and that often last longer. Remedies that can help quell the itch include Calamine lotion, antihistamines and hydrocortisone cream.
Bed Bugs: Los Angeles is not immune to bedbugs, whose bites appear as tiny, red and itchy spots on your skin. One California-based exterminator company reported a 240 percent increase in its bedbug work from 2000 to 2006. Bed bugs feed off your skin and create nasty, persistent infestations. You can spot them on your mattress, as little black marks. Because bed bugs can plague your home or apartment, it's important to get rid of them quickly so they don't keep coming back.
Whether it's bedbugs, fleas, midges, bees, wasps, biting flies, kissing bugs (conenoses) or mosquitoes, if your infestation is serious enough, don't be silly -- call for not only medical help if besieged but also professional extermination or public health assistance. Besides dressing right when active and outdoors, reconsider those bug-attracting perfumes, colognes and sprays. Cover and avoid food in trash cans and dumps. Wear insect repellant. Don't set down beer or soda cans and leave them unattended, then reach without looking to guzzle from them. And don't go out of your way to agitate insects.
Frankly, as with snakes and jelly fish and sting rays (all of which I've written about before), bugs and the other creatures great and small can just as easily go their own way, coexist in the environment and not bother us. Their bites typically stay benign if bothersome. But take it from me -- a guy who once went to the emergency room because a tick dug into my skin, died there and had to be cut out -- even common, little health issues can escalate if you don't care for them properly. Play it safe for a great summer, please.