Transcription:
Important Information About Vectorborne Diseases and Ways to Prevent Them

Melanie Cole (Host): Well as the weather warms up, we all engage in a number of activities that can make us more vulnerable to fleas and ticks and mosquitoes and according to the CDC, there has been a steady increase in the occurrence of vector borne diseases over the last couple of years. My guest is Sandy Benson. She’s an infection preventionist at Hendricks Regional Health. Sandy, what are some of the latest indications that you are hearing on vector borne diseases? Are we seeing more of them?

Sandra Benson, BSN, RN (Guest): Yes Melanie, we are. Recently, the CDC is estimating there are about 300,000 kind of Lyme disease infections in the US each year, but recently, eight to ten times is what’s being reported at what we typically have. And that has been a little bit unusual. The ticks are also something that we are seeing an increase in the United States. They are the biggest threats. The diseases spread by ticks are rapidly on the rise as well. These things can’t necessarily always be found by traveling but, many can be picked up in your own back yard. So, we are definitely seeing an increase nationwide in a number of these what we call vector borne ailments.

Melanie: So, let’s describe for the listeners a little bit about vector borne ailments. What are some of the main vectors and the diseases that they transmit, and you have mentioned a few of them, but speak about because there is such a long list of them and people have heard of West Nile or mosquito things or malaria but speak about some of the others that you see.

Sandy: Well, we see quite a few. I know many have heard about Lyme disease, many may have heard about Rockie Mountain Spotted Fever which is another type of tick. Most of us have been well aware about the information regarding mosquitoes. We had quite the time last year regarding the mosquitoes and they can spread things like malaria, Zika, Dengue fever, West Nile and other illnesses. So, so many of these pest-borne diseases seem to be nonexistent or we don’t think about these, but they are rapidly on the rise and it’s kind of worth doing anything and everything you can to avoid getting infected by these.

Melanie: Well, then let’s start with one of the more obvious is mosquitoes. So, what can we do? Is product with DEET is this enough? And how do we know if a mosquito bites us if it’s something that we should be worried about?

Sandy: Well, one of the things that you can do, first of all, is if you are going to be walking through the woods or in buggy regions where it’s easiest for a mosquito or a tick to reach your skin; is to make sure that you limit the amount of exposed skin in the first place. Long pants, sleeves, socks, those kinds of things can help keep ticks and mosquitoes from finding a patch of skin to bite. You also want your clothes to help you battle the bugs, but you want to look at your gear that you are using if you are an outdoor kind of person. You want to see if you can find some outdoor gear that’s been pretreated with a type of chemical that’s a chemical that doesn’t work on your skin, something like a permethrin. It doesn’t stay on your skin, but it stays on your clothes or your camping gear and those kinds - that kind of chemical can deter bugs from getting into some of your tent supplies and things like that and some of these pretreated clothes, they are great and last about 70 wash cycles. You can also buy spray or wash to apply and then of course applied to your skin. There is always skin prep that you want to make sure that you put EPA registered product – skin repellant on your skin. Most of them should contain at least 20% DEET which is the chemical that is deemed safe by the Centers for Disease Control. It is safe for even children over two months of age, pregnant women and adults.

Melanie: I’m so glad you mentioned about children because I was going to ask you that so thank you for clarifying that DEET is safe for children. Now, we like to go to the beach and sandflies are the worst. They just absolutely are such a nuisance. Are there diseases we worry about with them as well?

Sandy: With sand flies? In any kind of blood insect that is kind of biting blood sucking that you run into, those kinds of things they can not so much carry diseases, they could possibly carry diseases, but the other thing is they have these large red itchy bites that kind of turn into a rash and people start scratching and oftentimes if your hands are not clean, and you are scratching with your fingernails and you’ve got things under your fingernails and you’re scratching, you could end up with a basic skin infection. Now sometimes sand flies can carry what’s called a Chandipura virus which is a cousin of rabies and it could be deadly, but those are typically found in places like India, but yes, over the counter repellants with large concentrations of DEET again, a proven to work on these sand flies and they are pretty annoying. Because their bites last a little bit longer that the mosquito bites. Sometimes you can use some lemon eucalyptus oil that’s been shown to be kind of effective. So, you want to pre-treat as much as you can and limit the time that you are hanging out in the sand. It sounds wonderful to spend all day out there, but sometimes you have to use a little bit of precaution.

Melanie: That’s great advice. Now ticks, because Lyme disease and boy we have to check out little pets and ourselves. What do you want us to do as far as tick prevention, but also tick checks if we are out in the woods or if we are camping, where are the spots we really need to be locking to make sure that we didn’t get one?

Sandy: Oh absolutely. You want to make sure that you are paying attention to that. What you really want to do as I mentioned, you want to not only take precautions about making sure that you cover as much skin as you possibly can. You want to make sure that after spending time in the woods or spending time walking around, you want to get yourself in a situation where you can examine the skin, particularly with pets, you want to make sure you look behind the ears, you want to look under the collar. You want to make sure that you look at their food pads. Oftentimes the tick will go for wherever they can get access to a blood supply or a blood meal and they will go for whatever is exposed. You also want to make sure I can remember if you have children, going off to camp, summertime is a great time to go camping, they have the Boy Scout camps and the day camps and whatnot; when the child comes in, you want to probably take the backpack and all of the luggage and all of the clothing. You want to separate it, shake it out, look what’s in it and you want to go ahead and do your laundry, making sure that you inspect everything there and then the child. They might balk a little bit, but you want to check behind their ears, in the folds of their ears, the folds of their skin. You want to do a pretty detailed inspection if they have been out for a very long time like camping and that kind of thing. Those are the kind of typical things that you want to do. Antibiotics sometimes people will try to pretreat, not recommended in that case. But the best approach is to start out with making sure that your dressed properly, you use any kind of repellant screens with DEET as much as possible and then if you do get a tick bite, you want to make sure that you wash and use antibiotic cream at that point. If the bite area develops some itching, preparations containing Benadryl is typically recommended. You can apply it directly to the skin. However, treatment of the pathogens that the tick might pass on to a person depends on a number of factors such as the type of tick, the time that the tick has been attached to the host, the kinds of diseases you are seeing in the community and the symptoms developed by the patient. And specific treatment for a tick bite, it really depends on the identity of the pathogen that is transmitted. And oftentimes, it’s important when you go into visit a physician if you are not feeling well, tired, listing, itching, that type of thing, very important to tell the physician well I have been camping, well I have been out in the woods, those kinds of things because that help diagnose the situation pretty quickly.

Melanie: And now the last one I would like to ask you about in our time today Sandy is water-borne vector diseases because sometimes you see some spores in the water, maybe they are harmful, maybe they are not, is there anything in the water we should be wary of if we are swimming around in lakes or that sort of thing? What should we be aware of if anything?


Sandy: Yes, one thing that I like to tell folks about, you know when it gets hot, the first thing most of us want to do is we want to jump in the water to get cool. Oftentimes, there are things like Cryptosporidiosis that might be hanging out if you jump into a water supply that has not been maintained. Sometimes water depending on the conditions like when you have 90-degree weather or water that is stagnate, you can have pathogens to grow and there are pathogens that aren’t a normal part of a fresh water flora. Very important if you have got broken skin or if you have got a rash to not just jump willy nilly into unfamiliar water. If you are out hiking, jumping into a fresh water, it may look refreshing, but you are not sure what’s in that water. Oftentimes, if you are in a pool, waterparks; it’s important to make sure that that water park has been maintained you know – pools very important to make sure the proper chemical levels are being maintained. Oftentimes, the water safety piece about avoiding putting a child with a soiled diaper into a pool, avoiding things like that, you want to just kind of pay attention to those types of things. Real easy to pick up something in unfamiliar water. Sometimes you have blood flukes hanging out in water, sometimes can infect victims, you just don’t know what’s going in the water. So, try to avoid going into water unless you know it’s a well-maintained pool or you are familiar with the water supply. But I would encourage you to avoid unfamiliar water that you just come across particularly when the weather has been kind of sunny, you have been having flooding in the area or changes in the environment or if it’s a situation where the temperature has been kind of crazy. I know we have all heard of flesh eating bacteria and heard things in the media about people jumping into unfamiliar water sustaining a scratch or an injury and ending up hospitalized for something like that. So, not wanting to frighten anybody, but it is wise to use precaution in jumping in unfamiliar water.

Melanie: As you wrap up for us Sandy, what does the World’s Health Organization say about travelling and what we need to be aware of? We heard a lot about Zika for a while, just what you want us to know in terms of summer travel to any places we need to be aware of and then wrap it up with your very best advice about vector borne diseases and preventing them this summer because that is so important, and we hear so much about ticks, and mosquitoes, and people really want to keep themselves safe.

Sandy: Okay. Best advice is if you are going to a tropical place or if you are going to where the weather is going to be hot, warm, sticky; I encourage you to go on the internet and there is usually some precautions printed online about what to watch out for. Make sure that you have proper vaccinations as required. That’s what I would do if I were travelling. You want to make sure that in your luggage you supply yourself with maybe Benadryl cream, a supply of DEET if you are going to be in a place where there having mosquitoes. You want to carry yourself that type of supply along with you. The best advice that I can give to folks is prevention goes a long way with avoiding illnesses caused by vectors like mosquitoes and ticks. Again, if you are going out in the woods, put clothes on, long, cover as much skin as you possibly can. Use DEET on the skin, exposed skin areas. Try to limit the time that you are out. If you are going camping, take advantage of purchasing some of the pretreated items such as tents and some of the supplies come pretreated now to help repel some of those. Avoid jumping in unfamiliar water sources. Very important to use some common sense when going to a place that you are unfamiliar with, making sure that you don’t take a chance or increase your potential for getting ill. If you have got breaks in your skin, make sure that you wash and cover those breaks in your skin. That’s also helpful as well. So, prevention goes a long way.

Melanie: Well it certainly does Sandy and you are just such an excellent guest and so well-versed in these kinds of things and thank you so much for being with us today and for sharing this expertise about the ways that we can prevent some of these vector-borne diseases. This is Health Talks with HRH, Hendricks Regional Health. For more information please visit www.hendricks.org that’s www.hendricks.org. This is Melanie Cole. Thanks so much for tuning in.