News about the Zika virus spreading in these parts of the world is causing a lot of us to worry about our families' health, not only because of the dreaded effects of the virus to pregnant women and their unborn babies, but also because we know that besides Zika, the aedes mosquito also carries the threat of dengue, chikungunya, and other potentially fatal diseases. As of yet, there is no cure for Zika. So what could we do to protect our loved ones?
Two words: mosquito repellents.
To learn all about the efficacy and safety of insect repellents available in the market today, we sought the expert advice of pediatric dermatologist Cindy Jao-Tan, fellow of the Philippine Dermatological Society (PDS) and member of the Pediatric Dermatology Subspecialty Core Group of the PDS; and pediatrician Florence Irena A. Atutubo, M.D., D.P.P.S.:
Q: Is it safe to use an anti-mosquito aerosol spray at home (insecticide)?
Dr. Jao-Tan: Most of these aerosol products are organophosphates. I don't recommend those with malathion, so choose ones with pyrethrins and pyrethroids. These are safer alternatives.
Follow the instructions on the label. As much as possible, don't expose your child to aerosol spray. He shouldn't be in the same room where you are going to spray because residue could fall on the furniture, books, and toys.
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There are potential risks, but there are also regulatory bodies that look into these products. It's better to choose the more reliable and trusted brands over the newer ones proclaiming to be safe.
Q: How much should I spray? And when is it safe to re-enter the room?
Dr. Jao-Tan: They say it's enough to spray the product for 10 seconds long. Air it out first for 10 to 20 minutes and open the doors and windows to let the fumes out. Don't let your child enter the room until four to eight hours after spraying.
Q: How can I tell if an insect repellent is really all-natural?
Dr. Jao-Tan: Unfortunately, here in the Philippines, we don't have a seal of approval for organic or natural products. Anyone can claim a product is natural as long as it has a natural ingredient in it.
As pediatric dermatologists, this is really our advocacy. Our stand is to make sure the products have undergone testing, because that's the only way we can find out whether they are safe enough for children.
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Q: How often should we fumigate our home?
Dr. Atutubo: Fumigating is a widely popular way of redirecting mosquitoes. However, it does not kill insects; it just drives them out of the fumigated area. From a public-health standpoint, this is actually counter-productive. As a community with social responsibility, the focus should be on eliminating breeding areas for mosquitoes rather than just transferring the problem to another location.
Dr. Jao-Tan: You can get it done if you want. Barangay-initiated fumigation activities are held regularly. You have to define first whether the fumigation entails fogging or using insecticides.
[Ordinary] fogging is when they blow smoke into the area to drive the mosquitoes out of their shelter and to keep them from breeding.
Meanwhile, fumigations that use insecticides should be done at longer intervals, because insecticides have residue, so you have to be extra careful.
The frequency of fumigation also depends on your environment. Some houses don't have mosquitoes, while others have a lot. Having many plants in your area means more breeding ground, so you have to fumigate more often.
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Q: Where do mosquitoes generally lay eggs?
Dr. Jao-Tan: Indoors, these would be domestic containers such as flower-pot plates and trays, ornamental containers, toilet bowls or cisterns that you don't use that often, and even the hardened soil in indoor-plant pots and canvas or plastic sheets.
Outdoors, it's aircon trays, tree holes, the plant axil (where the branch and the stem meet), barbecue pit, canvas or tarpaulin, gutters on roofs, roadside grates, and discarded receptacles that gather water.
Q: What are some general guidelines for applying insect repellent and keeping mosquitoes at bay?
Dr. Jao-Tan: First and foremost, use clothing as a protective barrier. The application of insect repellent is really dependent on several factors: the product, its concentration, the patient's age, his activities, and the type of his clothing.
If, for example, your child has a skin condition, such as atopic dermatitis (AD), then I would definitely not recommend the use of DEET (an ingredient in some insect repellents). AD patients have open wounds or breaks on the skin that can facilitate the penetration of lotion, which would enhance DEET absorption. Also, DEET can irritate the skin. For those with open wounds, we don't recommend the application of insect repellents.
Just apply the repellent on the child's exposed skin (except his face). Insect repellent can stay on the skin for long periods of time.
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Q: My kid uses just one mosquito patch at a time. Is this enough protection?
Dr. Jao-Tan: Studies show that the scent of citronella has an effect on insects, although it is not comparable to 10- to 20-percent DEET in terms of the protection it gives. Its effect and coverage are very limited, and you'll need to change the patch often to make sure that it still has a scent.
Q: Are some people more prone to mosquito bites? Is it true that there are some blood types that mosquitoes find 'sweeter'?
Dr. Jao-Tan: Technically, there are attractive and repulsive factors for mosquito bites. These are just general guidelines: Mosquitoes are attracted to: 1) the night, 2) humidity of more than 85 percent, 3) immobility -- that's why we recommend that you move your feet and walk around, and 4) noise. Individuals who have a loud voice, apparently, are the ones who get bitten a lot, but more studies should be done on this.
[On sweeter blood,] that is not evidence-based, so more research is needed. I think it's a combination of a lot of factors, such as one's diet and the scent you exude.
This article first appeared in the July 2014 issue of Smart Parenting magazine. Minor edits were made by the Smartparenting.com.ph editors.
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