Use this one as it is seasonally dated

 

Bites, Burns, And Other Bumps In The Summer Road

By Jeff Cersonsky, MD, FAAP

We all look forward to summer, especially our children. Prevention of some problems that we see in summer (bites, sunburns, water hazards, rashes) can help to make the summer healthy and pleasantly memorable.

Lyme Disease. Lyme disease is caused by a bacteria transmitted to people from deer ticks (the smaller ticks, not the larger wood ticks). The tick bites its victim and the bacteria slowly enter through the bite. In fact, studies have shown that a bite of less than three days duration is unlikely to cause the disease. By the end of three days, the normally very small tick (nymphs are as large as the period at the end of this sentence, adults are pin-head size), enlarges to more than three times its original size as it fills with blood.

The first element of protection is to prevent tick bites. Wearing long sleeves and long pants tucked into socks can certainly make it hard for a tick to attach to the extremities or torso. But realistically, how many people are going to dress like this on a hot summer day in their yards or the woods? Clothes can be sprayed with a bug repellant containing DEET. When using DEET on the skin, it should be used sparingly and only a preparation of 20 percent or less should be applied. Wash off the repellant as soon as the child comes inside.

One of the best ways to prevent Lyme disease is by nightly (every night) head-to-toe, behind-the-ears, and between-the-toes body checks of your child. Ticks love warm spots such as underarms, necks, groin areas, etc. If you find a tick, don’t panic! Studies show that ticks removed within 48–72 hours of the initial bite generally do NOT transmit Lyme disease. Remove the tick by grasping it as close to the skin as possible with a fine tweezers and pulling firmly, but not jerking it. Clean the area with alcohol and keep an eye out for any rash that develops at the site between three and 30 days after the bite. Check the site every day because the rash from Lyme disease can disappear within 48 hours. Report any rash quickly to your pediatrician. The typical rash from Lyme disease is an expanding pink ring with a pale center, but the rash can look different, especially on the scalp or ear. Important: If the Lyme disease is treated when the rash is present (the early phase) it is virtually 100 percent curable. The best plan, however, is prevention and observation.

Bug Bites. Children often suffer from allergic reaction to mosquito bites and other flying insects. With the exception of bees, wasps, etc, these reactions are rarely serious, but can be very uncomfortable. Cooling the bite can help with the itching. A one percent hydrocortisone cream applied to the bite and diphenhydramine (Benadryl®, etc) or loratadine (Claritin®) by mouth can reduce the itching. Avoidance, as always, is important. Use a safe bug spray and avoid being out at sunset or sunrise as the insects tend to bite more at those times. Avoid areas with standing water where the mosquitoes tend to breed.

West Nile Virus, carried by mosquitoes, is still relatively rare but still is a concern. Use the same prevention strategies as for ticks and bug bites to minimize the risk of this potentially life-threatening (but rare) illness.

Bee stings can cause severe allergic reactions in certain individuals. The allergic reactions fall into two classes — local or systemic. Local reactions are evidenced by swelling and redness at the site of the sting and significant pain. The local reactions can be large and uncomfortable but not life-threatening. The systemic reactions include wheezing, hypotension, shock, and hives and should be brought to medical attention immediately. If a child has had a previous systemic reaction, the doctor will prescribe an Epi-pen® to be kept with the child to treat any future reactions. This Epi-pen® should be used immediately in case of any future stings, even if no reaction has occurred as of yet.

Sunburns. Sunburns can make a vacation miserable. They are also an indicator for future risk of skin cancers. Prevention is easy these days with a plethora of sunblocks available. I recommend a 30 or 45 SPF rating. These must be reapplied every couple of hours and after swimming. If sunburns occur, a combination of one percent Hydrocortisone and/or vitamin E oil should be applied and acetaminophen (Tylenol®, etc.) or ibuprofen (Advil®, Motrin®, etc) can be used for the pain. Hats and sunglasses are also essential protection from the sun.

Water Hazards. No child, even those considered “good swimmers,” should ever be left unattended in water, even for a minute. When I practiced medicine in sunny California with the ubiquitous backyard pools, there were so many preventable tragic swimming injuries and deaths. Don’t take chances, period! (Also wearing life vests is the law on any boat — make sure they are on tight.)

Summer is wonderful and safe if we use some prevention and common sense.