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Bites and stings (Children)

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Bites and stings (Children)


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Insect bites and stings are quite different attacks on our skin. Stings result when an insect is protecting itself when it feels threatened. Other than the initial pain of the attack, the sting can cause varying degrees of allergic reaction. A bite is a deliberate attack by the insect in order to feed from our blood. After the initial bite, the insect injects its saliva into the wound to allow the blood to flow and for the insect to feed. A reaction to the insect's saliva causes the bite to become red and swollen and to make it itch.

There are many insects that live in the UK that bite or sting to feed or protect themselves. Stingers include wasps, bees, hornets and ants. Biters include mosquitoes, midges, sand flies, horse flies and ticks. It is very rare to catch diseases from insect bites and stings in the UK but it is possible. For example if bitten by a tick when walking in fields where deer have been, the person may catch Lyme disease, a serious infection caused by bacteria (Borrelia burgdorferi) spread by ticks. Abroad, in places such as Africa, Asia and South America there are a number of diseases that can be caught through insect bites such as malaria, yellow fever, Dengue fever, and West Nile disease.

When stung by an insect your child will feel immediate pain. The area around the sting will swell, redden almost straight away and, later, may blister and produce an itchy rash.

When bitten, your child may notice a sharp jab, by which time the insect has already injected its saliva. It may take several minutes for the bite to become itchy and swell into a lump or redden. In the case of midges when they attack in swarms there may be several areas where they have successfully attacked. These areas become hot and itchy and can remain so for several days. Some children are particularly sensitive to insect bites and stings and will suffer a severe allergic reaction resulting in dizziness, fainting, breathing difficulties, rash, raised pulse, sickness, or a swollen mouth and face. In very severe cases the victim may even collapse and die. This severe reaction is called anaphylactic shock.
There are precautions you can take to avoid your child being stung or bitten by insects.

Stings in the mouth or on the face and hands commonly occur in children when wasps, attracted by the sweet smell of drinks, ice cream, lollipops and sweets, are accidentally touched when eating or drinking. Warn children to be careful when eating or drinking outdoors, if a wasp comes near them, don't aggravate the insect by flapping around, react calmly and simply brush it away.

Indoors, if bothered by fleas treat your pets. Spray rooms with an insecticide and vacuum thoroughly. If outdoors after dusk get your child to wear long trousers and tops with long sleeves to cover as much bare skin as possible. Avoid areas such as ponds where mosquitoes, midges and horse flies commonly occur. When travelling abroad, close all doors and windows at night, spray rooms with an insecticide or use electric vapour producing mosquito killers and cover the bed with a mosquito net.

Insect repellents containing low concentrations of DEET or icaridin can be used on children over 2 years of age.

If your child has been playing or walking in fields where deer may have been, inspect your child's legs and arms closely for ticks; small brown spider-like insects attached to the skin. If present, get hold of the tick with a pair if tweezers and gently lift away from the skin without twisting.

Most bites and stings do not require special treatment. Wash the area and apply an antiseptic cream. If itching persists an application of calamine lotion or an antihistamine cream will help. Children may also be given an antihistamine in the form of a tablet or syrup if the reaction is severe. There are also products containing a mild local anaesthetic or steroids to alleviate pain and itching and reduce swelling. Ordinary pain killers such as paracetamol or ibuprofen may be given for pain relief. Aspirin should not be used in children under 16 years of age. Do not let your child scratch the bite or sting, as this will make the itch worse and may cause an infection. Do not burst any blisters as these help to protect the skin.

If your child has suffered a severe allergic reaction to an insect bite or sting previously, carry self-injectable adrenaline with you and make sure you and your child know how to use it if your child exhibits wheezing or swallowing difficulties after being bitten or stung.
When to consult your pharmacist
Whether your child has already been bitten, whether you just want something to keep at home for First Aid, or whether you are planning to travel abroad, speak to your pharmacist about bites and stings. There are a variety of products available. To prevent infection your pharmacist may recommend an antiseptic cream. To reduce itching, pain and swelling there are lotions, creams and sprays containing calamine, antihistamines and local anaesthetics, or oral antihistamines and pain killers. If travelling abroad, there are insect repellents that your pharmacist may recommend. Your pharmacist will also be able to advise you about precautions you may need to take to avoid catching malaria and other insect-borne diseases.
When to consult your doctor
Seek medical advice if a bite starts to swell up or does not go away after about 2 days, or if your child develops a rash, experiences flu-like symptoms, or has swollen glands, as the bite may be infected.

If you think that your child may have been bitten by a tick and develops a rash around the armpits, groin or thighs or has a flu-like illness, see your doctor as there is a risk that your child may have Lyme disease and urgent treatment with an antibiotic will be necessary.

Also talk to your doctor if your child has suffered a severe allergic reaction to an insect bite or sting and are worried that it may happen again. Your doctor will prescribe adrenaline in the form of an injection that can be easily administered by you, your child or a relative.

If planning a holiday abroad, make an appointment to see your doctor several weeks before you are due to travel. If necessary, your doctor will recommend an appropriate course of anti-malarial tablets and vaccines to protect against other diseases.

If your child feels unwell or develops a fever when you return from abroad, seek medical advice as she or he may have caught a disease when you were on holiday but the symptoms only appeared after your got back home.
Useful Tips
  • Prevention is better than cure; use an insect repellent
  • Choose an insect repellent carefully. Is it safe on children? Remember their skin has a higher surface area than that of an adult and so more of the insect repellent will be absorbed. If use of strong repellent is unavoidable, use sparingly
  • If outdoors in the evenings, cover as much of your child's body as possible with long trousers or long sleeved tops
  • Spray insect repellent on skin under light clothing
  • Refrain from scratching itchy bites
  • Seek advice regarding anti-malarial treatments when travelling abroad

Reviewed on 11/11/2009