Warmer weather means ticks are active and looking to suck your blood; they can make you sick; here's how to deal with them

Mosquito Squad of Louisville graphic, adapted by Kentucky Health News; click on it to enlarge

State wildlife officials are reminding Kentuckians to take precautions against tick bites, which can transmit disease.

“Ticks are common across the state, and whether you’re hunting, hiking or spending time in your backyard, you’re probably going to encounter them,” said Dr. Christine Casey, wildlife veterinarian for the Deparment of Fish and Wildlife Resources. “The key to avoiding any health risk from a tick bite is by taking steps to protect yourself from being bitten in the first place.”

The most common tick species in Kentucky are the blacklegged tick or deer tick, the American dog tick and the lone star tick. The type of tick can determine whether you get sick from a single bite; other factos include where it was acquired and how long it was attached.

"While few ticks transmit disease, tick bites should always be taken seriously," the department said in a news release. "Lyme disease, transmitted by infected blacklegged ticks and common in the northeast and north central U.S., is of growing concern to Kentucky.

"Ticks don’t have to ruin a day outdoors," the department says, offering these precautions to avoid tick bites and deal with them if you are bitten:

Before going outdoors

• Use Environmental Protection Agency-registered insect repellents containing DEET (the oldest, most common and most effective insect repellent), picaridin, or oil of citronella.

• Treat clothing and gear with products containing 0.5% permethrin, which kills ticks on contact. Permethrin should not be applied directly to the skin.

• Take extra precaution if walking through wooded or brushy areas, tall grasses, woodpiles and leaf litter.

After spending time outdoors

• Perform tick checks. Ticks are known to be found under the arms, in and around the ears, the back of the knees, in and around hair, between the legs and around the groin and waist. Be sure to check gear and pets as well.

• Shower soon after coming indoors; this can remove any unattached ticks.

• Tumble-dry clothes in a dryer on high heat for 10 minutes to kill ticks attached to clothes.

If you are bitten by a tick

If a tick is found attached to the skin, remove it as soon as possible. Use tweezers to grab the tick close to the skin and gently pull on the tick with steady pressure. Do not jerk or twist the tick; this can cause mouth parts to break off and remain in the skin.

After removing the tick, clean the bite site and wash hands with soap and water or use an alcohol-based hand sanitizer. Dispose of a tick by submersing it in alcohol, placing it in a sealed bag or other container, wrapping it tightly in tape, or flushing it down the toilet. Do not attempt to crush a tick between the fingers.

If symptoms of a fever, rash, muscle or joint aches, or other types of illness arise within several weeks of removing a tick, consult a health-care professional and tell them about the recent tick bite, when it occurred and where the tick was acquired.

Kentuckians who are interested in contributing to the study of tick-borne diseases and their distribution across the state are encouraged to submit samples of ticks to the Kentucky Tick Surveillance Project. This project, produced by the University of Kentucky Martin-Gatton College of Agriculture, Food and Environment, aims to improve knowledge about where ticks are found and the diseases they might carry.

For more information about ticks and tick prevention, visit www.cdc.gov.

UK wants your ticks: dead, dry and properly packaged

Getty Images via UK

By Jordan Strickler
University of Kentucky

The Kentucky Tick Surveillance Project is now accepting tick-testing submissions from Kentucky residents. This project, produced by the University of Kentucky Martin-Gatton College of Agriculture, Food and Environment, aims to improve knowledge about where ticks are found and the diseases they might carry.

The results help further public health research at the state level and alleviate concerns for citizens worried about tick-borne illnesses.

To ensure the safety and integrity of the samples, and to comply with postal regulations, participants are urged to follow strict guidelines when preparing ticks for submission:

• Do not mail live ticks: Ensure that ticks are not alive when sent.
• Avoid liquid alcohol: Do not send samples in containers of liquid rubbing alcohol.
• Proper packaging: Avoid using only paper envelopes for mailing ticks as they may get damaged in mail processing machines.
• Avoid taping ticks: Do not place ticks between pieces of tape.

Participants must complete a submission form before sending their tick sample. This form is crucial for processing and can be found at https://bit.ly/49SixpO. Samples without a completed form will not be accepted. Detailed instructions for preparing the tick sample, including necessary supplies and packaging steps, ensure samples arrive in good condition for testing.

Important Considerations:

• Selective Testing: Ticks will not be tested for all possible pathogens. The project focuses on gathering data for surveillance purposes.
• Notification Process: Submitters will only be contacted if their submissions test positive for pathogens. There will be no notification of negative results.
• Backlog and Time: Due to the project's volunteer nature, there is a testing backlog. Participants should expect delays.
• Not a Substitute for Medical Care: If a tick has bitten you and has symptoms, seek immediate medical attention. Do not rely solely on submitting the tick for health decisions.

"Community involvement is the backbone of the Kentucky Tick Surveillance Project," Larson said. "Every tick submitted is a piece of the puzzle in understanding our state's tickborne disease landscape. We thank everyone who participates for their contribution to this important work."

Please send all ticks to: Tick Surveillance Program, c/o Subba Palli, Department of Entomology,
S-225 Ag Science Center North, Lexington KY 40546-0091.

For more information, visit https://entomology.ca.uky.edu/ticksurveillance2022.

Mosquito repellents tested: DEET is best; plant-based alternatives to it work fine in lower-risk areas if they are reapplied as needed

For a larger version of this graph, click on it. To download and save, right-click.

By Immo A. Hansen and Hailey A. Luker

For The Conversation 

Now that summer is in full swing, mosquitoes have come out across the United States. The use of mosquito repellents can protect both your health and sanity this summer.

While mosquitoes leave bothersome, itchy bites on your skin, they can also pose a serious and sometimes deadly risk to your health. When a mosquito bites you, it may transmit harmful pathogens that cause dangerous diseases like malaria, Dengue fever, Zika and West Nile.

Avoiding mosquito bites

Mosquito females bite people to get vital nutrients from our blood. They then use these nutrients to make their eggs. One single blood meal can give rise to about 100 mosquito eggs that hatch into wiggling larvae.

There are several ways to avoid getting bitten by mosquitoes, from wearing long, loose clothing and limiting time outside to placing screens over your windows and getting rid of standing water that mosquitoes might use to breed.

However, one of the best ways to protect yourself when you’re going to a place where hungry mosquitoes will be buzzing around is by using mosquito repellents.

Our team at the New Mexico State University Molecular Vector Physiology Laboratory has studied different types of mosquito repellents and their efficacy for over a decade. Here’s what you need to know to protect yourself this summer:

All about repellents

The use of mosquito repellents goes far back in history, certainly predating written historical accounts. Some of the oldest records of the use of mosquito repellents date back to early Egyptian and Roman history. During this period, smoke from smudge fires was often used to repel mosquitoes.

Today, we have more options than our ancestors when it comes to choosing what type of mosquito repellent to use – sprays and lotions, candles, coils and vaporizers, to name some.

These repellents interfere with a mosquito’s sense of smell, taste or both. The repellent either blocks or overstimulates these senses. Scientists understand how certain repellents like DEET work at the molecular level, but for many of them, it is still unknown why exactly they repel mosquitoes.

Testing repellents

We used a variety of scientific laboratory experiments and field tests to find out what works. For some products, testing was as simple as putting a volunteer’s treated arm into a cage with 25 mosquitoes and waiting for the first mosquito bite.

For others, like citronella candles, we used a slow-speed wind tunnel and put a candle or device between a person and a cage of mosquitoes. Depending on the repellent efficacy of the device, mosquitoes either flew toward the person or away. Another experiment we conducted was the Y-tube choice assay where mosquitoes chose to fly toward someone’s hand or, if repelled, fly toward the blank or empty option.

Mosquito repellents that don’t work

Bracelets don’t work. Department stores and pharmacy chains sell hundreds of different varieties of bracelets. They are marketed as “mosquito repellent” bands, wristbands and watches, and their materials can vary from plastic to leather. Even if they are loaded with repellents, they can’t protect your whole body from mosquito bites.

Ultrasonic repellent devices don’t work. These come as electrical plug-ins, free-standing varieties or watchlike accessories that claim to emit a high-frequency sound that deters mosquitoes by mimicking bats. However, in scientific studies, ultrasonic repellent devices fail to repel mosquitoes. In fact, when our lab tested one of these devices, we found a slight increase in mosquito attraction to the wearer.

Dietary supplements – vitamin B, garlic and so on – don’t work. No scientific evidence shows these supplements protect people from mosquito bites.

Light-based repellents don’t work. These devices come as colored light bulbs, and they don’t attract insects that fly toward white light. This approach works well on moths, beetles and stinkbugs, but not on mosquitoes.

Mosquito repellents that work

And here is our ranking of what does work, starting with the best repellent/active ingredient:

• DEET works. DEET, chemical name, N,N-diethyl-meta-toluamide, was developed in the 1950s by the U.S. Army and is a well-established mosquito repellent with a long history of use. The higher the percentage, the longer the protection time is – up to six hours.
• Picaridin works. This synthetic repellent can protect for up to six hours at a 20% concentration. This repellent is a promising alternative for DEET.
• Oil of lemon eucalyptus, or OLE, works. OLE, with the active ingredient PMD, is a plant-based alternative to DEET and picaridin. Its repellent properties can last for up to six hours.
• Other essential oils – some work, some not so much. We applied 20 different essential oils in a 10% essential oil lotion mixture to volunteers’ skin. Here’s what we found: Clove oil works. This oil, with the active ingredient eugenol, can protect from mosquito bites for over 90 minutes at a 10% concentration in lotion. Cinnamon oil works. This oil, with the active ingredients cinnamaldehyde and eugenol, can protect from mosquitoes for over 60 minutes at a 10% concentration in lotion. Geraniol and 2-PEP, or 2-phenylethyl propionate, work for about 60 minutes at a 10% concentration in lotion. Citronella oil works, just not so great. We found citronella oil at a 10% concentration only protected from mosquito bites for about 30 minutes.

If you are planning to mix your own plant-based mosquito repellent this summer, remember that essential oils are complex mixtures of plant-made chemicals that can cause skin irritations at high concentrations.

Based on our study, we recommend using repellents with the active ingredient DEET if you live in or are traveling to regions with a high risk of vector-borne disease transmission. However, plant-based repellents will work just fine to prevent nuisance mosquito bites in low-risk areas, as long as you reapply them as needed.

Immo Hansen is a professor of biology at New Mexico State University, where he studies new ways to control vector-borne diseases. Hailey Luker is a Ph.D. biology student at New Mexico State. Her research ranges from repellent testing using ticks and mosquitoes to molecular research studying amino-acid transport proteins in mosquitoes.

Asian tiger mosquitoes, which are aggressive biters, breed in small vessels of water, not ditches or marshes like other skeeters

https://www.kentucky.com/news/state/kentucky/article275915186.html

Bedbugs, long thought to pose no risk to human health, produce large amounts of inflammatory histamines, UK researchers find

Bedbugs in an entomology lab (Photo by Matt Barron, UK)

By Haley Simpkins
University of Kentucky

Bedbugs produce large amounts of histamine that may pose risks to humans, entomologists at the University of Kentucky and North Carolina State University have discovered in a study. 

Histamines are naturally produced chemical compounds that may cause inflammation and alert the immune system to threats. They can cause allergic reactions, rashes and respiratory problems. A previous study showed links between excess histamines and headaches, gastrointestinal issues, irregular heart rate and asthma, especially in people with histamine intolerance.

Sudip Gaire, a post-doctoral scholar in the UK Department of Entomology, and Zach DeVries, assistant professor of entomology, led the latest study. It looked at levels of histamines excreted by bedbugs across the bugs’ different life stages, different populations and varying lengths of time, and the effects that feeding on blood had on the bugs’ histamine production levels.

The study, recently published in The Journal of Medical Entomology, showed bedbugs can produce large amounts of histamine. It found that a hypothetical infestation of 1,000 bugs could produce up to 40 milligrams a week, more than 2 grams per year without even considering natural population growth of the infestation.

“That's an amount you can actually see, and we don't see that with any other containment,” DeVries said. “When we talk about pesticides, allergens, any other thing in our home that some invading organism is producing, it's always on microscopic levels, not something where you could actually hold it in your hand.”

Scientists typically haven't considered bedbugs a great risk to human health, aside from their bites, because they are not known to carry pathogens. However, high-level histamine production reveals a potential risk. While scientists don’t know the specific health impacts of histamine produced by non-human animals, DeVries, Gaire and their fellow entomologists do suspect that it may have negative clinical effects.

“It’s not only the fact that they’re producing histamine, but they’re producing it right next to where you spend the most time, generally speaking, within our homes, which is in our beds or sleeping areas,” DeVries said.

The research also has social-justice implications, DeVries said: “Anybody can get bedbugs, but it’s only those who have the means and resources who can actually get rid of the problem. There is a significant portion of the population who either don't have the money or the resources to do this, and so they're left to deal with bed bugs on their own. So, we have disadvantaged communities, who are not only having to deal with bed bugs, but maybe dealing with the health ramifications of them as well.”

One important discovery of the study was that blood-fed bed bugs produced “significantly higher” amounts of histamine than those feeding on saline or those that were starved. “Blood is the primary factor for histamine production, but we don’t know how exactly they are producing the histamine,” Gaire said.

Gaire said close exposure to histamine is also a concern for agriculture. Bedbugs are common in poultry houses, and previous studies have found histamines reduce egg production.

DeVries and Gaire said that while their study answered important questions, scientists need to do more research before sounding an alarm. DeVries received funding for the study through his 2019 National Institutes of Health Director’s Early Independence Award, which will fund similar future studies through 2024.

Tick that can clone itself is found on cattle in Southern Ky. and wildlife in Eastern Ky.; it's also a threat to pets, and hard to identify

Asian longhorned tick (Photo by Anna Pasternak, UK)

By Katie Pratt
University of Kentucky College of Agriculture, Food and Environment

The Asian longhorned tick, which preys on a variety of hosts including humans and wild and domestic animals, has been found in Kentucky. This new tick is known to attack animals in large numbers and will be a concern to livestock producers, wildlife enthusiasts and pet owners.

“This tick is an aggressive biter and frequently builds intense infestations on domestic hosts that can cause stress, reduced growth and severe blood loss,” said Jonathan Larson, UK extension entomologist. “One reason for their rapid buildup is that the female ticks can lay eggs without mating. It only takes a single fed female tick to create a population of ticks. Potentially, thousands can be found on an animal.”

The tick has been found in small numbers on elk in Martin County and black bear in Floyd County. It was found in large numbers on a bull in Metcalfe County in the south-central part of the state.

“The Metcalfe County ticks were submitted by a veterinarian who answered a call about a bull so infested that it was showing signs of severe fatigue,” said Anna Pasternak, UK entomology graduate student who manages the Kentucky Tick Surveillance Program. Pasternak and Monica Cipriani, a student in the UK College of Public Health, sampled the Metcalfe County field and found more Asian longhorned ticks.

Metcalfe County (Wikipedia map)

“The Metcalfe County finding is particularly troubling,” Pasternak said. “It means the tick may have already spread farther across the state.”

The tick was found in the U.S. in 2017. It has also been confirmed in Arkansas, Tennessee, the Carolinas, West Virginia, Pennsylvania, Maryland, Delaware, New Jersey, New York and Connecticut.

In addition to wildlife, the asian longhorned tick preys on cats, dogs, horses and chickens. Humans also are a host. It is a known or suspected vector of several important livestock viral, bacterial and protozoan agents. Scientists are conducting tests on ticks collected in the United States, and it is likely that some ticks will contain germs that can be harmful to animals. 

The tick is hard to identify because it has no distinctive markings and unfed adults are smaller than other common adult ticks in Kentucky.

If you find an unusually large number of ticks on a pet or livestock, contact a veterinarian. If you think a tick might be an Asian longhorned tick, work with your county extension agent for agriculture and natural resources to submit the sample to UK entomologists for positive identification.

Ticks are a bigger problem than they once were, Kentucky Health News reported recently. UK has information on tick-bite prevention and removal at https://entomology.ca.uky.edu/ef618 and at county offices of the Cooperative Extension Service.

Rural weekly reports on increasing tick-borne allergy to red meat

Map shows cases entered by site users and is not verified. For a larger version of the map, click on it.

A tick-borne allergy to red meat is becoming more common, the Adair County Community Voice reported Oct. 31, in a pair of front-page stories: one on the main front and the other leading its occasional Health and Wellness section.

The allergy is caused by a sugar molecule called alpha-gal. Anna Buckman writes, "Dr. Kourtney Gentry Gardner, an allergist-immunologist in Bowling Green, diagnoses about five people a month with the alpha-gal allergy, and it’s becoming increasingly more common, she says."

Close-up of the Lone Star tick, which
is much larger when it is full of blood.

People who are bitten by the Lone Star tick, especially those bitten repeatedly, are at risk of "having allergic reactions to the molecule, which is found in most mammalian or red meat," Buckman notes. "It is relatively new to the allergy world," having been identified in scientific literature only 10 years ago.

Buckman deals with the science but brings the story home by writing about some local victims, illustrating the varying manifestations of the allergy:

"Tiffany Bean can no longer hang out at summer gatherings where friends grill burgers because, following a tick bite, she developed a food allergy so severe that she even has reaction being around the fumes of cooked beef. . . . Rick Wilson is also allergic to red meat but can eat dairy products. He only had occasional reactions when he was still consuming red meat."

Joshua Wethington (Adair Co. Community Voice photo)

"Five-year-old Joshua Wethington doesn’t like dairy-free pizza, but that’s the only kind he can have. Because of a tick bite at some point in his short life, he is so allergic to red meat that allergists recommended removing dairy from his diet because it is a byproduct of cows." Joshua’s mom, Dana Wethington, told Buckman, “I’m having a hard time getting him to eat things because it doesn’t taste the same to him.”

Other differences: "Bean went from just having an itchy tick bite to having a stomach illness for hours or breaking out into a rash if she consumed anything with alpha-gal. She has lost 40 pounds due to the allergy," Buckman reports. "Joshua got hives all over his body every day that he consumed red meat. Wilson experienced severe itching and nearly passed out during one of his few reactions. Speak to three people with alpha-gal and you’ll discover one thing is certain: it’s complicated. The only similar experiences that Bean, Wilson and the Wethingtons have are the difficulty of living with the allergy and dealing with its affects when they go out publicly."

Bean told Buckman, “People don’t seem to take it seriously. You tell people that you have it and that you could die from it, and people are like, ‘Oh no, you can’t die from eating a hamburger or bacon.’ Well, yeah, you can.”

Alpha-gal victims use technology to help each other, including a smartphone app ("Is it Vegan?"), a Facebook groups (“The AlphaGal Kitchen” and “Alpha-Gal Support Kentucky”) and an interactive map that locates cases (above).

"Recommended by a member on a Facebook support group, the Munfordville Pool Hall and Grill is a relief to alpha-gal sufferers and also sets a great example for other restaurants for being allergy-friendly in general," Buckman writes. "The pool hall has designated one fryer where no red meat or cheese is prepared. They have designated skillets to cook foods for separate consumption because people with alpha-gal allergy can have a negative reaction from even the residue from a mammal product.

Pool-hall employee Justin Minton told Buckman that employees acted after notiing that several people in the community have the allergy. “Speaking from experience, going to Subway is pretty much the only place my grandpa can go,” Minton told Buckman.

Even though "people with alpha-gal are helping one another with useful information, Kandace Webster, an advance-practice registered nurse at T.J. Health Columbia Primary Care, "urges sufferers to seek professional guidance," Buckman reports.

Scores of reported cases of Rocky Mountain spotted fever in Lincoln Trail area; awaiting state health department confirmation

Kentucky Health News

Rocky Mountain spotted fever, the main tick-borne disease in Kentucky, has affected scores of people in the area served by the Elizabethtown-based Lincoln Trail District Health Department.

The six-county department "has investigated a total 79 cases of Rocky Mountain spotted fever for June in the district, which comprises Har­din, Meade, LaRue, Nel­son, Washington and Mar­ion counties," Mary Alford reports for The News-Enterprise in Elizabethtown.

In Grayson County, which is in the Lincoln Trail Area Development District but has a separate health department, 26 cases were reported from July 7 to 17. All the numbers are subject to confirmation by the Kentucky Department for Public Health. In a typical year, the entire state has 10 to 30 cases, Grayson Brown, director of the University of Kentucky Public Health Entomology Laboratory, told Kentucky Health News as the summer tick season began.

Dog ticks (middle) are the usual carriers of Rocky Mountain spotted fever.

"Reports of tick-borne illnesses that make it to the health department stem from people with a known tick bite who go to the doctor, exhibiting symptoms such as fever, rash, headaches, muscle aches and tiredness, and are tested for Rocky Mountain spotted fever, Lyme disease and other ailments,"Alford reports. The district health department has also found a few cases of tick-borne Lyme disease.

How can you protect yourself from these diseases, which can be debilitating and in rare cases fatal? Use insect repellents, shower soon after being outdoors, and check for ticks daily, especially in hard-to-see places, Rebecca Morris writes for The Record in Grayson County, citing material from the federal Centers for Disease Control and Prevention web page about ticks.

CDC recommends "a full body check upon return from potentially tick-infested areas," Alford writes. "Ticks most commonly attach around the ears, inside the belly button, behind the knees, between the legs, around the waist and especially in and around the hair. To remove a tick, people should use tweezers to grab the tick close to the skin and gently pull on the arachnid with steady pressure, and wash hands and the bite site with soap and water after the tick is removed. Also, apply an antiseptic to the bite."

Other tips, from UK's Brown:

• Check your pets.
• Keep grass and shrubs trimmed, and clear overgrown vegetation in your yard.
• Don't walk through uncut fields, brush and overgrown areas.
• Walk in the center of hiking trails.
• Wear light-colored clothes, which make it easier to spot ticks.
• Wear long pants tucked into boots or socks, and tuck your shirt into your pants.
• Place a band of duct tape, sticky side out, around your lower legs to trap ticks.
• Use tick repellent that has DEET or picaridin, or use permethrin-based clothing sprays.

Rocky Mountain spotted fever "can take three to 12 days to incubate," Morris notes. "Initial symptoms appear in one to four days, and include a high fever, severe headache, swelling around the eyes and on the backs of the hands, nausea and vomiting." The spotted rash usually appears two to five days after initial symptoms, but 10 percent of victims never develop a rash.

"After five days without medical treatment, patients can have altered mental states, lapse into a coma, develop respiratory problems or even have organ failure," Morris writes, citing the CDC. The disease "can lead to death if patients aren't treated early."

West Nile virus report for Kentucky: four cases in humans, four in horses, and in some mosquitoes in Jefferson County

Four cases of West Nile virus have been found in Kentucky this summer: two in Hopkins County and one each in Jefferson and Fayette counties, the state Department for Public Health reported Friday. All were in adults. The number is below the annual average of 10 reported from 2012 to 2016.

All but eight states have reported cases of West Nile in people, horses, birds or mosquitoes this year, the department said. The virus is transmitted by mosquito bites. The Louisville health department recently found West Nile-infected mosquitoes in four Jefferson County ZIP codes (40204, 40205, 40206, 40208, 40212 and 40214), but there have been no other positive reports of mosquitoes with the virus in Kentucky.

“It’s common for us to find mosquitoes infected with West Nile in Louisville around this time each year. What this means is people should take the appropriate precautions, Louisville Health and Wellness Director Sarah Moyer told Darla Carter of The Courier-Journal.

The state health department says four horses have tested positive for West Nile, in Bourbon, Franklin, Hart, and Russell counties. The virus can cause severe illness in horses and certain species of birds, but does not usually affect domestic animals. There is no West Nile vaccine available for people, but several are available for horses, and owners are advised to vaccinate their horses annually.

In most human cases, infected people have no symptoms or show relatively mild symptoms, such as fever, headache, body aches, joint pains, vomiting, diarrhea, or rash. They typically recover on their own, though symptoms may last several weeks. Fewer than 1 percent will develop a serious illness such as encephalitis or meningitis. People over 50 and those with certain medical conditions, such as cancer, diabetes, hypertension, kidney disease and organ transplants, are at greater risk for serious illness if they contract West Nile.

The health department advises Kentuckians to avoid mosquitoes, particularly between dusk and dawn, when the insects are most active. It recommends these precautions:

Avoid Mosquito Bites

·        Use insect repellents when you go outdoors. Repellents containing DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products provide longer-lasting protection. To optimize safety and effectiveness, repellents should be used according to the label instructions. More information about insect repellents can be found at http://www.cdc.gov/westnile/faq/repellent.html.

·        When weather permits, wear long sleeves, long pants and socks when outdoors. Mosquitoes may bite through thin clothing, so spraying clothes with repellent containing permethrin or another EPA-registered repellent will give extra protection. Don't apply repellents containing permethrin directly to skin. Do not spray repellent on the skin under your clothing.

Mosquito-Proof Your Home

·        Install or repair screens on windows and doors to keep mosquitoes outside.

·        Help reduce the number of mosquitoes around your home by emptying standing water from flowerpots, gutters, buckets, pool covers, pet water dishes, discarded tires and birdbaths on a regular basis.

More information can be found online at: https://www.cdc.gov/westnile/ or http://www.chfs.ky.gov/dph/epi/westnile.htm. 

Tick season is expected to be more dangerous this year; here are lots of tips to keep you protected

Warm weather and outdoor activities go hand in hand, but it also mean tick season is upon us -- and it's expected to be a bad one this year because the winter was so mild. Tick season in Kentucky runs through August.

Mosquito Squad of Louisville graphic; click on it to see a larger version

The lone star tick and the American dog tick are the most common ticks in Kentucky, and are commonly found in wooded or grassy areas.

The dog tick can transmit Rocky Mountain spotted fever, which begins with a sudden onset of fever and headache two to 14 days after being bitten. Other symptoms can include nausea, muscle pain, lack of appetite and a rash that occurs two to five days after the fever. RMSF can be fatal in the first eight days of symptoms if not treated correctly, according to the Centers for Disease Control and Prevention.

The lone star tick is the main carrier of erlichiosis, which causes fever, headache, chills and muscle pain about one to two weeks after being bitten. It is an aggressive biter, and saliva from its bite can cause painful, itchy areas.

The deer or black legged tick is less common in Kentucky, but it is the one that is known to transmit Lyme disease and Powassan virus.

Symptoms of Lyme disease can range from mild to severe, and include fever, headache, fatigue and a skin rash. If left untreated, the infection can spread to joints, the heart or the nervous system. It is most prevalent in the Northeast, Mid-Atlantic and Upper Midwestern states. The CDC estimates there are 300,000 Lyme disease infections each year. "If a tick is attached to your skin for less than 24 hours your chance of getting Lyme disease is extremely small," says the CDC.

While Powassan virus is most common in the Northeast and the Great Lakes region, it's important to be aware of this virus, especially if you are traveling to these areas, because it can cause encephalitis, or swelling of the brain, and can be deadly. It is also dangerous because it can be transferred from a tick to a human within the first 15 minutes of attachment.

The CDC reports that about 75 cases of Powassan virus have been reported in the U.S. over the past 10 years. Some symptoms of Powasan virus infection are fever, headache, vomiting, weakness, confusion, seizures and memory loss.

The Mosquito Squad of Louisville blog says that 10 percent of people the infected with this virus who get encephalitis will die, "and there is no treatment. Only the symptoms are treatable. Fifty percent of those that survive will have permanent neurological damage of some kind."

Removing ticks: A popular social-media video advises dousing ticks in peppermint oil to get them to pull away from the skin for easy removal. Almost half a million viewers have shared the post, but experts say this is one of the worst things you can do, Caroline Picard reports for Country Living.

"Ticks carry all sorts of diseases," entomologist Dr. Neeta Connally recently told KFGO Radio in Fargo, N.D. "Those are actually salivated into the body when the tick attaches, and so we don't want to agitate the tick in any way that is going to make it salivate more and thereby be more likely to transmit anything."

                                 CDC image

Remove ticks by grasping them as close to the skin as possible with tweezers and pulling straight out with gentle, even pressure. Multiple sources say to not use petroleum jelly, gasoline, hot matches or other "folk remedies" to remove ticks. Dispose of the tick by submersing it in alcohol, placing it in a sealed container or bag or flushing it down the toilet. Once removed, wash the bite area, apply antiseptic and cover with a Band-Aid.

"Never crush a tick with your fingers," warns the CDC.

To protect yourself from ticks, here are some tips from experts:

• Keep grass and shrubs trimmed, and clear away overgrown vegetation; 
• Don't walk through uncut fields, brush and overgrown areas; 
• Walk in the center of hiking trails; 
• Wear light-colored clothing, which makes it easier to spot ticks; 
• Wear long pants tucked into boots or socks and tuck your shirt into your pants; 
• Place a band of duct tape, sticky side out, around your lower legs to trap ticks; 
• Use tick repellent that has DEET or picaridin, or use permethrin-based clothing sprays; 
• Check your body and clothing at the end of each day; 
• Take a warm soapy shower after potential exposure; 
• Check your outdoor gear and pets;
• To kill ticks on clothing, tumble dry for 10 minutes; wash dirty clothes in hot water. If clothes can't be washed in hot water, tumble dry for 90 minutes on regular heat or 60 minutes on high.

FTC warns online marketers about claims of Zika protection

"It appears that some online marketers may be trying to take advantage of consumer concerns" about the Zika virus, so the Federal Trade Commission has sent letters to 10 of them warning that "Zika protection claims must be supported by competent and reliable scientific evidence in the form of well-controlled human clinical testing," the FTC said in a news release this month.

Some mosquito species carry Zika better than others.

"The products of concern include wristbands, patches, and stickers that purportedly can repel the mosquitoes that carry Zika or otherwise protect users from the virus," the FTC said. "The letters also point out that the testing supporting claims of protection from the Zika virus must use the mosquito species that are able to carry the virus, and must be able to demonstrate that the repellent effects last as long as advertised."

The agency "is concerned that some products don't work as advertised," FTC consumer education specialist Aditi Jhaveri wrote on the agency's Consumer Information blog. "To prevent mosquito bites, the Centers for Disease Control and Prevention recommends using skin-applied insect repellents registered with the Environmental Protection Agency with certain active ingredients. The EPA also has registered products to treat clothing and gear. These registered products have been evaluated by the EPA for safety and effectiveness."

The EPA registry is searchable by type of insect, active ingredient, company name and the length of time protection is needed.

"If you’re considering an all-natural repellent — or a wristband or sticker — not registered with the EPA, know that the CDC and EPA don’t speak to their effectiveness," Jhaveri wrote. "And if you’re a parent, know that certain ingredients aren’t safe for children under 3 — even if they’re advertised as all-natural. Here’s more from the EPA on using repellents safely and effectively.

Prevention is the key to surviving tick season in Kentucky, which runs through August; here are some tips

By Melissa Patrick
Kentucky Health News

With outdoor summer activities in full swing, it's important to remember that tick season, which runs from mid-March through August in Kentucky, is upon us.

American dog tick

Ticks hang out in tall grass, woods, low-hanging tree limbs and weeds just waiting to attach themselves to you or your pets to "feed," a polite way to say they want to suck some blood. And while that is reason enough to avoid them, the real problem is that ticks can carry potentially life-threatening infections, like Lyme disease, Rocky Mountain spotted fever and Erlichiosis.

"The most prevalent tick-borne disease in Kentucky is and has been for a long time Rocky Mountain spotted fever," or RMSF, Grayson Brown, director of the University of Kentucky Public Health Entomology Laboratory, told Kentucky Health News. "We get somewhere between 10 and 30 cases of that a year."

RMSF is transmitted by the American dog tick, which is about the size of a pencil eraser. It is the second most common tick in the state, according to Kentucky Pest News. The greatest risk of getting RMSF in Kentucky is in the western part of the state, near the Land Between the Lakes, said Brown.

RMSF usually begins with a sudden onset of fever and headache that appear from two to 14 days after being bitten by an infected tick. Other symptoms can include nausea, muscle pain, lack of appetite and a rash that occurs two to five days after the fever. RMSF can be fatal in the first eight days of symptoms if not treated correctly, according to the federal Centers for Disease Control and Prevention.

Lone Star Tick, all images Wikipedia

Kentucky's most common tick is an aggressive biter called the lone star tick, which is also about the size of a pencil eraser, says Kentucky Pest News.

The saliva from this tick can produces painful, itchy areas that can become infected from scratching. It can transmit Erlichiosis, a Lyme-like disease that can cause fever, headache, chills, muscle pain and in some cases a rash. These symptoms usually show up one to two weeks after being bitten by an infected tick. It can also transmit RMSF.

And though it is not very common, Kentucky is also home to the blacklegged tick, which is known to transmit Lyme disease. This tick is much smaller than the other two more common ones.

"The number of Lyme disease cases is increasing quite rapidly, with 13 or so last year that were reported," Brown said. "The blacklegged tick is found most commonly around rivers and so the river areas, along the Ohio River, the Kentucky River . . . that is where the biggest risk is going to be.

Black-legged Tick

Symptoms of Lyme disease can range from mild to severe and include fever, headache, fatigue and a skin rash that looks like a bull's-eye, although not everyone has this rash, says the CDC. If left untreated, the infection can spread to joints, the heart or the nervous system. Lyme disease is most prevalent in the Northeast, Mid-Atlantic and Upper Midwestern states, so be mindful if you travel.

Infection from these diseases is unlikely in Kentucky because very few ticks in the state are infected with their respective diseases. And even if the ticks are infected, they must be attached and feeding for at least 12 to 24 hours to transmit its infection, says Kentucky Pest News. This makes self-inspection and prompt removal of ticks an important line of defense against these diseases.

Getting a tick borne disease in Kentucky "is something like the risk of getting struck by lightning," Brown said.

The best way to avoid being bitten by ticks is to use "common sense precautions," Brown said. Here are some tips:

• Keep grass and shrubs trimmed, and clear away any overgrown vegetation in your yard;
• Don't walk through uncut fields, brush and overgrown areas;
• Walk in the center of hiking trails;
• Wear light-colored clothing, which make it easier to spot ticks;
• Wear long pants tucked into boots or socks and tuck your shirt into your pants;
• Place a band of duct tape, sticky side out, around your lower legs to trap ticks;
• Use tick repellent that has DEET or picaridin in it or use permethrin-based clothing sprays;
• Do a body and clothing check at the end of each day;
• Take a warm soapy shower after potential exposure;
• Check your pets.

It is also important to promptly and properly remove ticks by grasping them as close to the skin as possible with tweezers and then pulling straight out with gentle, even pressure. Multiple sources say to not use petroleum jelly, gasoline, hot matches or other "folk" methods to remove ticks. Once removed, wash the bite area, apply antiseptic and cover with a Band-Aid.

The CDC has recommended washing tick-infested clothes and then drying them for one hour, but new research, published online in the journal Ticks and Tick-borne Diseases, says putting dry, tick-infected clothes in a hot dryer and spinning them for six minutes will kill them, Ann Lukits reports for The Wall Street Journal.

Brown said May is the month when you are most likely to encounter "pathogen-bearing ticks," but you can still get infected at other times. Tick season generally runs through August

He also noted that tick-borne diseases primarily occur in rural settings because wildlife, especially deer, often covered in ticks, and field mice, because ticks can transmit diseases to them and then the infected mice can infect other ticks as they feed.

"So if you are really worried about those things," Brown said, "pay attention to the wildlife that you have or that you attract to your property."

Obama asks public to tell Congress to fund the $1.9 billion Zika fight he wants; Senate passed $1.1 billion, House $622 million

The Zika funding package of Appropriations Committee Chair Hal Rogers and other House Republicans "doesn't make a lot of sense" and the somewhat larger Senate package backed by Majority Leader Mitch McConnell and a bipartisan Senate majority falls well short of what is needed, President Obama told reporters Friday.

The Senate has passed a $1.1 billion package and the House approved $622 million. Obama wants more than three times the House figure, $1.9 billion, to fight the virus that causes a serious birth defect.

"We didn’t just choose the $1.9 billion from the top of our heads," Obama said. "This was based on public-health assessments of all the work that needs to be done. And to the extent that we want to be able to feel safe and secure, and families who are of childbearing years want to feel as if they can have confidence that when they travel, when they want to start a family that this is not an issue -- to the extent that that's something that we think is important, then this is a pretty modest investment for us to get those assurances."

Obama said the House package is not only inadequate, "That money is taken from the fund that we're currently using to continue to monitor and fight against Ebola. So, effectively, there’s no new money there. All that the House has done is said, you can rob Peter to pay Paul. And given that I have, at least, pretty vivid memories of how concerned people were about Ebola, the notion that we would stop monitoring as effectively and dealing with Ebola in order to deal with Zika doesn’t make a lot of sense."

The president added, "This is something that is solvable. It is not something that we have to panic about, but it is something we have to take seriously. And if we make a modest investment on the front end, then this is going to be a problem that we don't have to deal with on the back end." He said each child who has a small brain as a result of Zika "may end up costing up to $10 million over the lifetime of that child in terms of that family providing that child the support that they need. . . .  It doesn’t take a lot of cases for you to get to $1.9 billion. Why wouldn't we want to make that investment now?"

Part of the money would go to develop a vaccine for Zika, and part of that work is going on at the University of Kentucky. "You don't get a vaccine overnight," Obama said. "You have to test it to make sure that any potential vaccine is safe. Then you have to test to make sure that it's effective. You have to conduct trials where you're testing it on a large enough bunch of people that you can make scientific determinations that it's effective. So we've got to get moving."

Obama said the Centers for Disease Control and Prevention and the National Institutes of Health are "taking pots of money from other things -- universal flu funds or Ebola funds or other funds -- just to get the thing rolling. But we have to reimburse those pots of money that have already been depleted and we have to be able to sustain the work that’s going to need to be done to finish the job. So, bottom line is, Congress . . . needs to get me a bill that has sufficient funds to do the job."

The president said that should happen before the summer congressional recess in August, "to provide confidence to the American people that we're handling this piece of business." He said the money would be insurance for young families or couples thinking about having children.

"To the extent that we're not handling this thing on the front end, we're going to have bigger problems on the back end," Obama said. "Tell your members of Congress, get on the job on this. This is something we can handle. We should have confidence in our ability to take care of it. We've got outstanding scientists and researchers who are in the process of getting this done, but they’ve got to have the support from the public in order for us to accomplish our goal."

Tips on how to avoid getting bitten by mosquitoes

By Melissa Patrick
Kentucky Health News

Spending time outdoors is one of the great pleasures of summer. Unfortunately, this is also the active season for the 50 mosquito species that call Kentucky home. These mosquitoes are more than just a nuisance; some carry disease, making it important to protect yourself from them.

Photo from cdc.gov

Chikungunya is the latest mosquito-born virus transmitted in the U.S., although most cases in the U.S. are still caused by infections acquired from travel to the Caribbean, South America or the Pacific Islands, according to the federal Centers for Disease Control and Prevention. It is rarely fatal, but commonly causes fever, severe joint pain and other symptoms.

Kentucky had 17 confirmed cases of Chikungunya last year as well as eight probable ones, all in residents who had traveled recently to the Caribbean. and none of the cases were fatal. The state also had three confirmed cases of other mosquito-borne illnesses in 2014, including two dengue fever cases and one West Nile case, according to the Kentucky Cabinet for Health and Family Services.

Repellents

Insect repellents are your best guard against mosquitoes.

Four products have been registered with the U.S. Environmental Protection Agency for use as mosquito repellents: DEET (diethyltoluamide), picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products.

Consumer Reports tested 15 products that represented each of these recommended repellents by spraying the products on the forearms of the testers, waiting 30 minutes, exposing their forearms to mosquitoes and ticks, and then measuring the number of bites every hour.

Based on this experiment, the magazine recommended Sawyer Fisherman's Formula (20 percent picardin) and Repel Lemon Eucalyptus (30 percent oil of lemon eucalyptus) as its first and second choice for repellents.

"It was the first time in the history of Consumer Reports testing insect repellents that the non-DEET formulations did better than the deet products," Sue Byrne, the magazine's senior editor of health and food, told Darla Carter of The Courier-Journal.

These products were followed by Repel Scented Family (15 percent DEET); Natrapel 8 Hour ( 20 percent picardin); and Off! Deepwoods VII (25 percent DEET).

Read the Labels

The U.S. Food and Drug Administration strongly recommends that you read the labels of all insect repellents before use and then use them as instructed, paying careful attention to the age limitations and precautions.

"As long as you read and follow label directions and take proper precautions, insect repellents with active ingredients registered by the U.S. Environmental Protection Agency do not present health or safety concerns," according to the FDA website.

Multiple sources say it is also important to not use combination products that contain both sunscreen and insect repellent. Sunscreen is meant to be applied often, while insect repellent is meant to be used sparingly.

High doses of DEET have been known to cause rashes, disorientation and seizures, according to the U.S. National Library of Medicine.

The FDA also notes that concentrations of any of the active ingredients above 50 percent "generally do not increase protection time" and that products with less than 10 percent of the active ingredient "offer only limited protection, about one or two hours."

Insect repellents and children

Adults should always apply insect repellents for children, making sure they don't get any on their hands, around their eyes, on any cuts or irritated skin. Spray repellents should always be applied outdoors, to avoid inhaling them.

The FDA recommends that DEET not be used on children under 2 months of age and that oil of lemon eucalyptus products not be used on children under 3 years old.

The American Academy of Pediatrics recommends that products with more than 30 percent DEET not be used on children, and that you use just enough repellent to cover exposed skin. It also recommends immediately washing off the repellent, and washing any clothes worn while exposed to the repellent, before wearing them again.

KidsHealth recommends that if you use DEET products on children, you should adjust the concentration of product by the number of hours your kids will be outside, using a lower concentration if they are only out for an hour or two and a higher concentration, which will last longer, if they will be out longer.

Non-repellent protections

In addition to advice on repellents, the University of Kentucky College of Agriculture, Food and Environment's Entomology Department website offers these suggestions to avoid mosquitoes:

• Minimize the standing water around your house; this is where mosquitoes breed.
• Use larvicides if it is impractical to eliminate a breeding site.
• Remove tall weeds and overgrowth in your yard; mosquitoes like to rest here during the day
• Keep windows, doors and porches tightly sealed and keep your screens in good repair.
• Stay indoors during the evening hours.
• Wear long-sleeved shirts and pants when outdoors.

UK Entomology says most devices that claim to attract, repel or kill mosquitoes don't work, or are unproven. It says "bug zappers" kill only a small percentage of mosquitoes, and studies have found that portable electronic devices using high-frequency ultrasonic sound are "of negligible benefit in deterring mosquitoes and reducing bites." The website does say that citronella oil offers "a degree of protection," but you need multiple candles to be effective.

Some odors we emit make us more attractive to mosquitoes; various repellents, including plant oils, are available

Mosquitoes are attracted to some people more than others because of skin odors or chemicals they emit, Jill Richardson writes for Salon. Carbon dioxide, heat, moisture, scent and appearance attract mosquitoes, but it's the chemicals you emit that make them want to take a bite, she writes.

Photo from Lexington Herald-Leader

Kentucky has about 60 of the 150 species of mosquitoes found in the U.S., according to the University of Kentucky Public Health Entomology Laboratory. Not all bite, and if one does, it is always a female, which needs the protein found in blood to make her eggs, UK extension entomologist Lee Townsend writes in The Courier-Journal.

Each species differs in biting persistence, habits and ability to transmit disease and even flying ability, Richardson writes, but it is the chemicals we emit that dictate their preference of who to bite.  L-lactic acid, ammonia, carboxylic acids and octenol, especially in combination with each other, are the chemicals most likely to attract them.

Scientist have found that adding l-lactic acid to the scent of someone who is not normally bitten by mosquitoes will make them more attractive to certain kinds of mosquitoes, Richardson reports. The presence of carbon dioxide has also been found in studies to be attractive to certain mosquitoes. Ammonia, which occurs from a pH change when bacteria in sweat multiply, is also appealing to mosquitoes.

So are smelly feet. Studies with Limburger cheese, which resembles human foot odor, have confirmed this. However, malarial mosquitoes are most attracted to this odor, so the saying that "If you keep your feet clean then mosquitoes won't bite," is good advice only if you are traveling in the tropics, Richardson writes.

Human odor that attracts mosquitoes may be genetically driven, but theories vary. One says individuals who are not attractive to mosquitoes don't produce the odors that attract them; and another says some people actually emit an inherited odor that keeps mosquitoes from finding them.

For those who consider themselves "mosquito bait," Richardson makes several suggestions: bathe at dusk, when mosquitoes come out, to minimize sweat odor, rub your body with antimicrobial plants like sage, wear a full-body mosquito net suit or use a repellent, which is the most convenienct, effective protection.

The most common repellent is DEET, available over the counter in many preparations. A prescription repellent is permethrin, which Richardson says may be carcinogenic though it is approved by the Environmental Protection Agency.

A young jewelweed plant

Many people use essential plant oils, though they evaporate quickly, requiring frequent application. The one most commonly recommended is lemon eucalyptus oil, which has proven effective. Richardson's article has details about other plant oils, and recommends crushed jewelweed as a remedy for mosquito bites.

Darla Carter of The Courier-Journal also had a good roundup of mosquito information in the Louisville paper's July 18 edition: http://www.courier-journal.com/story/life/wellness/health/2014/07/17/guard-mosquitoes-summer/12786213/.

Some schools let kids with live head lice stay; policy change has some Kentucky parents scratching their heads

By Molly Burchett
Kentucky Health News

School districts across the country are adopting policies that say students diagnosed with live head lice or nits (louse eggs) can remain in school and parents don't need to be alerted when their child comes in contact with lice. Others schools say they will keep strict lice policies and will continue to alert parents about lice infestations. What's the policy at your child's school?

The American Pediatric Association, the Harvard School of Public Health and the National Association of School Nurses recommend that schools discontinue "no-nits" policies, taking the position that students should not be excluded from school due to suspected head lice or due to nits only. The Kentucky Department of Education and the Kentucky School Board Association also support this recommendation.

The organizations say "no-nit" policies that require a child to be free of nits before they can return to schools should be discontinued because nits are very unlikely to hatch and become crawling lice, nits are cemented to hair shafts and are unlikely to be transferred to another person, and the burden of absenteeism to the students and communities isn't doesn't outweigh the risks of head lice.

This policy shift is designed to help keep children from missing class and to shield children with lice from embarrassment, but these more lenient policies are bugging some parents, reports Jennifer Kerr of The Associated Press.

One school in Paducah says its strict policy about alerting parents if their child gets lice won't change anytime soon, reports Mychaela Brunen of WPSD-TV.

Vicki Brantner has been a school nurse at McNabb Elementary School in Paducah for six years and says the school's strict lice policy is here to stay. "When we have somebody that has head lice, we have a step-by-step procedure that we give to them to take home, it's not only washing the hair, but you have to clean your environment," Brantner told Brunen.

"We have a no-nit policy which means not only can they be here if they have the actual bug, but all the eggs removed also," said Brantner. She said parents with elementary school-aged kids should check their child's hair for lice once a week.

Marcey Davis, a mother of five, said she appreciates getting notices about lice infestations from McNabb Elementary. "It keeps me informed as a parent, as to what's going on in their classrooms and the school," she told Buren. "Parents need to stay on top of in order to keep a lice-free school, at the risk of embarrassing my child, I would rather know about it."

The head louse is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people, and the CDC estimates that 6 million to 12 million infestations occur each year between schoolchildren between the ages of 3 and 11. It is much more common for schoolchildren to get lice because schools bring large numbers of children together where they are in close contact with each other, reports Mike Potter of the University of Kentucky College of Agriculture.

Here are some tips from the CDC that can be used to prevent and control the spread of lice:

• Avoid head-to-head (hair-to-hair) contact during play and other activities at home, school, and elsewhere (sports activities, playground, slumber parties, camp). 
• Do not share clothing such as hats, scarves, coats, sports uniforms, hair ribbons, or barrettes.
• Do not share combs, brushes, or towels. Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5–10 minutes. 
• Do not lie on beds, couches, pillows, carpets, or stuffed animals that have recently been in contact with an infested person.

Don't get burned, bitten or bamboozled this summer; here are safety tips for dealing with the sun, insects and sales pitches

By Molly Burchett
Kentucky Health News

Summer is finally here, and after one of the coldest Kentucky springs, who doesn't want to be outside swimming, skiing, fishing, barbecuing or soaking up rays on the beach? While summer may bring much-anticipated fun in the sun, it's important to take some  safety precautions to make sure you and your family are not getting too much of a good thing.

Sunscreen can protect you from cancer, but don't spray it

The sun is bad for your skin, and exposure to its harmful ultraviolet (UV) rays can increase your risk for skin cancer, which is the most common cancer in the U.S., says the federal Centers for Disease Control and Prevention. It's critical to protect yourself and your children from sun damage because just one blistering sunburn in childhood more than doubles the odds of developing skin cancer later in life, says the Mayo Clinic.

Fortunately, it’s never too late or too early to lessen your risk of sun damage by using sunscreen, and the Environmental Working Group has recently released its 2013 Guide to Sunscreens, which rates more than 1,400 sunscreens, lip balms, and SPF moisturizers and cosmetics for safety and effectiveness.

This year, EWG says 184 sunscreens, 25 percent of those on the market, met its criteria of offering adequate UV protection and posing few safety concerns. You can click here to view that product list, or here to check out the EWG findings for moisturizers, lip balm and makeup.

EWG also created a somewhat surprising list of things NOT to bring on vacation because they are unsafe or do not provide adequate UV protection:

• Spray sunscreen: These sprays may pose serious inhalation risks, and they make it too easy to not apply enough sunscreen or to miss a spot.
• High-SPF sunscreens: These products may tempt people to stay in the sun too long, which can increase the risk of other kinds of skin damage, and EWG recommends that consumers avoid products labeled higher than SPF 50.
• Oxybenzone: Used in half of sunscreen products, this chemical penetrates the skin and can adversely impact health in several ways; in the body, it acts like the female hormone estrogen and can cause allregic reactions.
• Loose powder sunscreen: Tiny zinc particles in these products can also end up in your lungs when you breathe them in during application, which irritates the lungs.
• Retinyl palmitate: Some sunscreens contain this chemical, which is a form of vitamin A, but when applied to sun-exposed skin, it may speed development of skin tumors and lesions.
• Combined sunscreen/bug repellents: Studies show this combination leads to increased skin absorption of the repellent ingredients.
• Sunscreen towelettes: Whether they really work is unknown.
• Tanning oils: They are simply a bad idea and can ultimately lead to behavior that increases risk of developing skin cancer.

So, check the ingredients for your sunscreen, avoid high-SPF's or sprays and make it a habit to wear sunscreen during sports or whenever you're outside. Be sure to reapply often to ensure UV protection, particularly if you get wet or sweaty. Click here to read EWG's "Nine Surprising Facts about Sunscreen."

Hats and clothing: Choose the right kind

Children are more vulnerable to sun damage, so in addition to actual sunscreen, the best sun protections for them are a hat and shirt (which also protect adults). The CDC recommends avoiding straw hats that let sun through the holes, and to wear a hat with UV protection or a wide brim to shield the face, head, ear and neck. If you do chose to wear a baseball cap, protect your ears and neck with clothing, sunscreen (with at least SPF 15) or spend lots of time in shade.

Wear clothing to protect exposed skin. The CDC says loose-fitting long-sleeved shirts and long pants made from tightly woven fabric offer the best UV protection. Darker colors may offer more protection than lighter colors, and a wet t-shirt offers much less UV protection that a dry one.

Sunburn treatment: People with fair skin or light-colored hair are more likely to be sunburned. If you get sunburned, remember that "The skin heals but is forever damaged," writes University of Kentucky nursing Professor Mollie Aheshire. "The more frequent and more severe the burns, the more damage there is," along with risk for cancer and premature aging. "If a sunburn is blistering and covers a large portion of your body; is accompanied by a high fever, extreme pain, confusion, nausea or chills; or does not respond to at-home treatment within a few days . . . see a health-care provider." Mild sunburns can be treated with over-the-counter pain relievers, cold compresses and moisturizing creams — aloe vera or hydrocortisone lotions. "If blisters form, do not break them," Aheshire writes. "Drink plenty of fluids to prevent dehydration. Treat peeling skin gently. Stay out of the sun until redness and pain resolve." (Read more)

Sunglasses: Not just to help you see now, but to keep you seeing longer

Besides being dangerous for your skin, UV rays are dangerous to your eyes and can cause vision disorders, premature aging of the eyes or even blindness. It is important to wear sunglasses to protect eyes from sun damage, although a new survey from the American Optometric Association shows that only 40 percent of consumers cite this protection as the primary reason for wearing sunglasses, says a Kentucky Optometric Association press release.

To help reduce the risks of harmful UV exposure on the eyes, children and adults should start wearing protective sunglasses as as early as possible, and parents should ensure that babies are protected by sunglasses too, says the release. When choosing sunglasses or protective contact lenses, make sure that they block more than 95 percent of UV-A and more than 99 percent of UV-B radiation, says the KOA, and sunglasses should have a frame that fits close to the eyes so the UV rays can't sneak around the sides.

Insect repellent: Bugs can bug you, but don't over-react to them

Although nothing can ruin a relaxing summer picnic faster than bugs, take precautions to ensure you're using the right type of bug repellent-- one that's been approved by the Environmental Protection Agency -- and that you're using it wisely.

Not only are bugs annoying, they can also carry dangerous diseases, and for the safe and effective use bug repellents, always read the product label before using the product, EPA says. It says to follow these bug-repellent safety tips:

• Repellents should be applied only to exposed skin and/or clothing. Do not use them under clothing.
• Store insect repellents safely out of the reach of children.
• Do not apply near eyes and mouth, and be use sparingly around the ears.
• When using sprays, spray on the hands first and then apply to the face, not directly to the face.
• Never use repellents over cuts, wounds or irritated skin.
• Do not spray in enclosed areas and avoid spraying near food.
• After returning indoors, wash treated skin and clothes with soap and water.
• Do not use any product on pets or other animals
• Most insect repellents do not work on lice or fleas. 
• Click here to search for a repellent that's right for you.

Beware if you want to use a wearable repellent that's not sticky and has to be continuously resprayed, such as Off!'s clip-on mosquito repellent. It works once the cloud of mosquito protection is built around the wearer, says Brighid Moret of The Washington Times, but it's not a good option for an active or young child. The manufacturer warns on the label that a chemical on the product's enclosed disk is harmful if swallowed, directly inhaled or absorbed through the skin, and young children should not wear it.

Whether you're going on vacation or a "stay-cation," these tips can help protect you and your family from the sun and bugs in order to safely make the most of your summer. Click here for more sun safety tips from EWG.