MALARIA

Insect Repellents


INSECT REPELLENTS


Table 1: Precautions to Minimize Potential for Adverse Reactions from Repellents
  • Apply repellent sparingly, only to exposed skin or clothing, not under clothing.
  • DEET concentrations between 30% and 35% are quite effective for adults. In general, avoid applying high-concentration (more than 30-35% DEET) products to the skin; for children, 35% is the highest concentration recommended. It is preferable not to use DEET on children under age 2 months.
  • Avoid inhalation or ingestion of repellents. Do not get them into the eyes.
  • Wear long sleeves and long pants, when possible, and apply repellents (e.g., permethrin) to clothing to reduce skin exposure. DEET generally won't harm cotton, wool, or nylon but it may damage synthetic fibers (e,g., spandex, rayon, and acetate), plastic or paint.
  • Avoid applying repellents to portions of children's hands that are likely to have contact with eyes or mouth.
  • For use on a child's face, apply to adult hands and then rub on child's face.
  • Minimize use of repellents in pregnant and nursing women.
  • Avoid use of repellents on wounds or irritated skin.
  • Use repellent sparingly; one application will last approximately 4 hours. Saturation does not increase efficacy.
  • Wash repellent-treated skin after coming indoors.
  • If a suspected reaction to insect repellents occurs, wash treated skin, and call a physician. Take the repellent container to the health care provider.

    Based on Centers for Disease Control & Prevention, Health Information for International Travel, 1999-2000.

Insect repellents should contain DEET (N,N-diethyl-meta-toluamide). DEET can be used directly on the skin or clothing. The World Health Organization recommends wearing anklets dipped in repellent. Insect repellents should be applied from dusk to dawn - the time malaria mosquitoes bite the most. Reapply repellent when the weather is hot and you perspire more. The American Academy of Pediatrics recommends that children not apply repellents containing more than 35% DEET. Examples of DEET-containing insect repellents include:
MAXI DEET - Contains 95% DEET. Comes in a spray pump. Available from Sawyer Products, Inc.
Jungle Juice 100 - Contains 95% DEET. Available at REI stores.
         OFF! ® Deep Woods for Sportsmen - Contains 100% DEET.
3M Ultrathon ® (formerly available as HourGuard-12TM) - contains 31.58% DEET. It is a slow-release, polymer-based product.
Sawyer, Controlled Release DEET Formula - Contains 20% DEET with extended duration up to 24 hours. Available from Sawyer Products, Inc.
REPEL® Sun & Bug Stuff - Contains 19% DEET and SPF 15.
Bite Block Sunscreen - Contains 19% DEET. Available from Banana Boat (Playtex).
OFF!® - Contains 4.75, 7.125, 14.25 or 28.5% DEET.
OFF! Skintastic® - Contains 9.5% DEET and SPF 30.
Cutter® - Contains 6.65, 9.5, 21.85% or 28.5% DEET.
DEET Plus - Contains 17.5% DEET.
Skedaddle Insect Protection (children) - Contains 10% DEET.

Many insect repellents are available that do not contain DEET. They usually contain citronella or other "natural" ingredients, but their duration of action is short and they are not considered as effective as DEET:
Bug Guard Mosquito Repellent SPF 15 - Available from Avon.
Bug-Off - An all purpose formula derived from plants; for mosquitos and black flies.
Fishing Friend Natural Bug Repellent - Available from Demeter Fragrances.
Lemongrass Insect Lotion - Contains citronella and other natural oils. Available at The Nature Company.
Outdoor Bug Repelling Sunscreen Lotion - Contains citronella. Available in three scents from Bath and Body Works.
Insect Repelling Wristband - Contains DEET encapsulated in a plastic matrix so it will not touch the skin. Supposedly releases a vapor that repels flying insects. May be used by children and adults. To order direct, call 1 (800) 980-5678.
Citronella, Skin So Soft, and high-piercing-sound devices are not considered effective.

There are many other techniques that are useful to prevent mosquito bites.

  • Use pyrethrum flying-insect spray (for example, Raid®) - spray in living and sleeping areas during evening hours and at night, while also using DEET-containing insect repellent.
  • Permethrin 0.5% (available as REPEL Permanone) may be sprayed on clothing or on mosquito netting, although soaking is the preferred method. It maintains potency from 2 to 6 weeks even with laundering. If used on the skin, it becomes deactivated very quickly.
  • Avoid being outside at twilight and at night. Stay indoors or in a well-screened area as much as possible from dusk to dawn.
  • Wear loose clothing with high necklines, long sleeves, and long pants. All clothes should fit snugly around the neck, ankles, and wrists.
  • Avoid sheer fabrics, bright colors, shiny jewelry, perfumes, scented soaps or shampoos, after-shave lotions, open sandals. Light-colored clothing is best (some authorities believe mosquitoes are attracted to the color blue).
  • Don't go barefoot.
  • Consider sleeping under a net. Be sure the net is tucked in and is not torn. Be sure there are no mosquitoes inside the net and consider spraying the net with permethrin.
  • Consider using pyrethroid mosquito coils that burn slowly through the night.

    Several portable mosquito nets are available:
  • The Indoor Travel Tent. Call (800) 359-6040. Write Long Road Travel Supplies, P.O. Box 638, Alameda, CA 94708.
  • LaMosquette. Call (716) 754-4883 (U.S) or (519) 836-0102 (Canada). Write IAMAT, 417 Center Street, Lewiston, NY 14092.
  • SleepScreen I, SleepScreen II, The Spider and TropicScreen. Call (800) 872-8633 (U.S. and Canada). Write Travel Medicine, Inc., 351 Pleasant St., Suite 312, Northampton, MA 01060.

    If you're living or staying in a malarious area, mosquito nets will most likely be available locally.

Based on CDC, Health Information for International Travel 2000-2001, DHHS, Atlanta, GA, 2001; WHO, International Travel and Health, 2002, Geneva; and Dr. Richard Thompson's book Well on the Road - A Practical Guide for the International Traveler, 2002.