By the end of the third week of August 2012, 47 US states have reported West Nile virus infections in people, birds, or mosquitoes, says the Centers of Disease Control. A total of 1118 cases have occurred in people, with 41 deaths. These are the highest numbers reported in this time period since the virus was first detected in the United States in 1999. Almost half of this year’s cases occurred in Texas.
Here is what is known:
- In children the number of cases is small and the disease tends to be mild. While many infectious diseases are more common and more serious in children than in adults, this is not the case with West Nile. Virtually all severe cases and deaths have occurred in the elderly, mostly among those with underlying chronic diseases and, presumably, weakened immune systems. In children West Nile symptoms are typically indistinguishable from everyday respiratory viruses.
- West Nile is contracted from bites of mosquitoes infected with this virus. Insects become infected from feeding on infected birds. The disease cannot be transmitted from close contact with infected persons. But even where the disease is active, generally less than one percent of mosquitoes carry the virus. And most children who become infected show no symptoms. Moreover, the risk of infection can be further reduced with insect precautions, especially during the late summer and autumn, the prime time for the disease.
Stay current with the West Nile situation in your community. Most state and county health departments post unusual mosquito activity on their web sites and publicize findings in the media. Support local mosquito spraying programs. Available evidence shows that spraying from trucks and airplanes do not present a hazard to infants and small children, though it is prudent to keep children indoors while spraying occurs. - Help reduce the mosquito population. Most mosquitoes do not travel far, generally no more than a few hundred yards (meters) from their breeding grounds. Eliminate possible breeding places around your house/apartment. Mosquitoes prefer breeding in stagnant water in discarded tires, clogged drainage pipes, children’s sand pails, flowerpots, birdbaths, pet water dishes, and such.
Protect children from insects. Dress them in long pants, lightweight long-sleeved shirts, socks, and closed shoes. Avoid clothing that attracts mosquitoes (bright colors and flowery prints) and scented soaps, perfumes and hair sprays. Cover baby carriages/strollers with netting, when necessary. During increased mosquito activity, keep children indoors or use optimum protection methods at dawn, dusk and early evenings, the hours during which most mosquitoes feed. 
DEET-containing insect repellents appear to be the most effective and safest. DEET is the active chemical ingredient in a majority of insect repellent. It is approved as safe for children as young as two months of age. DEET has been available for decades, studied extensively, and used billions of times. No major adverse reactions are known to have occurred. Only extreme misuse (usually ingestion) has caused toxic reactions. Occasional skin rashes occur but these dissipate when use of the repellent is discontinued. Importantly, DEET repels more types of disease-carrying insects than other substances.
A newer repellent, Picaridin, appears to be as effective and as safe as DEET but has not been used as extensively.
DEET-containing repellents are available in various strengths and forms. Products containing 20 to 30% are recommended for children. Higher percentages are effective for longer periods of time but are only marginally more protective, and may be more likely to cause skin irritation. There are lotions, creams, gels, sticks, aerosols and towelettes. Acquaint yourself with several products. Read instructions. Check manufacturers’ websites, if necessary. Check with your doctor before using repellents on children with serious skin diseases. - Apply repellents to exposed skin only. There is no need to place it under clothing. Apply repellent to your hands and then rub them on the child. A thin coating is sufficient. Avoid eyes, mouth, wounds or rashes. If accidentally applied to such areas, rinse with water. Apply in a well-ventilated area. Wash off when protection is no longer needed. There are no known harmful effects to infants from drinking breast milk of mothers who are using DEET or Picaridin.
- Be wary of “natural” products. Wristbands are ineffective. Taking vitamin B may reduce itching from bites, causing people to think that it reduces the number of bites. Products which emit vapors may be harmful if inhaled indoors over prolonged periods of time, especially by children. Outdoors, vapor effectiveness depends on wind direction and other factors and therefore is unreliable. Most repellents labeled “organic”, “natural” and “non-chemical” have not been scientifically tested and may be ineffective.
- Avoid products that combine repellents and sunscreens. While many situations call for both, the intervals of application and other considerations make combination products impractical. Generally, apply the sunscreen at least twenty minutes before sun exposure while the repellent can be applied just before exposure. The repellent may reduce the effectiveness of the sunscreen. Consider using a stronger sunscreen when using both substances.
