We always think of mosquito bites , harmless in most cases, if not for swelling and an annoying itch. But the insects from which we can be stung or bitten, including children , are different: spiders, ticks, bees, fleas, bed bugs, wasps, hornets, gadflies, fleas, lice, mites and gnats . Then there are animals that, although not insects, can bite us, such as vipers, spider fish and jellyfish.
Symptoms of a sting or bite are usually a reddish swelling of the skin , a swelling that feels “hard”, sometimes painful and accompanied by itching, and which lasts a few hours. If not thoroughly cleaned and disinfected, the wound can become infected, with the possible presence and leakage of purulent material (pus).
Some people have a mild allergic reaction , which is characterized by a larger redness that tends to swell, redden and cause pain even for a few days. But there can also be cases of severe reactions. Let’s see how to recognize them in time and how to intervene.
What to do if you have just been bitten
The Istituto Superiore di Sanità invites to:
- Carefully remove any sting within seconds ;
- In case of a tick bite, remove the whole tickby turning it with pliers, as if unscrewing it, making sure that no pieces remain inside the skin;
- Apply cold products ( cold water, wet handkerchiefs in cold water or ice) to the wound for at least 10 minutes to reduce swelling;
- Avoid scratching or rubbing the wound and the area around it, even if it is itchy, to reduce the risk of infection.
- Avoid using so-called home “grandmother’s remedies” such as homemade compresses with vinegar or baking soda, lemon and tea tree, ammonia, which actually give anything but benefit. Instead, it is better to ask at the pharmacy or your doctor for products to reduce pain, itching and swelling, such as arnica-based creams;
- In children , as the experts of the Bambino Gesù Pediatric Hospital explain, in the case of a modest local reaction a non-steroidal anti-inflammatory cream is sufficient , while in the case of an intense inflammatory reaction, cortisone creamsmust be used for a limited period of time. acute phase or even antihistamines by mouth;
On the other hand, the use of topical antihistamines (in cream or ointment) which are often photosensitizing , making the skin more sensitive to the action of sunlight is absolutely contraindicated . Generally up to 3 months, it is best not to use any product to spread on the skin or to vaporize. If the child has a fever after the sting or the bite of an insect, it is good to contact a doctor. Normally the wound resulting from the puncture or bite and the disorders subside in 2-3 days , if this does not happen it is advisable to contact your doctor.
When to go to the doctor or the emergency room
The ISS always suggests contacting a doctor if:
- The bite or sting causes concern and agitation;
- Symptoms begin to worsen after 2 to 3 days instead of healing;
- The bite or sting affects the mouth , throat , area near the eyes ;
- The redness around the bite expands (at least 10 cm in diameter) and the area becomes swollen or painful;
- The wound shows signs of infection , pus, growing pain, redness, swelling
- General disorders (symptoms) appear , fever, swollen lymph nodes and muscle and joint pain, headache, dry cough, fatigue.
Instead, it is advisable to go to the emergency room or call 112 or 118 if the person has immediate serious symptoms such as:
- Difficulty in breathing ;
- Swelling of the face, mouth or throat
- Nausea or vomiting
- Increased heart rate ( tachycardia);
- Dizziness and a sense of weakness ;
- Difficulty swallowing
- Loss of consciousness.
How to tell if there is an allergic reaction going on
On the other hand, in individuals who have developed an allergy to poison , in the case of a new sting an intense reaction occurs which, in the worst cases, can take on characteristics of particular severity (anaphylactic shock), with itching all over the body, difficulty in breathing and marked drop in blood pressure .
The risk of severe allergic reactions, on the occasion of a subsequent hymenoptera sting in sensitized individuals, depends on the degree of severity of the reaction presented following the last sting: less than 5% of individuals who have presented an extensive local reaction will develop a reaction generalized to a subsequent puncture; the 50 – 65%those who have had a generalized reaction will develop a similar or more severe reaction .
The following are the four stages of severity of generalized reactions according to the Mueller classification.
- Stage 1 (mild) – Symptoms are generalized hives, itching , malaise, anxiety;
- Stage 2 (moderate) – Previous symptoms plus at least two of the following: edema, dizziness, nausea, pain in the abdomen, vomiting, diarrhea ;
- Stage 3 (severe) – Stage 2 symptoms plus at least two of the following: difficulty breathing ( dyspnea ), difficulty swallowing ( dysphagia ), dry mouth, difficulty speaking ( dysarthria ), hoarse voice ( dysphonia ); blurred vision, anxiety with a sense of imminent death, confusion ;
- Stage 4 (shock) – Symptoms of stage 3 plus at least two of the following: bluish discoloration ( cyanosis ), low blood pressure ( hypotension ), fainting (collapse), loss of consciousness , loss of sphincter control.
What to do in case of anaphylactic shock
The anaphylactic shock is a real emergency: in addition to a request for immediate medical intervention is required the immediate removal of the sting (for bee stings ) and the timely administration of epinephrine, a drug that strongly allergic patients should always carry itself in order to dampen the systemic allergic response. Other drugs useful for this purpose are antihistamines and intravenous cortisone ; to relieve breathing difficulties, a bronchodilator such as salbutamol should be administered .
Fortunately, it is very rare that the first allergic reaction is so violent that it leads to anaphylactic shock; generally it is limited to dyspnea ( breathlessness ) and a narrowing of the throat . It is essential, following the indications of the allergist specialist, to prepare for subsequent events which in all probability will be more intense.
In the event that there have been previous episodes of insect bites with striking skin reactions (severe and extensive swelling and redness), an immunotherapy aimed at desensitization can be started ; this opportunity is assessed through a specific blood test called RAST (Radio-Allergo-Sorbent-Test), which provides information on the severity of the allergy.
In desensitizing therapy the doctor administers very low doses of poison under the skin , but gradually increasing; this process is generally completed in 3 years and is aimed at making the immune system “forget” its particular sensitivity towards the substance.
What to do to reduce the risk of insect bites
The golden rule with insects is that the more we annoy them , the more likely they are to become aggressive towards us, to defend themselves. In the presence of wasps, bees or hornets, it is therefore good to move away calmly, avoiding to annoy them or groped to hit them. In any case, if near the place where we are there are insect nests or hives, it is good to avoid getting close and contact experts and specialized personnel for their elimination.
It is also important to be aware of when we are near flowering plants, garbage, standing water and in outdoor areas where there is food , stables and pastures., because these are areas where insects can congregate. Therefore it is good to avoid camping near these contexts.
With regard to personal hygiene, it is recommended to avoid the use of perfumes and deodorants, very fragrant soaps and shampoos because they could attract insects, it is suggested to keep food and drinks covered, especially sugary or sweet ones, because insects could get into cans and in the open bottles from which you are drinking.
On the market there are many insect repellent products that can be applied, but strictly following the indications on the dosages.
Now let’s see how the bites of different animals look and how to recognize them.
Spider bite
The 98-99% of the time the spider bite is harmless . Only in 2% of cases the bite leads to necrotic wounds, systemic toxicity and, more rarely, death.
If the injury does not cause too intense symptoms, it will be sufficient to carry out simple first aid maneuvers: apply ice and lift the limb . In case of allergy or systemic toxicity , a doctor’s intervention is necessary .
In Italy there are only three species of spiders dangerous for humans:
- The Loxosceles rufescens or ” violin spider “, so called because of a dark spot on the back in the shape of a violin. It is easy to find it in Sardinia, Sicily and in smaller islands;
- Lycosa tarentula, or ” tarantula “, spider covered with black and brown hair. It is located in central and southern Italy;
- Latrodectus mactans, or ” black widow “, widespread throughout central and southern Italy, but also on the islands.
Tick bite
Absolutely not to be underestimated, the mint is endemic in various mountain areas of Italy. The human tick is different from the dog tick .
It is recognized because it is usually black , as big as a pinhead and with a drop-shaped body and eight legs. It can be more or less large depending on its “age”: the “larvae”, that is the newly born ticks, are smaller than a millimeter, then there are the nymphs and finally the adult ticks, the size of a pinhead or even bigger. They are usually noticed because they are rounded black dots embedded in our skin. The tick does not sting, but it does bite. It inserts its head inside the skin, from which it sucks the blood by emitting poison.
The important thing, once we have the doubt of being bitten by a tick, is to avoid the do-it-yourself , to avoid the risk of breaking it and that its head remains in the skin. The way to remove a tick correctly is to grab it with pliers ( special pliers for ticks are available on the market ) and rotate it, like unscrewing a cork. It can then be disinfected. If you are unsure, the emergency room can take care of it , with a white code.
It is important to remove and ticks quickly and to keep any symptoms under control afterwards, because ticks can be infected and therefore become vectors, once in contact with our skin, of bacterial diseases (Borrelia, or Lyme disease , from the bacterium Borrelia burgdorferi) or viral ( TBE, Tick-borne encephalitis ).
For the first – Lyme disease – there is no vaccine, but antibiotic prophylaxis should the symptoms of the disease arise. Encephalitis, on the other hand, is a viral disease transmitted by the bite of infected ticks that affects the central nervous system . However, there is a TBE vaccine , which is taken in three dosesand that in some regions where the presence of ticks is high, it is free.
There are many products on the market to keep ticks away, both skin repellents and ultrasound devices to take with you that annoy the animal.
Flea bite
The fleas are common in domestic animals (eg. Cats and dogs), so it is essential to treat them with pesticides and in case of infestations by fleas in the house, providing a pest. In humans, they can nestle in our hair , but they can also move and bite other areas such as arms and legs .
Fortunately, flea bites cause small skin lesions . To cure them it is advisable to apply ice and in case use cortisone for topical use .
Sand flies bites
The sandflies are insects very common on summer evenings , often confused with mosquitoes although their color is more yellowish .There are also quiet as they approach, and not by chance that their name is derived from the words jelly + shut up and their other appellative, phlebotomist, derives from the Greek and means vein cutter. Their stings are very ferocious .
They mainly affect the lower limbs , given their low propensity to fly. When they sting they cause redness, even extensive, often painful, itchy and swollen. The problem is that sand flies can be vectors of infectious diseasessuch as leishmaniasis, and one of the symptoms of the current infection is the presence of a slight fever in the hours following the sting. As with other insects, if the area affected by the sting is very red, you can immediately apply ice and if this persists, ask your pharmacist for help .
Bed bug bites
Bed bugs are oval-shaped, brown- colored animals about the size of an apple seed when adults, which nest in hidden places in the home, particularly among mattresses and pillows , but sometimes also in sofas and armchairs . They are very common in hotels where deep hygiene is lacking.
Their bites cause small red spots , which itch, very annoying especially in those suffering from allergy to the saliva of bedbugs . To eliminate them permanently, it is recommended to wash clothes and sheets at 90 degrees .
Viper bite
The Italian vipers have a bite which is fatal only in 0.1% of cases and almost always depends on the mortality side complications such as allergic reactions, heart attacks or stroke and not the direct effect of poison.
The first thing to do is to call for help . Meanwhile, the bite should be washed with soap and water , then disinfected with alcohol-free solutions as this increases the toxicity of the poison. If the wound is located in the upper limb, it is advisable to remove rings and bracelets or watches before the swelling appears.
Alace about 5-6 cm upstream of the injured skin to stop the lymphatic circulation that carries the poison. But be careful not to over tighten the lace (you must be able to pass a finger) because you run the risk of blocking blood circulation. The bitten person must avoid any movement because this would speed up the distribution of the poison in the body. For this, the ideal position is the supine one .
It is also advisable to administer exciting drinks such as tea or coffee , which help to avoid a dangerous drop in blood pressure. The transport of the injured person to the emergency room is also
essential .
Recognizing the viper is easy: it has a triangular head , unlike the ovoid shape of other snakes, its body is rather squat and in no case exceeds one meter in length. The eyes have narrow and vertical pupils similar to cats. The viper is also distinguished by the two clearly visible canines. Let us remember that the viper never attacks first, its reaction is a defense when it is annoyed, for example beaten. It is important to pay attention in the mountains , especially on sunny paths, and we recommend the use of a stick to test the ground in case of poor visibility such as tall grass.
Weever or spider fish sting
From the mountains to the sea . Weepers are typical of sandy bottoms from 2 to 50 meters deep. It can happen that, inadvertently, a hand or foot ends up on its quills . These penetrate the skin and release a toxin which causes immediate very intense pain. Although the venom of the spider fish is not considered dangerous to humans, can cause tingling , loss of feeling in the affected part by the bite, nausea, vomiting and fever .
To relieve the pain, rinse the affected area with fresh water . Proceed, if necessary, withremoval of quills stuck in the skin. Then, considering that the heat destroys the poison and blocks its spread, it is useful to put your foot in the very hot sand (or even in hot water ): this gives an immediate feeling of relief. Absolutely
avoid applying ice or ammonia .
BIBLIOGRAPHICAL REFERENCES
- https://www.issalute.it/index.php/saluteaz-saz/m/567-morsi-e-punture-di-insetti#prevention
- http://www.ospedalebambinogesu.it/punture-di-insetto#.XwxWdi1abjA
Questions and answers
WHAT TO DO IN CASE OF ANAPHYLACTIC SHOCK?
In addition to the immediate request for medical intervention, the immediate removal of the sting (for bee stings) and the timely administration of adrenaline, a drug that highly allergic patients should always carry with them in order to dampen the systemic allergic response, is necessary. Other drugs useful for this purpose are antihistamines and intravenous cortisone; to relieve breathing difficulties, a bronchodilator such as salbutamol should be administered.
HOW TO RECOGNIZE A BEE STING?
Usually it is a red dot with a surrounding area that is also red, swollen up to 2-3 centimeters in diameter and painful even at the precise moment of the puncture. If the swelling is much more extensive and if there are other symptoms such as fever, swollen lymph nodes and muscle and joint pain, headache, dry cough, and fatigue, you should seek medical attention.
HOW LONG DOES AN INSECT BITE LAST?
It depends on the insect and our reaction, whether allergic or not. Normally the wound and ailments subside within 2-3 days. Ice can be applied on the spot to soothe redness, itching and swelling in the early hours. If this does not happen and if indeed other symptoms begin to add, it is good to contact a doctor.
WHAT ARE THE SYMPTOMS OF A TICK BITE?
Ticks are usually noticed because they are round black dots embedded in our skin. The tick does not sting, but it does bite. It inserts its head inside the skin, from which it sucks the blood by emitting poison. It is important to remove it immediately by “unscrewing” it with tweezers (do not tear it!), Being careful not to leave anything inside, and to observe if in the following weeks other symptoms appear, such as the well-known erythema in the shape of a reddened target, indicating a possible infection by Borrelia. In this case, contact the doctor who will diagnose and administer the antibiotic therapy. Regarding encephalitis, in 70% of cases the infection is asymptomatic while 3 out of 10 cases the disease presents with flu-like symptoms (high fever, severe headache, sore throat, fatigue, muscle and joint pain) for a few days. In 10-20% of cases there is a second phase characterized by signs of involvement of the central nervous system.
HOW TO REMOVE A TICK FROM A CHILD?
The important thing, once we have the doubt of being bitten by a tick, is to avoid the do-it-yourself, to avoid the risk of breaking it and that its head remains in the skin. The way to remove a tick correctly is to grab it with pliers (special pliers for ticks are available on the market) and rotate it, like unscrewing a cork. It can then be disinfected and the redness should disappear in a couple of days.
