Mosquito and tickborne illnesses in United States have tripled, says CDC

Pharmacists can serve as important educators

The latest Vital Signs report from CDC should give pause to anyone who hasn’t thought about protecting themselves and their loved ones from mosquito, tick, and flea bites. CDC found that illnesses in humans from these insects have tripled in the United States since 2004. What’s more, nine new diseases have been spread by mosquitoes and ticks in the same time frame, and 80% of vector-control organizations lack at least one core vector-control competency.

“Rates of infection are increasing, new diseases are emerging, and we are not prepared to prevent and control these diseases—that is very concerning,” said Patricia Fabel, PharmD, BCPS, from the University of South Carolina College of Pharmacy.

Zika virus disease, Lyme disease, West Nile fever, and chikungunya viruses are some of the known diseases that can be caused from the bite of an infected mosquito, tick, or flea. However, as CDC Director Robert Redfield, MD, noted in the report, “we don’t know what will threaten Americans next.”

Making sure patients know how to prevent bites is a top priority. Fabel said that educating and reminding the public about risks from mosquito, tick, and flea bites are the first things frontline pharmacists can do to help reduce the threat. Pharmacists have the biggest role to play in recommending EPA-registered insect repellents to patients, along with instructions on how to apply them correctly.

According to Monique Bidell, PharmD, BCPS, an assistant professor at Albany College of Pharmacy and Health Sciences, DEET-containing insect repellents offer the versatility of protecting against ticks, mosquitoes, and other insects. Generally, the recommendation for most people is to use a product with at least 20% DEET. If patients are using sunscreen as well, Bidell pointed out that it’s important to apply the sunscreen first and the insect repellent after.

DEET products also provide a longer duration of protection and are the best repellent to use in a heavily infested area. Although alternative or natural insect repellents might be attractive to some patients these days, Fabel said, they are less effective at keeping insects away and preventing bites.

Bidell stressed that it’s wise for individuals to wear protective clothing, like pants and long sleeves, along with insect repellent, especially in wooded areas.

“Generally, people forget the importance of protective clothing during warmer months, but taking a dual approach is the best way to help patients protect themselves and their families,” said Bidell.

In addition, boots, pants, socks, and outdoor gear like tents can be treated with permethrin or purchased already containing this insecticide. Insect repellent should still be used along with these treated products.

With the threat of Zika virus disease less prominent in the news these days, Fabel worries that the public is not as concerned about mosquito bites—when they really should remain vigilant.

“There have been nine new germs since 2004; we have no idea what will be discovered in the future,” she said. “Pharmacists can help remind patients that the risk of other diseases is still there, and they need to continue to take precautions.”

Infected individuals can propagate Zika virus disease if they are bitten by a mosquito and that mosquito bites another individual. The disease can also be transmitted through the semen of an infected male.

Besides providing information on EPA-registered insect repellents, pharmacists can educate patients on what’s needed to control mosquitoes inside and outside of the home.

“CDC recommends emptying, scrubbing, turning over, covering, or throwing out anything that holds water at least once a week,” said Fabel. “This is especially important if the patient lives in an area that does not spray for mosquitoes or cannot spray for mosquitoes due to the presence of honey bee hives.”

The greatest concern with being bitten by a deer tick is the risk of developing Lyme disease, and in some states such as New York and Pennsylvania, the risk can be even greater. To prevent ticks in one’s yard, CDC recommends applying pesticides. If that’s not possible, removing leaf litter, clearing tall grasses and brush, placing a barrier between yards and wooded areas, mowing the lawn frequently, and discouraging unwelcome animals can limit ticks.

Pharmacists can also educate patients on how to remove a tick if they find one.

For the full article, please visit www.pharmacytoday.org for the July 2018 issue of Pharmacy Today.