Just when it’s time to wear warm-weather clothes like shorts and short-sleeved shirts, insects swoop in to nibble every inch of your exposed flesh. While Beijing’s mosquitoes are generally nothing more than a nuisance, if you and the family go traveling this summer, there’s a lot to consider about those pesky pests. Dr. Jean-Pierre Dhenin, a physician in the Family Medicine Department at Beijing United Family Hospital, and a dermatologist at Vista Medical Center spoke to us about how to deal with the constant itch from bites and how to ward off insect-borne diseases.
If you’re in Beijing this summer, mosquitoes are likely the only insects you’ll need to think about. There are no common mosquito-borne diseases here, so the most frequent complication doctors see in Beijing are infections from scratching too much. If this is the case, Dr. Dhenin says that infected bug bites require antibiotics, but even better: don’t scratch.
Most kids find it impossible not to scratch, so Vista’s dermatologist recommends some traditional Chinese medicines to soothe the scratching. The first is qingliang you (清凉油), which is very similar to Tiger Balm; the other is fengyou jing (风油精). Both balms contain menthol, and fengyou jing can also be used as a mosquito repellant. Antihistamine creams are also effective itch-relievers, but if there’s a serious reaction to a bite, it may call for steroid cream. However, steroid cream should only be used for a short period.
If you and your family are traveling this summer, either within China or in Southeast Asia, there are more precautions to consider. If you’re going to southern China, there is a small risk of contracting dengue fever, though dengue fever is much more present in Southeast Asia and Micronesia. You may also need to watch out for malaria, which is present in rural parts of Anhui, Guizhou, Hainan, Henan, Hubei, and Yunnan. According to the US Center for Disease Control (CDC), some major river cruises pass through areas in Anhui and Hubei in which malaria is endemic.
Like dengue, malaria is a larger concern when visiting Southeast Asian countries. If you’re worried about the risk of malaria when your family travels, head to the doctor first and see if he or she recommends anti-malarial medication.
The other mosquito-borne illness that is prevalent in China is Japanese encephalitis (JE). While people are generally at a low risk of contracting JE in Asia, it is a severe virus that causes inflammation of the brain. JE is generally present in rural areas, especially areas where there are rice farms. Transmission of the disease generally peaks in summer and fall, though in tropical areas transmission can occur at any time of the year.
Dr. Dhenin suggests that if you travel to Southeast Asia or visit rural areas of China, you should consider getting the JE vaccine, as the disease is endemic in the region. The vaccine is especially
recommended if you’re doing outdoor activities like camping, hiking, or biking. If you’re traveling this summer, even to camp in rural areas of China, consult your doctor beforehand about any precaution or necessary vaccines.
Of course, no matter where you’ll be this summer, it’s a good idea to prevent mosquito bites before they occur. The most effective way to prevent bites from insects of any kind is to cover up: wear pants, long sleeves, and as Dr. Dhenin reminds, socks. Wear mosquito repellant and, if you’re in an area with persistent mosquitoes, sleep in an air-conditioned room under a mosquito net.
Dr. Dhenin recommends using repellants with DEET, a highly effective insect repellant created by the US army, to ward off mosquitoes if you’re in a tropical area with endemic malaria or other mosquito- or tick-borne illnesses. While DEET is effective, it is also very strong, and Vista’s dermatologist cautions that it can cause skin irritation. If you decide to use repellant with DEET, be careful not to use a repellant with a high concentration of DEET (Canada bans concentrations of over 30 percent). Don’t apply it over cuts, wounds, or skin irritations. Don’t use a lot of it, don’t spray it on in enclosed areas, and don’t put it on young children. Wash the clothing you wore while wearing DEET repellant before wearing it again.
There are other natural repellants like citronella, a plant-based essential oil that Dr. Dhenin recommends instead of chemical repellants. Citronella can be used in soaps, candles, and even felt bracelets.
Dr. Dhenin says that while they do see tick bites, he doesn’t see them very often, and even better, he’s never heard of Lyme disease in China. He says this is more prevalent in the US and Western Europe, though there is tick-borne encephalitis in China closer to Siberia. If you get a tick bite, it’s important to remove the tick. You can do this yourself, but it should be done carefully with tweezers, not a match, says Dr. Dhenin. When removing a tick, it’s essential to take care not to cut the tick’s body or leave its head under the skin.
Again, flea bites do happen, but generally result in nothing more than irritation or infection from scratching. While there are flea-borne illnesses, they are generally rare. Keep yourself, your kids, and your pets away from stray animals that may carry fleas.
Vista’s dermatologist cautions that scabies is very common in China’s rural areas. This contagious skin condition is caused by tiny mites that burrow into the skin, causing intense itching. Contagion generally occurs in close quarters where there is direct skin-to-skin contact. Dogs and cats that have scabies are infected by different mites than humans, so if canine or feline mites land on your skin, you will most likely only get a mild itch that subsides without medication.
Scabies is very itchy, tends to get worse at night, and will only progress as the weeks go by. Vista’s dermatologist treats scabies with a sulfate lotion.
The most important things to take into account with insect bites are to be aware of insect-borne illnesses wherever you’re traveling. And no matter where you are, if you have a bite, don’t scratch it!
illustration by sunzheng