Insect and Spider Bites

The season of bites and stings has begun in earnest.  Many parents call worried that an bite is from a spider or a tick. We cannot usually distinguish between an insect, spider or tick bite without seeing the actual offender in action.  However, these bites are all initially treated in the same way (providing symptomatic relief.) 

Tick bites are less likely to cause initial inflammation and redness, and are only an issue if followed (3-30 days later) by a steadily expanding, ringed, pain/itch free, flat rash that is present for at least several days (or an acute, febrile, flu like illness.)  If you are worried about a possible lyme rash, take a photo daily and come in if the area is increasing in size over several days.
 
Insects such as bees, ants, fleas, flies, mosquitoes, wasps and arachnids such as spiders may bite or sting when provoked or distressed, or bite to feed on our protein filled blood. The saliva or venom injected into the skin will cause the body to release histamine, a chemical that brings more blood flow into the area (to help fight infection.)  This results in swelling, redness, firmness, pain and/or itch in the area of the bite or sting. This type of localized reaction, while uncomfortable (and sometimes quite large) is of no danger.  It is often delayed, and some bites and stings are at their worst 24-48 hours later.
 
If you are very sensitive to an insect's venom ("allergic"), bites and stings can cause a rare but potentially fatal condition called anaphylactic shock.  Typical symptoms of anaphylaxis include wheezing, hoarseness or difficulty breathing; nausea, vomiting or diarrhea; dizziness or feeling faint; difficulty swallowing and/or swollen face or mouth; and confusion, anxiety or agitation.   If you child experiences any of these reactions after a bite or sting, call 911 immediately and administer an epinephrine pen if available.
 
When the reaction is mild, the majority of bites and stings can be treated at home. Remove the stinger if it is lodged in your skin, wash the affected area with soap and water, and apply an ice pack to reduce pain and swelling. Topical anti-itch creams (Cortaid, Benadryl, Calamine or Caladryl), oral pain relievers (acetaminophen or ibuprofen) and antihistamines (Benadryl, Zyrtec, Claritin or Allegra) may be used to combat uncomfortable symptoms.
 
Benadryl, ibuprofen and acetaminophen dosages by weight 
can be found here.
 
 
Bugs that Bite
 
Mosquitoes
Mosquitoes select their victims by evaluating scent, exhaled carbon dioxide and the chemicals in a person's sweat. Only females bite! (Males don't need blood as they don't make eggs.)
Most mosquito bites are harmless, but occasionally a mosquito bite causes a large area of swelling, soreness and redness. This type of reaction, most common in children, is sometimes referred to as "skeeter syndrome".
Mosquito bites start as puffy, white bumps that appear a few minutes after the bite.  The bumps usually swell and turn redder, itchier over 24-48 hours, and can sometimes become quite large.  Occasionally there will be a small blister in the center. As the swelling goes down, the area may look like a ringed lyme rash, but the size does not increase as a lyme rash would.
 
Fleas
Flea bites can be grouped in lines or clusters. If you're particularly sensitive to flea bites, they can cause hives or blisters.
Photos of flea bites

 
Horse Flies 
Horse fly bites are more immediately painful than those of mosquitoes. Their bites may become very itchy, sometimes causing a large swelling that can take days to resolve.  Again, this is not dangerous allergic reaction- merely uncomfortable.
 
Black fly bites are common in the northeast from April to July, especially in wet areas.  These flies secrete an anticoagulant (blood thinner) into the skin, which both numbs the area and causes bleeding.  The bites often look like blood blisters, and tend to be around the neck and ears, or by the ankles.  Localized swelling and itch can last as long as several weeks.
 
Stinging Insects
Insects will sting humans only as a defensive move against a perceived threat. Typically, a bee or stinging ant's stinger will be accompanied by a small amount of venom that, when injected into your skin, causes most of the itching and pain associated with sting, as well as any allergic reaction. Common stinging insects in the U.S. include bees, wasps, hornets, yellow jackets, and fire ants.
A bee sting feels similar to a wasp sting, but the sting and a venomous sac will be left in the wound. You should remove this immediately by scraping it out using something with a hard edge, such as a bank card. Don't pinch the sting out with your fingers or tweezers because you may spread the venom.  Stings are often worse after 24-48 hours, but are not dangerous unless accompanied by symptoms of anaphylaxis.
 
 
Spider Bites
THESE ARE VERY UNCOMMON IN CONNECTICUT!
There are primarily two spiders in the United States that are harmful to humans: the brown recluse and the black widow.
Most active at night, the brown "recluse" spider hides and is not commonly found out in the open, preferring woodpiles and sheds, closets, garages, basements, and other places that are dry and generally undisturbed. The brown recluse is most commonly found in the South and is not native to any of the New England States.
brown recluse spider bite initially often is not felt, or causes just mild discomfort.  Within the first hour, a local burning/stinging sensation develops. The bite area becomes red and skin temperature increases. Within four hours, the area exhibits a "bull's-eye" appearance, forming a blister in some cases. This blister may rupture in 8 to 36 hours, creating an ulcer or brown/black scabbed center. There is no special treatment or medication used to treat a brown recluse spider bite. If infection develops it is treated with antibiotics.
 
Brown Recluse Spider:
brownspider.jpg
 
Brown recluse spider bite pictures can be found here.
 
Black Widows may be found throughout New England, but true black widow spider sightings or bites are uncommon.
If a black widow spider bites, do not panic! No one in the United States has died from a black widow spider bite in over 10 years. Very often, no serious symptoms develop. Black widow bites may go unnoticed or feel like a sharp pinprick. These spiders may bite more than once and may hold on for a few seconds. The wound site may show one or two small puncture wounds. Within 20 to 40 minutes the patient usually experiences a dull ache or numbing sensation near the bite site. Pain progresses and spreads to the abdomen (stomach cramps), back, and extremities.
If muscle cramps develop or pain is severe, take the patient to the nearest hospital for treatment of the symptoms.  Anti-venom is available, but rarely needed.
 
Black Widow Spider
blackwidwo.jpg  
 
Photos of various stings and bites can be found here
For more information on tick bites, click here.
For more information on bug repellents, click here