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Prevention

Personal protective measures are the first line of defense in preventing bites and mosquito­-borne diseases.1

Guidance for your patients1,2

epa

Apply EPA-registered insect repellent

EPA-registered insect repellent includes2:

  • DEET (diethyltoluamide)
    • DEET works to confuse and interfere with a mosquito's receptors, deterring them from landing on the skin and biting3
  • Picaridin (known as KBR 3023 and icaridin outside the US)
  • IR3535
  • Oil of lemon eucalyptus (OLE)
  • Para-menthane-diol (PMD)

Guidance2:

  • Follow the label
  • Reapply every few hours
  • Do not spray repellent on the skin under clothing
  • Apply repellent after sunscreen
long cloths

Wear long clothing treated with permethrin

  • Wear long-sleeved shirts and long pants when possible
  • Treat items such as boots, pants, socks, and tents with 0.5% permethrin, or purchase permethrin-treated clothing and gear
    • Permethrin is an insecticide that kills or repels mosquitoes
      • Follow the product instructions
      • Do not use permethrin directly on skin
mosquitoes out

Keep mosquitoes out

  • Choose a hotel or lodging with air conditioning or screens on windows and doors
  • Sleep under a mosquito net if the room is not well screened
  • Buy a mosquito net before traveling overseas
  • Choose a mosquito net that is:
    • Compact
    • White
    • Rectangular
    • 156 holes per square inch
    • Long enough to tuck under the mattress
vaccinated

Take preventive medication and get vaccinated when appropriate

Consider the following in addition to personal protective measures:

  • Preventive medications are available to protect against malaria but are not 100% effective4
  • Vaccines are available for dengue, Japanese encephalitis, and yellow fever; however, there are no available vaccines or prophylaxis for chikungunya, West Nile, or Zika5,6
    • Consult the CDC guidelines for the latest vaccination recommendations

The CDC recommends that travelers continue to take personal protective measures for 3 weeks upon their return to avoid getting bit by a mosquito. This helps prevent the spread of viruses to uninfected mosquitoes in the area and reduces the risk of local transmission.7

SWAT

SWAT can help travelers remember the personal protective measures they can take to prepare for and protect against deadly viruses spread by mosquitoes.

Encourage travelers to SWAT…7

  • See

    a travel health specialist

  • Wear

    long-sleeved shirts and long pants

  • Apply

    insect repellent

  • Take

    medication and vaccines if appropriate

Getting travelers to properly adhere to personal protective measures can be a challenge. In fact, a study showed only 2.5% of the participants applied the recommended dose of repellent.8,9

If appropriate, prescribe preventive medication and vaccinate travelers in accordance with CDC recommendations.

Download the SWAT mnemonic

download

References: 1. Prevent mosquito bites. Mosquitoes. Centers for Disease Control and Prevention. Updated July 11, 2022. Accessed March 13, 2023. https://www.cdc.gov/mosquitoes/mosquito-bites/prevent-mosquito-bites.html 2. How to protect against mosquito bites. Centers for Disease Control and Prevention. Updated March 26, 2020. Accessed March 13, 2023. https://www.cdc.gov/mosquitoes/pdfs/mosquitobitepreventionus_508.pdf 3. Rockefeller University. Scientists investigate how DEET confuses countless critters. ScienceDaily. Published September 26, 2018. Accessed March 13, 2023. https://www.sciencedaily.com/releases/2018/09/180926140832.htm 4. Choosing a drug to prevent malaria. Malaria. Centers for Disease Control and Prevention. Updated July 1, 2022. Accessed March 13, 2023. https://www.cdc.gov/malaria/travelers/drugs.html 5. Symptoms, diagnosis, & treatment. West Nile virus. Centers for Disease Control and Prevention. Updated October 14, 2022. Accessed March 13, 2023. https://www.cdc.gov/westnile/symptoms/index.html 6. Symptoms, diagnosis, & treatment. Chikungunya virus. Centers for Disease Control and Prevention. Updated October 11, 2022. Accessed March 13, 2023. https://www.cdc.gov/chikungunya/symptoms/index.html 7. Prevent mosquito bites. Division of Vector-Borne Diseases (DVBD). Centers for Disease Control and Prevention. Updated June 1, 2022. Accessed March 13, 2023. https://www.cdc.gov/ncezid/dvbd/media/stopmosquitoes.html 8. Lalani T, Yun H, Tribble D, et al. A comparison of compliance rates with anti-vectorial protective measures during travel to regions with dengue or chikungunya activity, and regions endemic for Plasmodium falciparum malaria. J Travel Med. 2016;23(5):taw043. doi:10.1093/jtm/taw043 9. Hasler T, Fehr J, Held U, Schlagenhauf P. Use of repellents by travellers: a randomised, quantitative analysis of applied dosage and an evaluation of knowledge, attitudes and practices (KAP). Travel Med Infect Dis. 2019;(28):27-33. doi.org/10.1016/j.tmaid.2018.12.007