Wednesday, September 26, 2012

West Nile Virus, Part 2

Previously I presented my husband’s request to start using insect repellent on our baby, who is four months old.  I wanted to do some research on the different insect repellents and their safety before I started to use it on the baby.  I did a review of scientific research that I could access online and have several sites you can look at to see for yourself. 

Last month (8/2012) the American Academy of Pediatrics published tips on preventing West Nile Virus.  It clarified for me that I can use up to 30% DEET on babies over 2 months old, but it should only be applied once a day.  It also should be wiped off at the end of the day.  There have been cases of DEET toxicity but using the lowest effective concentration of DEET on only the areas of exposed skin and wiping it off after returning indoors reduces exposure.

OK, so I could use a DEET insect repellent on the baby, but this talk of toxicity isn’t sounding great to me so I still have more research to do to make my decision. 

The AAP tips page also mentioned Picaridin, which has been available in Europe but only recently has been available in the US.  It does not mention how old babies have to be to use it or possible side effects.

The CDC recommends DEET (N,N-diethyl-m-toluamide), Picaridin, or Oil of lemon eucalyptus as the three most effective insect repellents.  In general, it is wise to use the lowest concentration of the key ingredient that is effective for the amount of time you are going to be outside.

Kidsmeds has a great webpage describing the various insect repellents and how long they are active.  It includes DEET, Picaridin, Eucalyptus, and Citronella.  Citronella is only effective for about thirty minutes, but the other three can last about 6 hours in the stronger concentrations.

Dr. Mark Fradin reviewed the available research on insect repellents in 2001.  He reported that in 50 years there were only 50 significant cases of DEET toxicity.  These cases seemed to have had long-term, excessive, or inappropriate use of DEET repellents but the details of exposure were not well documented.  14 of these were children under age 8 who developed encephalopathy.  Wait, that sounds as bad as West Nile Virus.  But 14 cases in 50 years with millions of uses every year meants it is pretty rare.
He also found few studies on Picaridin, but indicated low concern for toxicity.
A 2008 risk assessments review for the insect repellents DEET and Picaridin had essentially the same conclusions as Dr. Fradin.

Oil of lemon eucalyptus may seem more natural than DEET or Picaridin, but the labeling for oil of lemon eucalyptus says it is not to be used on children under the age of three and Picaridin is derived from pepper.
A final couple of websites for you to look at:

So far for me, it’s toss-up between DEET and Picaridin.  I think they are both safe enough for the baby when used correctly.   DEET is more studied but also has more documented side effects than Picaridin.   Tomorrow I will look at just how big the risk is for West Nile Virus.

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