![]() If nets are permethrin-treated, it increases their effectiveness however, caution should be used in infants to avoid toxicity.ĭEET (diethyltoluamide) is the most commonly recommended and studied mosquito repellant to date. In fact, “la mosquetera” is a mainstay gift of baby showers in Latin America. In many countries in the developing world, mosquito nets are used to protect from bites at night. Patients are advised to wear clothes that cover their arms and legs and to avoid the most active time for mosquitos, dusk, and dawn. Preventing mosquito bites is the most important therapy, as it prevents not only the local skin reaction but also any mosquito born illnesses. It is thought that IgG also triggers an immune complex type 3 reaction, responsible for the case reports of serum sickness-like symptoms in some case reports. IgG and T-cells are involved in Type 4 delayed reactions. When this IgE binds to mosquito saliva proteins, mast cells are triggered, causing a release of histamines and leukotrienes responsible for the wheal, itch, and warmth of immediate reactions. ![]() Immediate reactions are postulated to be due to IgE mediated type 1 reactions as they correlate with serum levels. In real life, the time to desensitization may be prolonged due to efforts to avoid exposure and seasonal changes. One study was able to induce desensitization in healthy volunteers by subjecting them to 100 bites every two weeks for ten months. With time this progresses to only an immediate reaction and later no reaction at all this is species-specific due to varying antigens in the mosquitoes’ saliva. After more bites from the same species, they develop an immediate reaction, peaking at 30 minutes, in addition to this delayed response. ![]() Initially, they will only have a delayed response with a pruritic wheal that forms around the bite peaking at around 24 hours. A 1940 paper described five stages of mosquito bite reactions. However, once sensitized, individuals will go through a spectrum of presentations. The thinking is that a bite in unsensitized individuals will cause no observable reaction, although some may have a small pruritic papule. However, in sensitized patients, there will be a local reaction. These toxins usually serve the purpose to aid in feeding via vasodilating, anticoagulant and antiplatelet properties. Unlike other biting insects, they do not leave stingers or fangs in the skin of victims. The reaction after a mosquito bite is believed to be mostly from toxins located in their saliva.
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