Summertime and bugs go together. The symptoms of bug bites or stings depend on the insect and the victim’s reaction. Recently, on Whidbey we have seen more than the usual number of Hobo spider bites and even bedbugs. This summer I hope the only bug that bites you is the exercise bug, but, just in case…

Spiders

Almost all spiders are predatory, and as predators, are beneficial to balance in nature. If cornered or trapped between the victim’s clothing such as gloves or shoes, the spider may deliver venom by bite. Fortunately, most bites are not serious. Wash the area with soapy water, apply cold compress or ice, and elevate the area if possible above the heart. A pain reliever or oral antihistamine for itching may be necessary.

Hobo spider

As pediatricians on Whidbey Island, we see only a few bites a year that may be attributed to the hobo spider. Hobo spiders are found throughout Washington, including Whidbey Island. They look to the untrained eye just like the common house spider, their cousin, but are faster. The spider is l to l.75 inches in diameter including the legs. They are most abundant from midsummer until fall. These spiders build their nests in dark, moist areas like basements, rarely climb vertical surfaces, usually stay on the ground or lower floors or in adjacent vegetation outdoors.

The hobo is known as the aggressive house spider and bites with any threat especially when cornered, such as may happen if the victim lifts firewood, or puts on clothing containing the spider. Bites usually are minimally felt, within 30 minutes the area is hard, red and may be 2 to 6 inches around. Within 15 to 30 hours later, the area blisters and 24 hours later the wound may ooze. There may be an ulcer left, and healing may take months and require grafting. Symptoms may include severe headache, nausea, weakness, loss of memory or vision, or hallucinations and rarely death. See a doctor.

Black

widow spider

Black widows are a problem. We do have this spider on Whidbey Island. Black widows are rare but a bite from this spider can be very serious, especially in a small child. The venom from the black widow does not locally react, has no tissue toxin, but gives a neurotoxin and within 30 to 90 minutes the patient may have cramping all over the body, nausea and vomiting and severe generalized pain. A doctor should be consulted immediately.

The black widow is usually a shiny black creature about l.5 inches in diameter including the legs and has two red marks on the underside which may form an hourglass marking. These spiders love piles of firewood, crawl spaces, outbuildings (especially privies, look first!)

Prevention

Remember: Spiders are helpful in their predatory role and are needed to control other insects. Rarely are chemicals necessary to control their population. My advice would be to take care and teach your children to do the same, as you handle firewood or reach into dark places. Check for egg sacks, usually in the fall, as you bring firewood into the house. Teach children not to play with spiders. With apology to Dr. Sweitzer, if you must kill a spider, step on it or vacuum it up and dispose of the bag immediately. Check gloves, boots, work clothing before you don them. Again, chemicals are not a solution, and at best would be a temporary fix. Contact WSU Cooperative Extension for further information, or for spider identification. This agency is a, highly capable Whidbey Island resource. Call 678-7327.

Flying insects

Bees, wasps, ants

Bees, wasps and ants are the cause of most insect-related deaths in our country. Death is by anaphylaxis, which means an allergic reaction to the sting. This usually occurs immediately l0 to 20 minutes after the sting causes shortness of breath due to swelling of the airway and shock. With any such suspicion, call 9ll immediately and give epinephrine (bee sting kit or Epi-Pen) if available. Emergency medical services brings this lifesaving medication to the scene, so phone 911 first.

As the bee dies as she leaves her barbed stinger in the victim. Use what you have nearby that is straight to sweep over the stinger site (credit card) to flick the bulb of venom out of the skin. Squeezing the bulb will actually inject more venom into the skin. Hornets and wasps rarely leave a stinger. Wash the site with soapy water, apply an ice pack and if needed, topical calamine lotion or oral antihistamine. Swelling may get large and painful.

Elevating the affected area above the heart helps with swelling. A pain reliever such as acetaminophen may help. Take time in the beginning to provide good wound care and keep a watch for lymphangitis (streaks of red starting from the swollen area) or a fever as signs of an unlikely secondary infection.

Multiple stings should be evaluated by a doctor immediately and if known to be bees, stingers should be removed carefully. Death has been reported from 20 to 200 simultaneous stings.

Prevention

To prevent stings, don’t look like a flower, dress like a flower, smell like a flower. — Our annual apple squeeze is fraught with bees because the sweet smell of apples and juice is in the air. Keep food covered and take the food indoors as soon as possible.

Mosquitoes

It is never good to be fed on by a blood sucker. Mosquitoes are drawn to warm-blooded hosts who exhale carbon dioxide. They find us from long distances. They inject their saliva (carrying other viruses by prior contamination) as they draw blood. Malaria and other diseases are spread by these blood sucking insects. In Washington, mosquito-borne West Nile Virus (WNV) and other diseases are infecting humans and horses and birds. Most humans infected by the WNV will not get sick but l in 5 will get mild symptoms of fever, headache, and body aches. More serious symptoms such as stiff neck, high fever, paralysis,and coma may occur. See a doctor for these symptoms, which need immediate intervention.

Prevention

l. Eliminate standing water breeding sites.

2. Screen them out of your house.

3. Work and play outside in non-peak hours — dusk and dawn are the mosquito hours

4. Cover up, head to toe. Cotton is cool coverage.

5. DEET chemicals are a last resort. Use not stronger than l0 percent on any child under age 8 and since it may absorb, use it sparingly and wash it off as soon as the child is back indoors. Skin so Soft and citronella have some benefit although short lived.

Ticks

We do have ticks on Whidbey. They too are blood suckers and are known to spread diseases such as Lyme disease. Ticks should be removed with tweezers or forceps or if necessary your gloved hand (remember the body juices carry the disease) Grab the tick as close to the person’s skin as possible and use steady upward even pressure until the tick lets go. If imbedded parts are left behind they will usually self extrude. Soap and water washing should follow. Tick bite paralysis is seen in Washington. The person may become paralyzed until the offending tick is removed. The tick may stay attached and feed on the blood for days. The longer attachment increases the risk of infection from Lyme Disease and the degree of paralysis from the neurotoxin in the tick.

Prevention

l. Ticks are stealth fighters, you must intercept them by removing them. Soccer and baseball fields adjacent to woods are likely culprits as well as parks like Deception Pass.

2. Cover up. Long pants tucked into socks and long sleeved shirts are low technology and preferred.

3. Chemicals as last resort. Permethrins (Tick Gard) are pesticide and may kill living organisms like ticks on contact (powerful). Do not put this on your skin because absorption is harmful (you too are a living organism).

4. DEET may be applied to the skin but use sparingly and never concentrations of greater than 10 percent in children under age 8 years. Wash off the DEET as soon as you come indoors.

Bedbugs

Bedbugs are back. I recently have seen patients whose home has this infestation on Whidbey Island, the first time in my 25 years in practice here. There is a national resurgence of bedbugs now likely related to our international mobility. Visitors to endemic areas bring back these extra passengers hiding in luggage or commonly in second hand wood furniture..

Bedbugs are visible to the naked eye and are about the size of a pencil eraser when mature and engorged, reddish brown on the top. You may follow their trail by groups of little black specks (blood from their food and excrement) on sheets, mattresses, and furniture crevices. Finding the bug, however, is difficult since they only come out in the dark once a week or so. The bedbug gorges itself with human blood, then crawls into its favorite hiding site for the next week or two to digest its meal while the victim itches and scratches for longer than that.

The bedbug bite is painless initially and later the site becomes very itchy, red and raised and as other bites, may become infected if fingernails with germs scratch. Did I mention wash with soap? The bedbugs do not stay on the skin, so there is no need to treat except for itch control or rarely secondary infection.

Bedbugs have not been associated yet with disease but they are an itchy nuisance. I rarely recommend pesticide because children are especially vulnerable to toxic accumulation but if you do find it necessary, call in a professional. Children and adults alike should stay clear of the pesticide use zone. “Sleep tight and don’t let the bedbugs bite” is rumored to come from sailing ship days when the sea was stormy, the children were strapped to their berths to keep them from being tossed about — bedbugs were apparently on board for the sail too!

Dr. Mays can be found at Pediatric Associates of Whidbey Island, 275 SE Cabot Dr., Suite B102 Oak Harbor.