Insects and Ticks

• Bed bugs are small insects that feed on the blood of people and other animals and birds.
• They are oval with flat, rusty red colored bodies and they cannot fly or jump.
• Bed bugs are not a sign of poor hygiene or cleanliness.
• Bed bugs are considered a public health nuisance; however, their bites are not known to transmit disease.
• Bites can become swollen and itchy and secondary infections can result, as well as anxiety and sleeplessness.
• When bed bugs are in a house or apartment, they often hide in bedding and mattresses, as well as in cracks and crevices in walls and furniture.
• Bed bugs usually come out at night and bite people while they are sleeping.
• They may be difficult to control without help from a pest control professional. Over the counter pesticides and aerosol foggers (bug bombs) are not effective in controlling bed bugs.

Additional Information
Bed Bugs: Get Them Out and Keep Them Out, US EPA

Public Health Nurses are available to assess for head lice infestation at the Health Department.  Please call the Health Department at 920-683-4155 before arriving.

• Lice are tiny grey to brown insects about the size of a sesame seed that live in human hair and feed on human blood to survive.  Lice do not fly or jump, but crawl.  Without a human host they can only live for about one or two days.
• Anyone may become infested with head lice, regardless of age, sex, race, or standards of personal hygiene.  Head lice are frequently found in schools and day care centers, and are easily spread from person-to-person.
• Head lice spread through direct head-to-head contact with an infected person or indirect contact with lice-carrying objects such as combs, brushes, hats or scarves.  Since nits, (louse eggs) are laid by the adult lice the chances of nits being spread from person-to-person are minimal.
• Lice from animals do not infest humans.
• The first indication of an infestation is usually itching at the back of the head and around the ears.  Itching in these areas should lead to an examination of the scalp for louse nits (eggs).  Severe scratching may result in secondary bacterial infection in these areas.  Head lice do not carry or spread disease.
• It may take 2-3 weeks for a person to notice the intense itching associated with head lice.

Treatments
There are several medicated shampoos commonly used to treat head lice.  Shampoos or creme rinses that contain 1% permethrin have the fastest killing time against adult lice and the highest nit-killing capability.  Permethrin has a residual effect that will continue to kill nits for several days after the first application.  While one application should be sufficient to kill lice and nits, some experts suggest a second treatment one week after the first.  Although resistance to permethrin has been reported from other countries, no resistance has been reported in the United States.

Shampoos that contain pyrethrin kill lice quickly but do not leave a residual that will continue to kill nits, resulting in a less effective treatment.  Two applications of these types of shampoo 7-10 days apart are recommended to kill nits.  Shampoos containing malathion and lindane are available by prescription only.  Lindane has the slowest killing time for head lice (up to several hours) and lowest nit killing capability.  Lindane is not recommended for young children, or pregnant or nursing women, and should only be used if other approved therapies did not work or cannot be tolerated.  Misuse or overuse of lindane may be toxic.  There are widespread reports from countries other than the United States of lice being resistant to lindane.

Alternate treatment methods such as the use of tub butter or margarine, mayonnaise, Vaseline® and olive oil, designed to smother head lice and nits can be used with discretion for those persons for whom lice-killing medications have failed.  The effectiveness of alternate treatments is unclear.  Kerosene, gasoline and other flammable products should never be used to treat head lice.  Avoid using powder to remove alternate treatments from the hair.  Grease cutting shampoos or dish soap may be used to remove alternate treatment.  Avoid wearing plastic wrap and shower caps when using lice-killing medication.  Lice-killing medications have not been safety-tested for use with plastic wrap or shower caps.  Such devices should never be used on young children, and used with discretion on older children and adults when alternate treatments are used.

Manual removal of nits with a nit comb, fingernails, or by cutting strands of hair that contain nits is essential following treatment with pediculocides or alternate treatments.

To aid in the removal of nits, hair can be soaked in a 3% to 5% white vinegar solution followed by application of a damp towel soaked in the same solution for 30-60 minutes before attempting nit removal.

Additional Resources
Head Lice Fact Sheet
How to Eliminate Head Lice and Eggs
Vinegar Rinse
Cleaning up after the Louse
Lice Killing Shampoo Treatment
Olive Oil Treatment

In the United States and Wisconsin, mosquitoes can spread West Nile Virus (WNV), La Crosse encephalitis, and Powassan virus infections.  These infections generally occur during the warm-weather months when mosquitoes are active.  Symptoms of illness are usually mild and nonspecific, and can include headache, fever, fatigue, muscle aches, and swollen lymph nodes.  Some people may experience severe illness and require hospitalization.

Prevention Tips

• Use effective mosquito repellant and apply according to the label instructions.
• Wear long-sleeved shirts, long pants, socks, and shoes.
• Mosquitoes may bite through thin clothing, so spraying clothes with a repellent containing permethrin or DEET will give extra protection. These repellants are the most effective and most studied.
• Avoid being outside during times of high mosquito activity, specifically around dawn and dusk.
• Keep window screens repaired so that mosquitoes cannot enter your home.
• Dispose of discarded tires, cans, or plastic containers left outside that may contain standing water.
• Drain standing water from pool or hot tub covers.
• Turn over plastic wading pools and wheel barrows when not in use.
• Change the water in bird baths, pet dishes and wading pools every 3-4 days.
• Keep drains, ditches and culverts clean of trash and weeds so water will drain properly.
• Clean gutters to ensure they drain properly.

Additional Information
Wisconsin Department of Health Services
Centers for Disease Control and Prevention (CDC)

• Scabies is a common skin condition caused by a microscopic mite.  Mites that cause scabies burrow into the skin producing pimple-like irritations and severe itching.  Secondary bacterial infections may occur following intense scratching at the site of the burrow.
• Scabies infestation can affect people from all socioeconomic levels without regard to age, sex, race or standards of personal hygiene.  Clusters of cases, or outbreaks are occasionally seen in nursing homes, day care centers
• Mites that cause scabies are transferred by direct skin-to-skin contact.  In severe cases indirect transfer from undergarments or bedclothes can occur only if these have been contaminated by an infected person immediately beforehand. and other institutions.
• Definitive diagnosis involves demonstrating the presence of the mite by skin scrapings and microscopic examination of the scraped specimen.  This can be done at your doctor’s office; contact your doctor if you believe you may have scabies.
• The most prominent symptoms is intense itching, particularly at night.  The areas of the skin most affected by scabies include the webs and sides of the fingers, around the wrists, elbows and armpits, waist, thighs, genitalia, abdomen and lower buttocks.  In infants younger than two years old the symptoms are likely to appear on the neck, hands, and feet.
• After exposure, symptoms will appear from 2-6 weeks in people who have not previously been exposed to scabies.  People who have had a previous infestation with scabies symptoms may appear within 1-4 days after subsequent re-exposure.
• A person is able to spread scabies until mites and eggs are destroyed, usually after one treatment with an effective anti-scabies medication.  Individuals with scabies should not attend school or daycare, nor enter their workplace until the day after treatment is initiated.  Except in severe cases, inanimate objects such as clothing, bedding or furniture does not spread mites that cause scabies.
• Medicated lotions applied to the skin or in severe cases, medication taken by mouth are available through a physician’s prescription for the treatment of scabies.  Sometimes itching may persist for one to two weeks after treatment, but this should not be regarded as treatment failure or re-infestation.  Avoid over treatment with anti-scabies medication.
• Avoid physical contact with infested individuals and their belongings, especially clothing and bedding.  In severe cases, clothing and bed linen worn or used by an infested person in the 48 hours before treatment may be laundered and dried at the highest temperature or stored in a container such as a plastic bag for 5-7 days to kill mites and their eggs.  Use of environmental pesticides should be avoided.  Preventive therapy is recommended for household members of an infested person or close contacts of person in nursing homes, day care centers or institutions.

Additional Information
Scabies Fact Sheet

Ticks can carry a wide range of bacteria, viruses, and parasites which can make you or your pet sick.  Local health departments investigate and follow up with several tickborne infections including Lyme disease, babesiosis, ehrlichiosis, anaplasmosis, and spotted fever rickettsiosis.  When visiting places where ticks are common, check everyone including pets for ticks after returning and remove any attached ticks immediately.  To remove a tick, grasp it with tweezers, as close to the skin as possible, and pull it straight out without twisting or jerking.  See your doctor right away if you develop a fever, rash or flu-like illness following contact with ticks or their habitats.  Remember to inform the doctor about your outdoor activities or any history of a tick bite.  Most tickborne diseases can be effectively treated if recognized early.

The best way to protect yourself from tick-borne diseases is:

Tick Avoidance: If possible, avoid wooded and bushy areas with high grass and lots of leaf litter since ticks prefer these areas. If you do go into areas like this, try to  stay in the center of a cleared trail to avoid contact with overgrown grass, brush, and leaf litter.

Tick Personal protection

• Use effective tick repellents and apply according to the label instructions. The Centers for Disease Control and Prevention recommends that adults use repellents with 20-30% DEET on exposed skin and clothing to prevent tick bites. Again, be sure to follow the label directions when using repellents. For more information on repellents, see the EPA Insect Repellants: use and Effectiveness website 
• Permethrin is also effective against ticks and lasts for days to weeks, but should only be applied to clothes and not directly to the skin.
• Wear long sleeves, long pants, and long socks to keep ticks on the outside of clothing. Light clothing will help you spot ticks.
• Tuck shirts into pants and pants into shoes or socks to keep ticks on the outside of clothing. If outdoors for an extended period of time, tape pant legs where pants and socks meet so that ticks cannot crawl under clothes.

Additional information
Illnesses Spread by Ticks