Bites on holiday

Insects

Insect bites are by far the most common. Some of these can cause unpleasant reactions :

• Seek medical attention if an insect bite causes significant swelling, bruising or persistent pain.
• Sometimes a bite becomes infected with bacteria, causing spreading redness of the skin and fever which requires antibiotic treatment.
• Occasionally an insect bite (especially bee or wasp stings) can cause an acute allergic reaction called anaphylaxis which can be fatal. There may be rapid swelling of the tissues, an itchy red rash, wheeze or difficulty breathing, nausea and abdominal pain and low blood pressure. An anaphylactic reaction needs urgent medical attention, so call the emergency services.

Many insects transmit communicable diseases. In many countries, for example, mosquitoes carry malaria, yellow fever or Japanese encephalitis. Insect repellents, protective clothing and mosquito netting are advisable in many parts of the world - and are vital in those countries where malaria is common.

• Always check the risks for your destination before you go – ask your doctor or travel agent, or check out the web.
• If there is malaria in the country you are visiting, take anti-malarial medication as advised (the drugs used vary from area to area depending on resistance). You will need to start it some weeks before you travel.
• Vaccination may also be recommended, for example against Yellow Fever.
• Use an insect repellent containing DEET. Wrist and ankle bands impregnated with this chemical are also available.
• Avoid applying high-concentration (30 per cent DEET) products directly to the skin and make sure you use a repellent that's appropriate for your child's age.
• Don't inhale or ingest repellents, and be careful not to get any in your eyes.
• Pregnant and breastfeeding women should minimise use of repellents. Seek specific advice from your GP.
• Keep your legs covered after sunset.
• Use a mosquito net at night. Those impregnated with insecticide are more efficient.
• Avoid using aftershave, perfumes or scented deodorants - they're 'mozzie magnets'.
• If someone in your party knows they have an insect bite allergy, make sure they travel with an emergency anaphylaxis kit at all times.

Animals

In general, animals tend to avoid humans but they can attack, particularly if they're with their young.

Animal bites can lead to infections that may be serious, sometimes fatal. They can also transmit rabies, an acute viral infection of the nervous system. Rabies occurs in Europe and North America, as well as in the developing world, in a range of different animals including dogs, cats, foxes, bats, monkeys and cattle. In New York State, USA it has been a particular problem in racoons for example.

In areas of endemic rabies, domestic dogs, cats and other animals shouldn't be petted. Explain to small children that it may be dangerous to go near dogs and cats in other countries. Wild animals should be avoided altogether.

If you're bitten by an animal, prompt treatment is vital. Treated early enough, rabies can often be prevented. Once symptoms develop, however, the disease is usually fatal.

If you or a member of your group is bitten by an animal:

• Wash the wound immediately using soap, or flush with clean water for at least five minutes. Apply antiseptic, if possible, and cover the area with a dry dressing.
• Seek medical attention immediately. If you need a rabies vaccination, the course must be started straight away.
• Note the details of the incident and description of the animal. If it's domesticated, try to identify the owner. Find out whether the animal has an up-to-date rabies vaccine. Check if the animal becomes sick within a fortnight.
• Report the incident to the police - you'll need a formal report for insurance purposes.
• Consult your GP on return to the UK.
• People going for prolonged periods to certain areas where rabies is common may want to consider getting vaccinated before they leave, especially if their work might put them at particular risk. The rabies vaccine is simpler than it used to be – talk to a travel medicine centre.

Snakes

Snake bites are a common problem especially in South and South East Asia and sub-Saharan Africa, where they are particularly feared. An estimated five million snakebites occur worldwide each year. Fortunately deaths from snake bites are relatively rare - about 125,000 of those 5 million bites prove fatal. The most dangerous snakes include the Australian brown snake, carpet vipers in the Middle East, Russell's vipers and cobras in southern Asia, and coral and rattlesnakes in North America.

Most snakebites are the result of harrassment - biting is a snake's defensive reaction. As snakes bite people when they're frightened rather than to kill them for food, many bites inject little poison. However, the venom of a small or immature snake may be more concentrated than that of an adult.

The following precautions can help you to avoid being bitten by a snake:

• Wear long trousers and heavy shoes or boots when walking through areas where snakes are common.
• Carry a walking stick to distract snakes should you surprise one.
• Take particular care at night and in warm weather, when snakes tend to be more active.
• Snakes and scorpions tend to rest in shoes and clothing - give everything a good shake in the morning (scorpions can be found in Mediterranean countries, not just in more exotic locations – fortunately these tend to be the less poisonous varieties).

If you or a member of your group is bitten by a snake:

• Offer reassurance, immobilise and bandage the limb, and take the casualty to hospital as quickly as possible.
• Specific therapy for snakebite is controversial. Leave it to the judgement of local emergency medical personnel.
• If the snake spits venom in the eyes, lie the casualty down and irrigate the eyes with clean water for at least ten minutes. Apply a dressing and obtain medical assistance.
• It helps to give a good description of the snake or scorpion. If the snake is dead, it may be useful to take it to hospital with you, but beware of the reflex bite - don't handle the dead snake's head.