Morbidity and Mortality Weekly Report West Nile Virus and Other Domestic Nationally Notifiable Arboviral Diseases - United States, 2019 Aug 13 2021. … West Nile virus (WNV) is the leading cause of domestically acquired arboviral disease in the United States. Other arboviruses, including La Crosse, Jamestown Canyon, Powassan, eastern equine encephalitis, and St. Louis encephalitis viruses, cause sporadic disease and occasional outbreaks. … For 2019, 47 states and the District of Columbia (DC) reported 1,173 cases of domestic arboviral disease, including 971 (83%) WNV disease cases. Among the WNV disease cases, 633 (65%) were classified as neuroinvasive disease, for a national incidence of 0.19 cases per 100,000 population, 53% lower than the median annual incidence during 2009-2018. More Powassan and eastern equine encephalitis virus disease cases were reported in 2019 than in any previous year. … Because arboviral diseases continue to cause serious illness, and annual incidence of individual viruses continues to vary with sporadic outbreaks, maintaining surveillance is important in directing prevention activities. Prevention depends on community and household efforts to reduce vector populations and personal protective measures to prevent mosquito and tick bites such as use of Environmental Protection Agency-registered insect repellent and wearing protective clothing. 10.15585/mmwr.mm7032a1

American Academy of Pediatrics, “Summer Safety Tips,” June 19, 2017 The current AAP and CDC recommendation for children older than 2 months of age is to use 10% to 30% DEET. DEET should not be used on children younger than 2 months of age. The effectiveness is similar for 10% to 30% DEET but the duration of effect varies. Ten percent DEET provides protection for about 2 hours, and 30% protects for about 5 hours. Choose the lowest concentration that will provide the required length of protection. (

World Health Organization Emergency preparedness, response July, 2019 To prevent bites from mosquitoes that feed during the day and early evening hours, travelers are advised to:

  • Wear clothing -- preferably light colored -- that covers as much of the body as possible;
  • Use insect repellents that contain DEET, IR 3535, or Icaridin or Picaridin. Repellents may be applied to exposed skin or to clothing and must be used in strict accordance with the label instructions. If repellents and sunscreen are used together, sunscreen should be applied first….

…Upon returning home: To prevent the onward transmission of Zika virus, travelers returning from areas with potential transmission of Zika and other mosquito-borne viruses to areas with competent mosquito vectors should continue to use insect repellent for at least 3 weeks to avoid being bitten and potentially spreading the infection to other people through mosquito bites.

Environmental Working Group EWG’s 2018 Guide to Bug Repellents Can Help Fend off Disease- CarryingTicks, Mosquitoes July 17, 2018 EWG’s top choices for repellents include those that contain the active ingredients picaridin, DEET and IR3535 …. And all three have good safety profiles. Many people are concerned about the possible drawbacks of common active ingredients like DEET. EWG researchers have analyzed the science in depth and found that, with proper application and precaution, our recommended active ingredients effectively reduce risk from life-altering diseases and have very low toxicity concerns.

CBS News Tick-borne diseases are on the rise. Here's what you need to know. June 10, 2019. CBS News' Dr. David Agus told "CBS This Morning" [some of the ways] you can avoid tick-borne disease when spending time outdoors is to wear DEET, tuck your pants into your socks, avoid tall grass, shower immediately after being outside and have someone check your body. If you get one though, time is of the essence, Agus warned. "Take a straight tweezers, pull straight out and put the tick into alcohol. The quicker you remove it the better, because it takes time before it can eject its saliva into you. The saliva is what contains the bacteria and the virus," he said. While most diseases like Lyme are treatable, there have been two cases of the Powassan virus reported in New Jersey. It is not treatable. "It's got a 10 percent mortality rate and 50 percent of people who get this virus have permanent neurologic injury. So have someone search you for ticks and pull them off right afterward. Avoid it. Wear DEET."

Scouting Magazine The colorful history of fighting off pesky pests May/June, 2019 The CDC and EPA agree that repellents DEET and picaridin are effective at fending off insects… The promise of a bug repellent that really works finally began to be realized with the development of the chemical DEET… While there are pros and cons to all repellents, concerns about the side effects of DEET have been largely put to rest, especially in light of DEET’s value in protecting against insect-borne diseases. the 3 Best Bug Sprays for Kids May 3, 2019.  The most popular bug sprays will have one of two ingredients that help ward off mosquitoes: DEET or Picaridin. DEET is a far and away the most common active ingredient in insect repellents… Despite any reports you hear, DEET-based formulas are considered safe for kids to use as a bug repellent so long as the concentration of DEET used is lower than 30 percent… For young children, you're better off with a DEET- or Picaridin-based formula.

New York Times How to Protect Yourself From Mosquitoes and Ticks May 1, 2018 This is one concern in life that’s preventable by following some simple guidelines, so it’s worth taking precautions,” said Dr. David Weber, professor of medicine and medical director of UNC Hospitals’ departments of epidemiology and occupational health service. Only DEET, picaridin and IR3535 are effective agents against ticks, and will require higher concentrations than when used against mosquitoes

Prevention Why Essential Oils Probably Won’t Protect You From Ticks This Summer May 1, 2019 The most preventative insect repellents are ones with active ingredients like DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone.

Consumer Reports: Which bug sprays are worth your bucks? Apr 23, 2019 Concentrations of DEET at 25% to 30% are really the best to keep you protected…Off Deep Woods, Sportsmen Insect Repellent IV Dry with 25% DEET performed excellently against mosquitoes. Or a CR Best Buy, Ben’s with 30% DEET. If you prefer wipes, CR recommends Repel Insect Repellent Mosquito Wipes with 30% DEET. So a lot of folks are worried that DEET might not be safe, but there’s a lot of evidence to show that when you follow the directions on the label and you use it properly, DEET is very effective and safe.

Yahoo Lifestyle A "Tick Explosion" Is Coming This Summer, and No One Is Safe Apr 23, 2019 Look for formulas containing DEET, picaridin or oil of lemon eucalyptus to deter ticks, according to the Centers for Disease Control and Prevention.

Organic Authority How to Avoid Mosquito-Borne Diseases When You’re Traveling Apr 16, 2019 DEET is the most effective barrier protection, according to the CDC.

Gliniewicz A. et al. Przegla̧d Epidemiologiczny Susceptibility of Dermacentor reticulatus tick to repellents containing different active ingredients 2019 DEET is considered by many to be the ‘gold standard’ of insect repellents, and we have also confirmed this in our studies. DEET expressed the higher repellency after 7 hours of application (90%) comparing to other formulations. Other repellents Picaridin 20% and IR3535 12% were effective only up to four hours after application (the efficacy was 85% and 40%, respectively).

The Wichita Eagle Wichita KS Most of Kansas continues to be at risk for West Nile Virus. Here’s how to prevent it. Jun 24, 2019 Since mid-May, most of Kansas has persistently been under a moderate risk advisory for West Nile Virus… The best way to prevent a mosquito-vectored illness is to follow the “three D’s”: drain, dress and DEET.

Butler, A. D. et al. Ticks and Tick-borne Diseases Tick-borne disease preventive practices and perceptions in an endemic area Mar, 2016 Overall, participants’ knowledge of tick-borne diseases was poor.

Rodriguez, S. D. et al. Journal of Insect Science The Efficacy of Some Commercially Available Insect Repellents for Aedes aegypti (Diptera: Culicidae) and Aedes albopictus (Diptera: Culicidae) Oct 2, 2015 …. Repellents are widely used to protect humans from a variety of protozoans, viruses, and nematodes. We present a comparative study on the efficacy of eight commercially available products, two fragrances, and a vitamin B patch. Repellents with DEET as active ingredient had a prominent repellency effect over longer times and on both species. Repellents containing p-menthane-3,8-diol produced comparable results but for shorter time periods. Some of the DEET-free products containing citronella or geraniol did not have any significant repellency effect. Interestingly, the perfume we tested had a modest repellency effect early after application, and the vitamin B patch had no effect on either species. This study shows that the different active ingredients in commercially available mosquito repellent products are not equivalent in terms of duration and strength of repellency. Our results suggest that products containing DEET or p-menthane-3,8-diol have long-lasting repellent effects and therefore provide good protection from mosquito-borne diseases.

Rodriguez, S. D. et al. Journal of Insect Science Efficacy of Some Wearable Devices Compared with Spray-On Insect Repellents for the Yellow Fever Mosquito, Aedes aegypti (L.) (Diptera: Culicidae) Nov 27, 2016 This study focuses on the efficacy of eleven different repellents in reducing the number of Ae. aegypti female mosquitoes.   Spray-on repellents containing [DEET] N,N-Diethyl-meta-toluamide and [Oil of Lemon Eucalyptus] p-menthane-3,8-diol had the highest efficacy in repelling mosquitoes compared to repellents with other ingredients. From the five wearable devices that we tested, only the one that releases Metofluthrin significantly reduced the numbers of attracted mosquitoes. The citronella candle had no effect. We conclude that many of the products that we tested that were marketed as repellents do not reduce mosquito attraction to humans.

Draft Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2019 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease 2019 To improve efficacy and safety, repellents should always be applied according to the manufacturer’s instruction. Despite public concern over the use of DEET, decades of use show there is a very low risk of adverse effects when used as labeled.  … Despite hundreds of millions of annual applications of DEET, reports of encephalopathy are rare and may not differ from the background rate in the general population…The American Academy of Pediatrics …does not recommend DEET for infants < [less than] 2 months of age. …The FDA recommends that sunscreen be applied before DEET. IR3535 and PMD are both EPA-registered as biopesticides (derived from natural materials), that are available for people who prefer an alternative to conventional synthetic repellents.  For people with frequent occupational or recreational exposure to tick habitats, a feasible option would be to wear permethrin-treated clothing, and then selectively apply a repellent to exposed skin if additional protection is desired.

Journal of Medical Entomology Assessing Effectiveness of Recommended Residential Yard Management Measures Against Ticks May 23, 2019 We examined the relationship between larval tick abundance and eight property features related to recommendations from public health agencies: presence or absence of outdoor cats, wood piles, trash, stone walls, wood chip barriers separating lawn from adjacent forest, bird feeders, fencing, and prevalence of Japanese barberry.  More questing larvae were found in yards where trash or stone walls were present. These effects were less pronounced as forest area increased within the yard. Counts of larvae per mouse were lower in properties with >75% of the yard fenced than in properties with less fencing. We find partial support for recommendations regarding trash, stone walls, and fencing. We did not detect effects of outdoor cats, bird feeders, barriers, wood piles, or Japanese barberry. There was low statistical power to detect effects of ground barriers (gravel, mulch, or woodchip), which were present in only two properties.