Environmental Health and Safety. Biosafety Program. Field Safety Manual Appendix 3: Insects and Infectious Diseases.

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1 Environmental Health and Safety Biosafety Program P310 Pathology Building 770 Bannatyne Ave Winnipeg, Manitoba Canada R3E 0W3 Tel: (204) Fax: (204) Field Safety Manual Appendix 3: Insects and Infectious Diseases. In Manitoba and surrounding areas biting insects including mosquitos and ticks can be present and active from the time snow melts until the snow falls again. During that time they can be a source of a number of infectious agents (see table below). No matter what you may be exposed to, infection with these agents commonly start with non-specific flu like symptoms. If you work in an area where you are exposed to biting insects you should take these symptoms seriously and see your family doctor. Be sure to explain that you work in an area where you are potentially exposed to biting insects and the pathogens they carry. For more information regarding ticks and the diseases they carry refer to the attached Lyme disease pamphlet from The Public Health Agency of Canada and the Tickborne Diseases of the United States from the US Centre for Disease Control. Vector Disease Notations Culex tarsalis mosquito West Nile Virus Commonly infection is asymptomatic or causes flu like symptoms. Serious complications can occur. See attached Pathogen Safety Data Sheet Blacklegged Tick Lyme Disease (caused by Borrelia burgdorferi) Important to treat early, can cause serious illness if infection is left long term. Bullseye rash may not always be present. Blacklegged Tick Anaplasmosis (caused by Can cause severe illness. Anaplasma phagocytophilum) Blacklegged Tick Babesiosis (caused by Babesia Can be life threatening. microti) Blacklegged Tick Powassan Virus Can be life threatening. Mosquito Snowshoe hare virus (Ref 4) Central nervous system infections Mosquito Cache Valley Virus (Ref 4) Central nervous system infections The following measures can help protect you against biting insects and the pathogens they carry. Protective Clothing Clothing that can be effective against biting insects are as follows: Footwear Best protection against ticks living on the ground and in the grass is given by wearing high cut boots (calf length) constructed from slick materials which are difficult for ticks to grab ahold. Rubber boots are bust but leather boots are also effective for this purpose. Wearing full shoes can help prevent mosquitoes from biting you.

2 Tuck pants into high cut boots Tucking your pants into your boots prevents ticks from crawling up under your pant leg and exploring areas of your lower body. If you don t have boots tuck your pant legs into your socks. Pants and full sleeved shirts It is more difficult for biting insects to bite covered skin so cover your arms legs and torso. Tuck shirts into pants to make it harder for ticks to crawl under your shirt and exploring areas of your upper body. Hat Wearing a hat can make it harder for ticks to crawl into your hair and latch onto your scalp. It offers the added benefit of protecting you from the sun. Light coloured clothing Wear light coloured clothing to make it easier to spot dark coloured ticks and pick them off your clothing. Light coloured clothing will also make you less attractive to mosquitos. Insect Repellents DEET This product is a repellent which is effective against ticks and mosquitos. It works by camouflaging humans from these biting insects. DEET interferes with neurons and receptors located on the mosquito s antennae and mouth-parts that detect chemicals such as lactic acid and carbon dioxide (ref 1). When applied correctly, DEET forms a vapour barrier at the skin surface that deters mosquitoes from landing on the skin (ref 1). Concentrations up to 30% are readily available in Canada. The product can be applied to both clothing and skin. For tick protection apply DEET to clothing. Read and follow the instructions on packaging of the product used. Conflicting information has been provided regarding the safety of DEET. For those concerned about direct exposure to this chemical applying it to clothing may be a more acceptable option. Icaridin/picaridin This product has levels of efficacy similar to DEET in preventing mosquito and tick bites. Although it is widely used in Europe and in the United States, this repellent was only licensed in Canada in Icaridin is considered to be the repellent of first choice by the Public Health Agency of Canada s Canadian Advisory Committee on Tropical Medicine and Travel for travelers six months to 12 years of age. Products containing up to 20% icaridin are considered to be safe and efficacious. (ref 2) Natural Repellents These may include products like oil of lemon eucalyptus, soybean oil or citronella oil. They are typically effective for a shorter period of time as compared to Icaridin or DEET and may not protect against tick bites (ref 2). Permethrin This product is a mild repellent and contact insecticide which is not approved for use in Canada. Clothing pretreated with permethrin and sprays for treating clothing with permethrin are available in America through online retailers and through a limited number of Canadian retailers. These products can be imported for personal use. Permethrin is designed for application to clothing only and must not be applied directly to skin. It is neurotoxic in insects causing muscle spasm, paralysis, and death (ref 3). Care must be taken if handling equine fly sprays which commonly contain permethrin. Wearing protective clothing treated with the insecticide permethrin in addition to using DEET or icaridin on exposed skin as a repellent may offer the most effective protection overall against mosquito and tick bites (ref 2). References: 1) 2)

3 3) 4) report-ccdr/monthly-issue/ /ccdr-volume june /ccdr-volume june html Acknowledgement This Appendix has been written with input and assistance from Dr. Kateryn Rochon in the Department of Entomology.

4 PROTECT YOURSELF FROM MOSQUITO BITES. SUMMER S HERE, AND SO IS WEST NILE VIRUS. Why protect yourself from mosquito bites? Summer s here, and it is more important than ever to protect yourself from pesky mosquito bites. Not only are bites uncomfortable, but the mosquito that bites you may also give you West Nile virus. What is West Nile virus? West Nile virus is mainly transmitted to people through the bite of an infected mosquito. Most people infected with the virus have no symptoms or they have flu-like symptoms, such as fever, headache, body aches and fatigue. Sometimes though, the virus can cause severe illness, including meningitis and encephalitis. The chances of getting West Nile virus from an infected mosquito are low. While anyone can become infected with West Nile virus, the risk of severe illness increases with age. Protect yourself and your family from mosquito bites! How can you protect yourself and your family from mosquito bites and West Nile virus? Choose an insect repellent that contains DEET or other approved ingredients. Wear light-coloured clothing, a long-sleeved shirt, long pants and a hat to go outside when mosquitoes are most active. Get rid of as much standing water as you can from around your home and property. Drain water from flower pots, wading pools, old tires and so on. Change water in birdbaths and pet bowls twice a week. Make sure your screens are in good repair. Why should you use insect repellent? Using insect repellent helps stop mosquito bites that may give you West Nile virus, so you and your family can continue to work and play outdoors with greater peace of mind. Is DEET safe? Yes. Insect repellents containing DEET are safe when used as directed. DEET has been safely used in North America for more than 40 years. Use only insect repellents that have a P.C.P. Act number on either the front or back of the bottle. This number means the product has been approved in Canada. Always read and follow the directions on the insect repellent container, especially when using on young children. Only a thin layer of repellent is needed. Apply to skin surfaces that are not covered by clothing. Repellents can also be applied to your clothing. If you plan to be outdoors for a short period of time, choose a repellent with a lower concentration of DEET and reapply as needed. Wash treated skin with soap and water when you return indoors or when you no longer need protection. Do not put repellent on children s faces and hands. This will reduce their chances of getting it in their eyes and mouths. You can use both sunscreen and insect repellent when you are outdoors. Apply the sunscreen first, followed by the insect repellent. Is there a specific time of day when you should use insect repellent? Mosquitoes can bite anytime day or night. Contact your local public health authority to find out when you are most at risk. Directions for application: Do not use DEET on infants less than 6 months. For children 6 months to 2 years, use only if there is a high risk for mosquito bites, and then use only once a day (use product containing 10% DEET or less). For children 2-12 years, use no more than 3 times a day (10% DEET or less). Avoid using over a long period. For adults and children over 12 years, Health Canada recommends insect repellents containing 5-30% DEET. Do not use repellent on open wounds or on skin that is sore or sunburned. Do not put on repellent unless you are going outdoors. This information is brought to you by the Public Health Agency of Canada with the collaboration of your local retailers. To find more detailed information on West Nile virus or to link to your provincial or territorial government Web sites, visit the Public Health Agency of Canada s West Nile virus Web site at: To receive more information on West Nile virus or to find the number of your local public health authority, call: (toll-free). Her Majesty the Queen in Right of Canada, 2004 Cat.: H39-4/ ISBN: Pub: 1395

5 PROTÉGEZ-VOUS CONTRE LES PIQÛRES DE MOUSTIQUES L ÉTÉ EST ARRIVÉ, ET LE VIRUS DU NIL OCCIDENTAL AUSSI! Pourquoi vous protéger contre les piqûres de moustiques? L été est arrivé et, plus que jamais, il est important de vous protéger contre les fichues piqûres de moustiques. Non seulement les piqûres sont inconfortables, mais le moustique qui vous pique peut aussi vous transmettre le virus du Nil occidental. Qu est-ce que le virus du Nil occidental? Le virus est principalement transmis aux êtres humains par une piqûre de moustique infecté. La plupart des personnes infectées par le virus ne présentent aucun symptôme ou ont des symptômes qui ressemblent à ceux de la grippe, comme de la fièvre, des maux de tête, des courbatures et de la fatigue. Toutefois, le virus peut parfois entraîner des maladies graves incluant la méningite et l encéphalite. Les risques de contracter le virus du Nil par une piqûre de moustique infecté sont peu élevés. Quoique chacun court le risque de devenir infecté par le virus du Nil occidental, les risques d être atteint d une maladie grave augmentent avec l âge. Protégez-vous donc, vous et votre famille, contre les piqûres de moustiques! Comment vous protéger contre les piqûres de moustiques et le virus du Nil occidental? Choisissez un insectifuge qui contient du DEET ou d autres ingrédients autorisés. Portez des vêtements de couleurs claires, un haut à manches longues, un pantalon long et un chapeau quand vous êtes à l extérieur et que les moustiques sont plus actifs. Éliminez le plus grand nombre de sources d eau stagnante autour de votre maison et de votre propriété. Drainez l eau des pots à fleurs, des barboteuses, des vieux pneus et de tout autre récipient. Changez l eau des bains pour oiseaux et des bols pour animaux au moins deux fois par semaine. Assurez-vous que vos moustiquaires sont en bon état. Pourquoi utiliser un insectifuge? L utilisation d un insectifuge aide à prévenir les piqûres de moustiques qui peuvent vous transmettre le virus du Nil occidental. Vous et votre famille pouvez ainsi continuer à travailler ou à jouer à l extérieur avec une plus grande tranquillité d esprit. Est-ce que le DEET est sécuritaire? Oui. Les insectifuges contenant du DEET sont sécuritaires lorsqu ils sont utilisés selon les instructions. Le DEET est utilisé en toute sécurité en Amérique du Nord depuis maintenant plus de 40 ans. Employez seulement les insectifuges dont le numéro d enregistrement aux termes de la Loi sur les produits antiparasitaires figure sur l étiquette avant ou arrière de la bouteille. Ce numéro signifie que le produit a été autorisé au Canada. Lisez et suivez toujours les directives sur le contenant, particulièrement lorsque vous utilisez le produit sur de jeunes enfants. Seule une mince couche d insectifuge est nécessaire. Appliquez le produit sur les surfaces de peau non couvertes par les vêtements. Les insectifuges peuvent également être appliqués sur vos vêtements. Si vous comptez être à l extérieur pendant une courte période de temps, choisissez un insectifuge à plus faible concentration en DEET et appliquez-en de nouveau, au besoin. Lavez les parties du corps traitées avec du savon et de l eau lorsque vous rentrez à l intérieur ou lorsque vous n avez plus besoin de protection. N appliquez pas d insectifuge sur le visage ou les mains des enfants. Cette mesure réduira les risques de contact du produit avec leurs yeux et avec leur bouche. Lorsque vous êtes à l extérieur, vous pouvez utiliser à la fois un écran solaire et un insectifuge. Appliquez d abord l écran solaire, et ensuite l insectifuge. Quand doit-on utiliser un insectifuge? Les moustiques peuvent piquer en tout temps le jour ou la nuit. Pour savoir quand vous courez le plus de risques, communiquez avec les services de santé publique de votre région. Mode d application : N utilisez pas de produits contenant du DEET pour des enfants de moins de 6 mois. Pour les enfants de 6 mois à 2 ans, utilisez le produit seulement si les risques de piqûres de moustiques sont élevés, et seulement une fois par jour (utilisez un produit dont la concentration en DEET est d au plus 10 %). Pour les enfants de 2 à 12 ans, appliquez un insectifuge dont la concentration est d au plus 10 %, mais pas plus de 3 fois par jour. Évitez d utiliser le produit sur une longue période. Pour les adultes et les enfants de plus de 12 ans, Santé Canada recommande d utiliser des insectifuges dont la concentration en DEET se situe entre 5 % et 30 %. N utilisez pas d insectifuge sur des blessures ouvertes ou sur une peau irritée ou ayant subi un coup de soleil. Appliquez un insectifuge seulement si vous allez à l extérieur. Ces renseignements vous sont offerts par l Agence de santé publique du Canada, en collaboration avec vos détaillants locaux. Pour obtenir de plus amples renseignements sur le virus du Nil occidental ou pour consulter le site Web de votre province ou territoire, visitez le site de l Agence de santé publique du Canada : Pour obtenir de plus amples renseignements sur le virus du Nil occidental ou pour connaître le numéro des services de santé publique de votre région, appelez sans frais au Sa Majesté la Reine du chef du Canada, 2004 Cat. : H39-4/ ISBN : Pub : 1395

6 Take a few minutes to inform yourself about the potential risks and the simple ways you can protect your family from tick bites, infection, and the long-term effects of Lyme disease. CAN MY PET GET OR SPREAD LYME DISEASE? Although pets, particularly dogs, can contract Lyme disease, there is no evidence that they can spread the infection directly to people. Pets can, however, carry infected ticks into homes and yards. Like people, the best protection for your pets is to avoid Lyme-infected tick bites. If possible, keep pets out of the woods and do regular tick checks. The most common symptom of Lyme disease in pets is arthritic pain, with some having fatigue and fever. Contact your veterinarian if you suspect your pet may have Lyme disease or to discuss appropriate measures to protect your pet. Don t let a SMALL PEST turn into a BIG PROBLEM Lyme disease is on the rise in Canada. Prevention is easier than you think. WHAT IS LYME DISEASE? Lyme disease is the most common disease spread by ticks in Canada, caused by the bite of infected blacklegged ticks. Lyme disease can have serious symptoms but it can be treated effectively if caught early. While not all blacklegged ticks carry Lyme disease, populations of infected blacklegged ticks are growing. This means that the risk of contracting Lyme disease is on the rise across Canada. Take steps to reduce your risk if you spend time outdoors in areas where there may be ticks. Ticks can be as small as a poppy seed and their bites are usually painless, so you may not know you ve been bitten. That's why it's important to be on the lookout for ticks and the symptoms of Lyme disease. For more information on how to prevent, recognize and take action on Lyme disease, visit: Canada.ca/LymeDisease PROTECT YOURSELF, YOUR FAMILY, AND YOUR PETS FROM LYME DISEASE Lyme disease is a serious illness that is spread by the bite of infected blacklegged ticks, found most often near wooded areas in Canada s southern regions. It can have severe symptoms, but it s also easy to prevent and treat when caught early.

7 WHERE ARE TICKS FOUND? Blacklegged ticks are most often found in forests and the overgrown areas between the woods and open spaces, although it is possible to be bitten outside of these areas. The Public Health Agency of Canada works with provincial and territorial health authorities to identify where populations of infected blacklegged ticks have been established or are spreading. The following are areas where blacklegged tick populations have been confirmed or are establishing: of spread. Visit Canada.ca/LymeDisease for the most up-to-date information. Ticks don t move far by themselves but they can attach to migratory birds, and may fall off far from their original location. For this reason, it is possible to find infected ticks in other areas than the ones listed above. HOW CAN YOU AVOID TICK BITES? The best way to prevent Lyme disease is to prevent tick bites. Here are some ways to protect yourself if you venture into forests or overgrown areas between the woods and open spaces: and pants. ticks from crawling up your legs. your skin and clothing. outdoors to wash away loose ticks. your children and your pets. Ticks can be infected with more than one type of bacteria that can cause human illness. Guarding against tick bites will protect you from more than just Lyme disease. WHAT SHOULD YOU DO IF YOU GET BITTEN? Removing ticks within hours usually prevents as close to the skin as possible and pull slowly straight out. Afterwards, wash the bite with soap and water or disinfect with alcohol or hand sanitizer. If mouthparts break off and remain in the skin, remove them with tweezers or, if you are unable to remove them easily, leave them alone and let the skin heal. If possible, save the tick that bit you in a zip-lock bag and record the date of the bite. If you develop symptoms of Lyme disease in the weeks after you are bitten, contact your health care provider right away. If you have saved the tick, bring it to your medical appointment as it may help the doctor in their assessment of your illness. WHAT ARE THE SYMPTOMS OF LYME DISEASE? Initial symptoms differ from person to person, which makes Lyme disease very difficult to fever or a skin rash soon after being bitten, while others may suffer severe symptoms, but not for weeks after the bite. one or a combination of the following with varying degrees of severity: recurring arthritis and neurological problems, numbness and paralysis. Although not common, fatalities from Lyme disease have been reported. HOW IS LYME DISEASE DIAGNOSED? Diagnosing Lyme disease can be difficult as symptoms vary from one person to another, and can be similar to other infectious diseases that are spread by ticks. The earlier you receive a diagnosis, the greater the chances of a successful treatment. As such, it is important to consult a health care professional as early as possible if you have symptoms or if you feel unwell in the weeks following a tick bite. Your healthcare provider will likely: Lyme-infected blacklegged ticks by asking about your recent activities used to further support a clinical diagnosis WHAT IS THE TREATMENT FOR LYME DISEASE? Lyme disease can be effectively treated with 2 to 4 weeks of antibiotics. Depending on your symptoms, and if you are diagnosed in the later stages of the disease, you may require a longer course of antibiotics. continue more than 6 months after treatment. Research continues into the causes of these persistent symptoms and methods of treatment. For more information and helpful tips, visit: Canada.ca/LymeDisease

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