First aid for coping with summer pests

My patient, a 51-year-old teacher, first noticed the problem when she tried to gargle one morning and the mouthwash dribbled onto her chin. Her eye felt funny too, and when she looked in the mirror, she noticed that she was unable to close her left eyelid. An examination later confirmed what I suspected on the phone: She had Bell's palsy, a weakness of the muscles on one side of her face, a possible complication of Lyme disease. When I looked closely, I found a fading remnant of the telltale rash—a red bull's-eye mark on her upper back. My patient had contracted Lyme disease from a recent tick bite and after 21 days of the antibiotic doxycycline, her facial droop was gone.

The risk of being bitten by an infected deer tick appears to be greatest from May through August, when many of us are outdoors and the nymph ticks, the size of a poppy seed, are active. Within a few weeks, the majority of Lyme disease victims, like my patient, develop the classic rash at the site of the bite. It's important to tell your doctor if you find a rash or have other symptoms—headache, joint pain, or muscle aches—because early treatment with oral antibiotics is extremely effective, and failures are rare.

Ticks are only one of many insects with bites that can cause trouble during hot summer months. Mosquitoes can transmit West Nile virus, which can be dangerous in seniors and those with compromised immune systems, who are already susceptible to infection. Complaints include fever, headache, weakness, muscle pain, and gastrointestinal problems. Although the virus doesn't cause symptoms in most healthy people, any mosquito bite can be annoying. The itch is most intense in the first few days, but cool compresses and a topical steroid cream like hydrocortisone can provide some relief.

Hydrocortisone cream also comes in handy for sunburn and poison ivy, which might start with itchiness and progress to a reddish rash and then to blisters. The symptoms of sunburn can start within a few hours of exposure, but the symptoms of poison ivy, poison oak, or poison sumac might not appear until two to three days after contact with the plant's oil. Don't scratch the blisters; they can become infected from bacteria under your nails.

Blistering and even ulceration might also occur after spider bites, so consider using antibiotic ointments to prevent infection. If you're stung by a bee, carefully scrape away the stinger in a side-to-side motion with a straight-edged object. Seek medical attention if inflammation and swelling extend beyond the sting or bite site, since you might require an antihistamine or a steroid. Topical pain relievers can numb the skin after stings or sunburn and provide some relief. And to best enjoy the summer, don't forget your sunscreen.

• Wear long sleeves and long pants tucked into your socks when in woodsy or grassy areas.
• Wear light-colored clothing to make it easier to spot ticks.
• Apply an insect repellent registered by the Environmental Protection Agency, such as one with deet, picaridin, or oil of lemon eucalyptus.
• Don't wear perfume or use scented soaps or deodorants.
• Drain standing water from containers outside your home.