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DEET

DEET (N,N-dimethyl-meta-toluamide) is an insect repellant developed by the US Army in the 1940's and approved for public use in 1957. It has been approved by the Environmental Protection Agency (EPA) as posing no significant risks to children, but is subject to ongoing monitoring for any adverse effects or reactions.

Despite long years of use in millions of adults and children, there have been few reports of adverse reactions. Most reactions in children have involved urticaria (hives) and other skin and respiratory irritation.

Seizures have been reported very rarely in DEET-exposed individuals (30 reports in over 40 years of use); according to the EPA about half of these reports may have been related to DEET exposure. Most reactions in general do involve children, most often related to chronic overuse of DEET.

Current American Academy of Pediatrics and EPA guidelines recommend use of products that contain no more than 30% DEET for adults and children. Parents concerned about possible toxicity may use products that contain 10-15% DEET. The higher concentration would be appropriate for use in areas where there is heightened concern about insect or tick borne diseases such as Rocky Mountain spotted fever, West Nile virus, malaria, Lyme disease, dengue fever and equine encephalitis.

The are the EPA recommendations from the American Academy of Pediatrics website for DEET use in children:

• Do not apply to infants under 2 months of age (skin permeability becomes similar to adult values by the second month of life).
• Read and follow all directions and precautions on the product label.
• Do not apply over cuts, wounds or irritated skin.
• Do not apply to young children's hands or near eyes or mouth.
• Do not allow young children to apply products themselves.
• Use just enough to cover the exposed skin and/or clothing.
• Do not use under clothing.
• Avoid over application.
• After returning indoors, wash treated skin with soap and water.
• Wash treated clothing before wearing again.
• Do not use spray solutions in enclosed areas or near food.
• For use on face, apply to adult hands and then rub on face. Do not spray the face. Avoid areas around eyes and mouth.

Do not use combination products of sunscreen with insect repellant. Sunscreen should be reapplied every hour or so outdoors, especially if the child is swimming; insect repellants should only be applied once or twice a day. Also, avoid any product with a food-like odor or color. These can be too attractive for young children to accidentally ingest.

The idea of using non-DEET-containing repellents is attractive, but there is no evidence that they work as well as or are any safer than DEET. Other means of avoiding mosquito bites should not be ignored:

• applying DEET-containing substances to clothing offers added protection with less potential for sytemic toxicity
• mosquito netting is very effective in areas where exposure to mosquitoes is likely; it can be used over infant carriers or other areas such as playpens
• DEET-impregnated mosquito netting is available in some locations but should not be used with small children who may suck or chew on the netting
• long sleeves with cuffs and long pants with tight cuffs or tucked into socks or shoes are excellent barriers to ticks

Don't forget to check around your house for any areas however small of standing water. These are an open invitation for mosquitoes to breed and bite.

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