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Part 4: Keeping Your Child Healthy  >  The A-Z of Childhood Illnesses  >  Bites and Stings


Mosquito And Bed Bug Bites And Bee And Wasp Stings

A mosquito bite can be recognised by the slightly raised red area with a bite mark at the centre. Consider the possibility of bed bugs when your child starts itching soon after a bus or a train ride; there will usually be a bed bug under his pants. He has probably been stung by a bee or a wasp if he was in a garden and complains of severe pain and swelling at the site. 

Sometimes, insect stings may result in anaphylactic shock (see Allergies).

Spider bites can also cause problems similar to bee and wasp stings. The bite of the monitor lizard (Goh), although it has a forked tongue like that of a snake, is not poisonous.

TREATMENT: Most insect bites subside within a day or two without any treatment. Calamine lotion helps to reduce the itching. For wasp or bee stings, ice packs with a small hand towel or a piece of cloth should be applied locally, despite the child’s initial protests. Applying vinegar on a wasp sting and lime on a bee sting also relieves pain.

Bees also have a venom sac attached to the stinger. If the stinger is present, scrape it with a knife. Do not try to remove it with your finger, otherwise you may squeeze the venom sac and push more venom into the child’s system. The stinger of the honeybee is difficult to remove, so leave it alone.

If the child goes into anaphylactic shock, consider the situation an emergency and seek immediate help.

PREVENTION: To prevent insect bites, avoid areas where the insects are more likely to be around (gardens, pools of water, etc). Though many insects are colour blind, some are attracted by bright colours and flowery prints. A strong smell also attracts insects. Dress the child accordingly. Keep his limbs covered in full-length trousers and full-sleeved shirts. If you decide to use an insect repellent cream, read the product label to ascertain its safety for babies. Even if safety is assured, use sparingly and only on exposed parts; the medicine in these repellents can get absorbed through the baby’s thin skin and can be harmful. If mosquitoes are a problem at night, keep the windows closed in the evening (when mosquitoes are more likely to enter into the room). Open the windows at night and use a mosquito net that covers the whole bed. Do not use an umbrella-type net for small babies; it may close automatically and injure the baby. Also note that repellents help prevent bites by mosquitoes and not those of bees and wasps.

Avoid using mosquito coils; they can cause chronic cough in some children. Dr. N. G. Wagle, an expert in this field, advises that 5 to 10 ml. of citronella oil be mixed with 100 ml. of coconut oil, a cotton swab dipped in the oil and kept near the head-end of the bed to repel the mosquitoes which are attracted by the carbon dioxide exhaled by a person. The oil can also be used for the skin in place of mosquito repellent creams. If a mat is to be used, switch on the appliance an hour or so in advance and when the child is not in the room. Open the windows after an hour or two. Switch off the appliance and then bring the child in; the mosquitoes in the room will have been dealt with and new ones are less likely to come in, once it is dark.

Scorpion Stings
These can be very painful. More than 80 species of scorpions are seen in India. The most dangerous species is the red scorpion, whose sting can cause systemic manifestations like vomiting, profuse sweating, abdominal pain, agitation and confusion.

TREATMENT: Localised treatment with an ice pack in a hand towel or a piece of cloth helps. Apply pressure on the wound with a thick bandage or pieces of cloth to reduce the risk of spread of the venom. Scorpion antitoxin, if available, should be injected preferably within 2 hours of the scorpion bite. A child with systemic features must be  hospitalised.

PREVENTION: Teach your children to turn their shoes upside down before wearing them, especially in a scorpioninfested rural area.

Most snakes in our country are non-poisonous, helpful in killing mice and other harmful pests, and should not, therefore, be wantonly killed. 

It is, however, important to seek medical advice for all suspected cases of snakebite. It is helpful to know that even when bitten by a poisonous snake, a person may not suffer any ill effects if no venom has been injected into his system.

There are 4 common poisonous snakes in India. They are the Indian cobra (Nag), the Indian krait (Bangam), the Russel’s viper (Daboia) and the saw-scaled viper (Phoorsa). While the cobra is familiar to us, the krait has white transverse lines right from the neck down to the tail. The viper has a triangular head and a narrow neck.

SYMPTOMS: It is important to know about the symptoms of poisoning due to snake venom because the bite may not always be obvious. If your child complains that he has been bitten by a snake, take it seriously and look for the site of the bite; the bite marks of a poisonous snake differ from those of the non-poisonous variety. Poisonous snakes have long fangs. The bites of these snakes display the marks of the two fangs. The bites of non-poisonous snakes leave behind the marks of two rows of teeth marks, but no marks of fangs (see illustration). 

Snake bite

The symptoms of snake poisoning are specific to the snake that has bitten the person. The venom of the cobra and krait affect the nervous system. Besides pain at the site of the bite, the patient may also manifest weakness of the eye muscles, resulting in drooping of the eyelids, double vision and squint. There may be difficulty in swallowing, cough and paralysis of the muscles required for breathing. The patient may also complain of pain in the abdomen, loose motions and vomiting. The blood pressure may drop and the patient may collapse. The respiratory paralysis can lead to death if the patient does not receive adequate treatment in time.

Swelling at the site of cobra and krait bites is not common.

Compared to the cobra and krait, a viper bite is usually very severe and the local swelling is quite marked. Blisters may form around the site of the bite. The bite of the viper affects the blood system and prevents clotting. Patients develop vomiting, the blood pressure falls and bleeding may occur from different parts of the body. The bleeding may continue if treatment is not given and the patient may go into a state of shock.

TREATMENT: Treatment for snakebite must be prompt. If the snake — alive or dead — is available, take it to the hospital for the doctor to decide if it is poisonous or not. Do not panic. Keep the child on an empty stomach. Do not suck the bite site or make cuts into it. Keep the bite site lower than the level of the heart; apply a tourniquet or a rubber tube or any constricting band between the bite site and the heart. To maintain the blood supply, the tourniquet should be slackened for a few seconds at regular intervals of about 10 minutes.

The bitten part should be kept steady. Usually, the bite is on the lower limb. As the venom spreads faster on movement, the child should not be allowed to walk. The venom from the site usually spreads through the lymph vessels lying under the skin. The best way to reduce the risk is to put a pressure bandage on the limbs and to immobilise it with a splint. (Take any clean cloth or a crepe bandage, if available, and apply it over the bite site and above it. Then apply a splint — a thin long piece of wood or any other material — that should include joints on either side of the bite. This prevents the use of the muscles around the bite site and hence reduces the lymph flow and the spread of the venom.

Carry the child flat with the bite site at a level lower than the heart. 

Paracetamol can be given for pain. Local application of ice reduces the pain. Since direct prolonged contact of ice with the skin can result in damage to the underlying tissues, crush the ice and pack it around the bandage.

For poisonous bites, an injection of a polyvalent antivenom (which protects against venom of all common poisonous snakes) must be given as soon as possible. Do not delay in taking the child to the nearest hospital. He may also need antibiotics and protection against tetanus. Those with severe complications may also have to be administered blood and blood products and put on artificial respiration.

7 March, 2016

Part 4
The A-Z of Childhood Illnesses

Abdominal Pain
Abrasions or Scratches
Acute Glomerulonephritis
Acute Nephritis
Acute Watery Diarrhoea
Anorexia (Poor Appetite)
Bed-Wetting (Enuresis)
Birth Deformities
Bites and Stings
Bone, Joint and Muscle Injuries
Bowlegs and Knock-Knees
Calcium Deficiency
Cardiac Pulmonary Resuscitation
Cerebral Palsy (CP)
Cleft Lip and Palate
Common Cold
Congenital Heart Disease
Convulsions or Fits or Seizures
Dengue Fever
Diabetes Mellitus
Diarrhoea, Dysentery ...
Down's Syndrome
Earache, Ear Infections ...
Electric Shock
Eye Problems
Foot Problems
German Measles (Rubella)
Glands in the Neck ...
Head Injury
Influenza (Flu)
Joint Disorders
Limp and Pain in the Legs
Malnutrition (Undernutrition)
Menstrual Problems
Mental Retardation (MR)
Mouth To Mouth Breathing
Nephrotic Syndrome
Nose-Related Problems
Premature Baby
Prolapse of the Rectum
Rheumatic Fever
Rheumatoid Arthritis
Short Child
Skin Conditions
Sleep and Sleep Problems
Sore Throat (Pharyngitis)
Stridor (Noisy Breathing)
Teething and Care of Teeth
Tetanus (Lock Jaw)
Tracheoesophageal Fistula
Tropical Eosinophilia
Tuberculosis (TB)
Umbilical Problems
Undescended Testis
Urinary Infection
Vaginal Discharge
Whooping Cough (Pertusis)

Part 4
Keeping Your Child Healthy
Choosing A Paediatrician
Proper Use of Medicines
Home Remedies
A First Aid Kit
The A-Z of Childhood Illnesses
Psychological Concerns
Managing A Hospital Stay
Prayer And Your Child's Health
The Role of Nature Cure
Ayurveda and Child Care
Congenital Heart Disease FAQ
Guide to Child Care
1 Pregnancy, Childbirth ...
2 The Growing Years
3 Feeding Infants, ...
4 Keeping Your Child Healthy
5 Keeping Your Child Happy
About Dr. R. K. Anand

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