IAMAT |International Association of Medical Assistance to Travellers| IAMAT |International Association of Medical Assistance to Travellers|

Malawi: Insect Bite Prevention

Preventing insect bites

During your travels you may encounter all types of insects, some of which are harmless while others can carry disease. Mosquitoes, ticks, bees, wasps, hornets, blackflies, spiders, and ants may be mild annoyances, but one small bite can have serious implications on your health.

Practicing meticulous and consistent insect bite avoidance is one of the most important things travellers can do to prevent illness and spreading infectious diseases. Of the common arthropod-borne diseases encountered by travellers, only Malaria and Japanese Encephalitis can be prevented by medication and a vaccine, respectively.

Did you know?

Here are 3 things to consider: 

  • You may not know that you have been bitten. Some insects like the Anopheles Malaria mosquito don’t buzz and don’t leave a welt after feeding.
  • Depending on your body’s tolerance, you may not develop hives, welts, itchy or burning skin – all signs indicating that you were bitten. 
  • If you were bitten by a disease-carrying insect, you may be asymptomatic, meaning you do not show any symptoms of the illness. Sometimes, you may even have a mild form of the illness and may think that you just have a flu or a cold, or even an unrelated skin rash.

Learn about insect behaviour

First, find out if, and exactly where, illnesses transmitted by insects are occurring at your destination. You may discover that there is no outbreak in the area where you’re staying.

Second, learn about the insect’s behaviour. This will help you better understand whether your travel, destination and activities have an element of risk or not.

  • What is their habitat? Do they prefer the indoors, outdoors, or both?
  • When are they most active, during the day or night? What are their peak biting times?
  • Are they present year-round or do they have seasonal cycles?
  • Do they live in urban, suburban, or rural areas?
  • Are they capable of carrying illnesses transmitted to humans? If so, which ones?

Use complementary methods

For optimal protection, use multiple methods of insect-bite prevention – mainly through skin protection, clothing protection, and proper use of a bed net.

Video courtesy of Anne Terry, ARNP, Hall Health Primary Care Center, University of Washington.

1. The following are physical barriers that you can use to prevent any insect from coming close to you in the first place.

  • Wear light-coloured, loose-fitting, long clothing (cotton and linen) as much as possible. 
  • Don’t use scented soaps, shampoos, deodorants, perfumes or after-shaves.
  • Ensure that all door and window screens do not have tears or holes and that they are tightly fitted.
  • Cover any food, drinks, compost and garbage.
  • Always wear shoes, both indoors and outdoors.
  • Sleep or rest under an insecticide-treated bed net.

2. Use chemical barriers like repellent and insecticide to prevent mosquito, tick, sandfly or blackfly bites.

  • Use a spray, lotion, towelette, or liquid repellent containing 20-30% DEET or 20% Picaridin on exposed skin. Apply according to manufacturer’s directions to ensure optimal protection. Re-apply on shorter times if you find that you are starting to get bitten. Note that repellents destroy items containing crystal or plastics so be careful if you wear jewellery or glasses.
  • Treat clothing, shoes, boots, and gear with permethrin that kills insects on contact. Note that this product is not commercially available in Canada, but you can obtain it online through major US retailers. Do not use permethrin directly on your skin.
  • Consider spraying your home or room with an insecticide. Note that some insects such as mosquitoes and bed bugs are becoming increasingly resistant to insecticides.
  • When using repellents on children, check the manufacturer’s directions. Talk to your doctor or travel health provider about using a repellent if you’re travelling with an infant to an area with high risk of mosquito-transmitted illnesses. To further protect your child, ensure that they wear long light-coloured, loose-fitting clothing, cover their carrier with tight-fitting mosquito netting or place them under an insecticide-treated net when playing or resting.

A note on repellents and sunscreens

  • Apply sunscreen first and repellent second. Allow the sunscreen to penetrate the skin for 20 minutes before using repellent. Note that this could reduce the efficacy of the sunscreen, so it’s best to reapply often or wear long clothing.

Myth busting

It’s important to use proven methods mentioned above, especially if you’re travelling to areas with risk of illnesses transmitted by insects. There is no evidence that the following products protect you against insect-borne illnesses.

  • Combined sunscreen and repellent lotions
  • Citronella-based plants, coils, or candles
  • Vitamin B1 or garlic
  • Ultrasonic products, electrocuting devices, odour-infused traps
  • Repellent-containing wristbands, ankle bands or neckbands

How to treat insect bites and stings

  • If you have a skin reaction that includes hives, itching, red patches or a burning sensation, consider applying hydrocortisone cream 1% or a natural skin balm to relieve itching. To reduce hives, take a non-sedating antihistamine. 
  • If the site of the bite or sting swells, is very painful, and develops blisters, seek medical attention immediately. 
  • If you have a past history of life-threatening allergic reactions such as anaphylactic shock where you can’t breathe or your throat swells, use an epinephrine auto-injector. Ensure that your travel companions know how to use one and seek medical care as soon as possible.

More about insect-avoidance tips

Mosquitoes

  • Get rid of any containers or items holding water inside and outside a building.
  • Sleep under an insecticide-treated bed net if you’re going to an area with risk of Malaria or Japanese Encephalitis. For maximum protection, find out if you need anti-malarial medications or if the Japanese Encephalitis vaccine is recommended for your trip.

Travel health risk: ChikungunyaDengueJapanese EncephalitisMalariaWest Nile VirusZika Virus.

Ticks

  • When hiking in wooded areas, tuck pants into socks, stay in the middle of the trail and avoid tall grasses and shrubs.
  • Carefully examine your clothing, gear, and pets for ticks before entering a dwelling.
  • Regularly check your body for ticks and promptly remove using tweezers by grasping the tick's head and mouth parts as much as possible and by pulling perpendicular from the skin.
  • Thoroughly disinfect the bite site with soap and water or alcohol. If travelling in an endemic area, save the tick in a zip-lock bag or container to have it analyzed through your healthcare practitioner.

Travel health risk: Lyme DiseaseTick-borne EncephalitisTick-borne Spotted Fevers

Sandflies

  • This insect is active at night so it’s best to avoid outdoor activities from dusk to dawn in risk areas. 
  • Sleep under an insecticide-treated bed net or air conditioned room.

Travel health risk: Leishmaniasis

Triatominae

  • This nocturnal insect (also known as the kissing bug, 'vinchuca' in Spanish, or 'barbeiro' in Portuguese) is responsible for Chagas in the USA, Mexico, Central America and South America. Sleep under an insecticide-treated bed net.

Travel health risk: Chagas

Tsetse flies:

  • This insect bites during the daytime, but is less active during the hottest time of the day. Wear neutral-coloured clothing since intense bright and dark colours (red, turquoise, navy blue) attract tsetse flies, but be aware that tsetse flies bite through lightweight clothing.
  • Insect repellent does not prevent tsetse fly bites, however using DEET-containing repellent on exposed skin and applying a permethrin spray (or solution) to clothing and gear will prevent other insect bites. 
  • Inspect vehicles for tsetse flies before entering since they are attracted to moving items.

Travel health risk: Sleeping Sickness

Bed bugs

  • This insect can be a traveller’s worst nightmare and is becoming increasingly resistant to insecticides. If you get a bed bug infestation, it will cost you money, derail your travel plans, and may cause mental anguish. Bed bugs are known to carry pathogens that can cause human illnesses although whether they actively transmit them is still inconclusive. To prevent bed bug bites, see Tip Sheet.

Last reviewed and updated: April 15, 2016

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