WASHINGTON, D.C.—Summer is in full swing, and more time outside typically means more bug bites. Some bites can be an irritating inconvenience while others can become a medical emergency. The American College of Emergency Physicians (ACEP) has a helpful guide to identify and treat common bug bites and stings.

“While most bug bites or stings are minor and can be treated at home, some reactions can quickly become severe or life-threatening,” said Gillian Schmitz, MD, FACEP, president of ACEP. “It’s important to pay attention to certain symptoms or allergic reactions and seek emergency care when necessary.”

Mosquito bites are more itchy than painful and can be treated with over-the-counter sprays, creams, or medications to reduce swelling. It is time to seek emergency care if persistent flu-like symptoms appear that include fever, head or body ache, or upset stomach. These are signs that could indicate a mosquito-borne illness, such as Zika or West Nile virus, and sickness can progress to include neck stiffness, confusion, changes to vision or other functions related to the brain, nervous system, or spinal cord.

Ticks are common, especially in wooded areas. If a tick embeds in the skin, it is important to remove it quickly. But do not pour chemicals on it or try to forcefully remove it. Using clean tweezers, grasp the tick as close to the skin’s surface as possible and pull upward with a steady motion. Avoid twisting or jerking the tick because when tick parts break off and remain in the skin it can lead to an infection. See a physician for a tick that cannot be safely removed. Other signs that medical attention is necessary include a “bullseye rash,” or spots on the palms or soles that could indicate a tick-borne illness such as Lyme disease or Rocky-Mountain Spotted Fever. 

Wasp, bee or hornet stings can usually be treated at home with an ice pack or over-the-counter remedies for itching, pain or swelling, as long as swelling is localized to the area where the sting occurred and there is no severe allergic reaction. Go to the closest emergency department for a severe allergic reaction to a bite or sting that includes difficulty breathing, dizziness, facial swelling, mouth, lip, or tongue swelling.

Anaphylaxis is a severe and potentially life-threatening, allergic reaction triggered by insect stings, certain foods, medications, or latex. If somebody is experiencing anaphylaxis, call 911 immediately. Injectable epinephrine should be carried by anyone who knows they are at risk, or their parent or guardian, and should be administered if it is available.

“Preventive measures, such as applying bug spray or wearing appropriate clothing for outside activities, can help avoid pesky bites. But knowing when to go to the emergency department, could save a life,” said Dr. Schmitz.