Uterine Fibroids

Uterine fibroids can cause infertility by presenting as a space occupying lesion. By continuous enlargement and subsequent blockade of the tubes. By formation of adhesions, by exhibiting...

What Is Tonsilitis

Tonsillitis is an infection of the tonsils, caused by either bacteria or viruses. Tonsils are groups of tissue, similar to the lymph nodes or glands that circle the throat. This circle of tissue..

What Causes Diabetes And Types Of Diabetes

A healthy diet, regular exercise, and culturally sensitive care may be helpful in preventing and controlling diabetes, say researchers. The findings are based on recent reviews..

Arthritis Medical Advice And Types Of Arthritis

In order to have an understanding of the two major types of arthritis, it is essential to know a little about the function and appearance of a joint. A joint is designed to allow smooth movement of..

Heart Attack Causes, Symptoms And Signs

The blood supply to the heart is usually stopped by a blood clot in the coronary arteries, causing the heart attack. The arteries are narrowed in places due to plaques - a build-up of ...

What Causes Asthma And Asthma Treatment

Asthma is a condition that affects your airways - the small tubes that carry air in and out of the lungs. People with asthma have airways that are almost always red and sensitive, inflamed...

Sunday, August 21

Exercise Induced Bronchospasm

Exercise Induced Bronchospasm

Bronchospasm is the contraction of smooth muscle in the walls of the tubes in the lungs known as bronchi and bronchioles, causing narrowing of their lumen and the obstruction of respiration. There are many potential causes but here we are discussing exercise-induced bronchospasm.

What Is Exercise Induced Bronchospasm?

Exercise induced bronchospasm (also called EIB) happens when the airways in your lungs shrink (get smaller) while you are exercising. This makes it difficult to breathe. If you have EIB, it can be hard for you to exercise for more than 30 minutes at a time.

What Are The Symptoms Of Exercise Induced Bronchospasm?

Symptoms of EIB typically start after 5 to 20 minutes of nonstop exercise, and may include wheezing (breathing that makes a hoarse, squeaky, whistling or musical sound), difficulty breathing, chest pain, coughing, and chest tightness.

What Are The Causes And Risk Factors Of Exercise-Induced Bronchospasm

Breathing in air that is cooler and drier than the air in your lungs during exercise may cause EIB. If you have exercise induced bronchospasm, your symptoms may get worse during spring and fall, when people tend to have trouble with allergies.

Pathogenesis of Exercise Induced Bronchospasm

Diagnosis And Tests For Exercise Induced Bronchospasm

How Can My Doctor Tell That I Have Exercise Induced Bronchospasm?

Your doctor will ask you questions about your symptoms, do a physical exam and perform breathing tests. During a breathing test, your doctor will have you breathe into a spirometer or a peak flow meter. These devices measure how much air you are able to blow out of your lungs. If your doctor thinks you might have EIB, he or she will help you decide on the right treatment for your symptoms.

How Is Exercise-Induced Bronchospasm Treated?

Medicines To Treat EIB Include The following:

• A short-acting bronchodilator: This medicine is usually taken 15 minutes before exercise and lasts 4 to 6 hours.

• A mast cell stabilizer: This medicine is usually taken 15 minutes to 1 hour before exercise and lasts for 4 hours.

• A longer acting bronchodilator. This medicine is usually taken 30 minutes before exercise and lasts up to 12 hours.

• An anti-leukotriene: This medicine lasts up to 24 hours. It is taken every day and helps keep your airways from shrinking.

Exercise Induced Bronchospasm

You and your doctor will talk about which medicine is right for you. He or she will tell you how to take your medicine. It is important to follow your doctor's instructions carefully to make sure your medicine is effective.

A warm-up and cool-down period of at least 15 minutes before and after exercise may help lessen the symptoms of EIB. Avoid exercising in extremely cold temperatures or when you have a respiratory infection, such as a cold or the flu. If you have allergies, avoid exercising when pollen levels are high. Also, if you smoke, stop.

Polymyalgia Rheumatica

Polymyalgia Rheumatica

What Is Polymyalgia Rheumatica?

Polymyalgia rheumatica (PMR) is a condition affecting the muscles. It causes pain and inflammation and is named after many (poly) painful muscles (myalgia). It affects men and women equally, and is most common over the age of 50.

What Causes Polymyalgia Rheumatica?

Despite extensive and ongoing investigations, its cause remains unclear. It is different to rheumatoid arthritis or any other type of joint or muscle inflammation.

What Are The Signs And Symptoms Of Polymyalgia Rheumatica?

Symptoms can occur suddenly, over the period of a few days, and are sometimes linked to a recent 'flu - like infection. There is pain and stiffness in the muscles - especially of the thighs and shoulders - which is much worse in the morning and on getting up. The pain can be severe, and make getting out of a car or rising from a chair difficult. The muscles can feel weak and there may be difficulty going up stairs or walking as a result. It is also common to feel generally unwell, lose a little weight or have a temperature.

Some people find they have a headache, or very tender temples. This is due to an associated inflammation of the arteries of the scalp, called temporal arteritis. The temples and scalp are tender to the touch, combing the hair may be uncomfortable, and chewing may cause discomfort on the affected side.

Areas Of Pain In Polymyalgia Rheumatica

Will I Have Any Tests Or Investigations?

Yes. Your doctor will take some blood for testing, especially for an erythrocyte sedimentation rate (ESR) test. This test measures how quickly red blood cells settle at the bottom of a test tube - the sediment. The quicker it settles, the greater the inflammation so someone with PMR will have a high reading. Most doctors feel that a reading of 20 or more is significant, although it rises with age also. At the same time, other illnesses will be looked for from the blood such as anaemia, rheumatoid arthritis and thyroid problems.

On occasions your GP may order some X-rays - such as on the neck or shoulders - to make sure there are no other conditions such as osteoarthritis present.

What Treatment Might I Need?

The mainstay of PMR treatment is corticosteroids. Our bodies produce these naturally, but the treatment is in much higher doses than normal. They are extremely effective (namely prednisolone), often at a starting dose of between 10mg and 15mg per day. They may be prescribed as an 'enteric' form - the tablets are coated to protect the stomach from irritation - and can reduce symptoms dramatically, sometimes within hours. Your doctor will monitor your progress, usually with regular blood tests, and aim to reduce your prednisolone by 1mg every few weeks. Each person with PMR reacts differently to steroids, so each treatment has to be tailored to that person, but in general improvement often becomes slower as the dosage falls.

Polymyalgia Rheumatica

It is important to remember that steroids do not 'cure' PMR. They are simply very good at reducing its symptoms while it settles naturally.

What Course Will The Illness Follow?

The majority of PMR sufferers are able to recover completely and be tablet-free within 12 months of starting treatment. A small percentage require low-dose steroids for longer and sometimes for life, but are able to lead a normal, active lifestyle with no symptoms. Occasionally, someone who has had PMR in the past may have a second episode, but recognise the symptoms and so seek treatment quicker than previously.

If there are symptoms suggestive of temporal arteritis, it is important this is treated rapidly and with higher doses of prednisolone than usual, since blurred vision, double vision or permanent sight problems (including blindness) can occur if left untreated. Arteritis responds very well to steroid treatment.

Can I Do Anything To Help Myself?

If you are taking steroids, it is important not to suddenly stop taking them without seeing your doctor. It is best to rest in the early stages of PMR, since exercise puts an added strain on the muscles and so the dose of steroids may need to be increased accordingly. Once the PMR is settling, it is quite safe to exercise again.

Tell Your Doctor

1. Have you ever had these symptoms before?
2. Are they worst early in the morning?
3. Is it physically difficult to get out of bed or a chair?
4. Do you have any problems with headaches or your eyesight?
5. D you remember having fflu or a cold just before you noticed your symptoms?

Ask Your Doctor

1. How long will I need to be on treatment for?
2. What are the side effects of steroids?
3. How severe is my PMR?
4. Am I more likely to get other forms of arthritis in the future?
5. Will any natural treatments help?

Useful Contacts

The British Society for Rheumatology
Address: Bride House, 18-20 Bride Lane, London, EC4Y 8EE
Telephone: 020 7842 0900
Email: bsr@rheumatology.org.uk
Website URL: www.rheumatology.org.uk

Saturday, August 6

Zika, Zika Virus Fever Or Zika Disease

Zika, Zika Fever Or Zika Disease

Zika virus infection causes a mild illness known as Zika fever, Zika or Zika disease.

Zika virus is spread to people through the bite of an infected female Aedes mosquito. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.

Outbreaks of Zika have occurred in areas of Africa, Southeast Asia, the Pacific Islands, and the Americas. Because the Aedes species mosquitoes that spread Zika virus are found throughout the world, it is likely that outbreaks will spread to new countries. In December 2015, Puerto Rico reported its first confirmed Zika virus case. Locally transmitted Zika has not been reported elsewhere but cases of Zika have been reported in returning travellers in the USA and UK.

Click here for a full schematic guide of how Zika Spreads »

There is no vaccine to prevent or medicine to treat Zika. Travellers can protect themselves from this disease by taking steps to prevent mosquito bites. When travelling to countries where Zika virus (see map below) or other viruses spread by mosquitoes have been reported, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens.

Zika disease is linked to microcephaly in newborns of infected mothers. The current U.S. Centers for Disease Control and Prevention (CDC) issued travel guidance on affected countries, including the use of enhanced precautions and considering postponing travel, and guidelines for pregnant women. Ireland issued a similar travel warning, while other governments, such as Colombia, Ecuador, El Salvador, and Jamaica, advised women to postpone getting pregnant until more was known about the risks.

Zika Virus Areas Map

Symptoms Of Zika Virus Infection

• About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
• The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache.
• The illness is usually mild with symptoms lasting for several days to a week.
• Severe disease requiring hospitalization is uncommon.
• Deaths are rare.

Symptoms Of Zika Virus

Diagnosis Of Zika Virus Infection

• The symptoms of Zika are similar to those of dengue and chikungunya, which are diseases caused by other viruses spread by the same type of mosquitoes.
• See your healthcare provider if you develop the symptoms described above and have visited an area where Zika is present.
• If you have recently travelled, tell your healthcare provider when and where you travelled.
• Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.

Zika Virus Factsheet

Treatment Of Zika Virus Infection

• No vaccine or medications are available to prevent or treat Zika infections.
• Treat the symptoms
• Get plenty of rest
• Drink fluids to prevent dehydration
• Take medicines, such as acetaminophen or paracetamol, to relieve fever and pain
• Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, should be avoided until dengue can be ruled out to reduce the risk of haemorrhage. If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.

Zika Virus Complications

• If you have Zika, avoid mosquito bites for the first week of your illness.
• During the first week of infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites.
• An infected mosquito can then spread the virus to other people.

Saturday, February 6

Bladder Cancer, An Introduction

Bladder cancer is where a growth of abnormal tissue, known as a tumour, develops in the lining of the bladder. In some cases, the tumour spreads into the surrounding muscles.
Classification Of Bladder Cancer - Bladder Cancer, An Introduction
The most common symptom of bladder cancer is blood in your urine, which is usually painless.

If you notice blood in your urine, even if it comes and goes, you should visit your GP so the cause can be investigated.

Types of Bladder Cancer

Once diagnosed, bladder cancer can be classified by how far it has spread.

If the cancerous cells are contained inside the lining of the bladder, doctors describe it as superficial or non-muscle invasive bladder cancer. This is the most common type of bladder cancer, accounting for 7 out of 10 cases. Most people do not die as a result this type of bladder cancer.

When the cancerous cells spread beyond the lining into the surrounding muscles of the bladder, it's referred to as muscle invasive bladder cancer. This is less common but has a higher chance of spreading to other parts of the body and can be fatal.

Why Does Bladder Cancer Happen?

Most cases of bladder cancer appear to be caused by exposure of the bladder to harmful substances which, over the course of many years, lead to abnormal changes in the bladder’s cells. Tobacco smoke is a common cause, it is estimated that half of all cases of bladder cancer are caused by smoking.

Contact with certain chemicals previously used in manufacturing is also known to cause bladder cancer. However, these substances have since been banned.

Treating Bladder Cancer

In cases of non-muscle invasive bladder cancer, it is usually possible to remove the cancerous cells while leaving the rest of the bladder intact. This is done using a surgical technique called transurethral resection of a bladder tumour (TURBT). This may be followed by a dose of chemotherapy medication directly in the bladder to reduce the risk of the cancer returning.

In cases with a higher risk of recurrence, a medication known as Bacillus Calmette-Guérin (BCG) may be injected into the bladder to reduce the risk of the cancer returning.

Treatment for muscle-invasive bladder cancer may involve surgically removing the bladder in an operation known as a radical cystectomy.

When the bladder is removed, you will need another way of collecting your urine. Possible options include making an opening in the abdomen so urine can be passed into an external bag, or constructing a new bladder out of a section of bowel. This will be done at the same time as your radical cystectomy.

If it's possible to avoid removing the bladder, or if surgery is not suitable, a course of radiotherapy and chemotherapy may be recommended. Chemotherapy may sometimes be used on its own before surgery or before being combined with radiotherapy.

After treatment for all types of bladder cancer, you will have regular follow up tests to check for signs of recurrence.

Who Is Affected?

About 10,000 people are diagnosed with bladder cancer every year.

The condition is more common in older adults, with the average age at diagnosis being 68 years old.

Rates of bladder cancer are four times higher in men than in women, possibly because in the past men were more likely to smoke and work in manufacturing industry.

Tuesday, January 26

Preventing Insect Bites And Stings

There are a number of precautions that you can take to avoid being bitten or stung by insects. It is particularly important to follow this advice if you have had a bad reaction to an insect bite or sting in the past.
Preventing Insect Bites And Stings

Some of the precautions that you can take to minimise your risk of being bitten or stung by an insect are listed below.

• Move away slowly without panicking if you encounter wasps, hornets or bees. Do not wave your arms around or swat at them.
• Cover exposed skin. If you are outside at a time of day when insects are particularly active, such as sunrise or sunset, cover your skin by wearing long sleeves and trousers.
• Wear shoes when outdoors.
• Apply insect repellent, particularly in summer or early autumn when stings are most likely to occur. This should be applied to exposed areas of skin. Repellents that contain diethyltoluamide (DEET) are considered most effective.
• Avoid using products with strong perfumes such as soaps, shampoos and deodorants, because they can attract insects.
• Avoid flowering plants, outdoor areas where food is served, rubbish and compost areas. Regularly and carefully remove any fallen fruit in your garden, and keep a well-fitting lid on any dustbins.
• Never disturb insect nests. If a nest is in or near your house, arrange to have it removed (see the GOV.UK website's section on pest control services for information about how your local council can help). Wasps build nests in sheltered areas including trees and roof spaces.
• Avoid camping near water, such as ponds and swamps, because mosquitoes and horseflies are commonly found near water.
Keep food and drink covered when eating or drinking outside, particularly sweet things. Wasps or bees can also get into open drink bottles or cans you are drinking from.
• Keep doors and windows closed or put thin netting or door beads over them to prevent insects getting inside the house. Also keep the windows of your car closed to stop insects getting inside.

Avoiding Ticks

Ticks are small arachnids mainly found in woodland areas. They attach to your skin, suck your blood and can be responsible for Lyme disease.

The Best Ways To Avoid Ticks Include:

• Being aware of ticks and the areas where they usually live
• Wearing appropriate clothing in tick-infested areas (a long-sleeve shirt and trousers tucked into your socks)
wearing light-coloured fabrics that may help you spot a tick on your clothes
• Using insect repellents
inspecting your skin for ticks, particularly at the end of the day, including your head, neck and skin folds (armpits, groin, and waistband)
• Checking your children's head and neck areas, including their scalp
• Making sure ticks are not brought home on your clothes
• Checking pets do not bring ticks indoors in their fur
• It is also important to remove any ticks you find as soon as possible.

Infestation

If you are bitten by fleas, mites or bedbugs, you may have an infestation in your home. Try to find the source of the infestation and then take steps to eliminate it.

Signs Of An Infestation

The following are signs of an infestation:

• Fleas or flea faeces (stools) in your animal's fur or bedding are a sign of fleas
• Crusting on your dog's fur is a sign of fleas
• Excessive scratching and grooming are a sign of fleas in your cat
• Dandruff (flakes of skin) on your cat or dog is a sign of mites
• Spots of blood on your bed sheets are a sign of bedbugs
• An unpleasant almond smell is a sign of bedbugs

If you are unsure whether your pet has fleas, speak to your veterinary surgeon.

Eliminating An Infestation

Once you have identified the cause of the infestation, you will need to eliminate it.

For Flea Infestations:

treat the animal, its bedding, household carpets and soft furnishings with an insecticide
thoroughly vacuum your carpets and soft furnishings
For mite infestations, seek advice from your vet as aggressive treatment is required.

For bedbug infestations, your home will need to be thoroughly treated with an insecticide by a reputable pest control company. See the GOV.UK website's section on pest control services for more information about how your local council can help with an infestation.

Travelling Abroad

Seek medical advice before travelling to a tropical area where there is a risk of catching malaria. You may need to take antimalarial tablets to avoid becoming infected.

When you reach your destination, make sure your accommodation has insect-proof screen doors and windows that close properly. Sleeping under a mosquito net and spraying rooms with insecticide will also help stop you being bitten.

Sunday, January 3

Complications Of Insect Bites And Stings

A number of complications can develop after you are bitten or stung by an insect.

Infection

Secondary bacterial infections are a common complication of insect bites and stings. They include:

Complications Of Insect Bites And Stings

• Impetigo - a highly contagious bacterial infection that causes sores or blisters
• Cellulitis - an infection that makes your skin red, swollen and painful
• Folliculitis - inflammation (redness and swelling) of one or more hair follicles (the small hole in your skin that an individual hair grows out of)
• Lymphangitis - an infection that causes red streaks in your armpit or groin and swollen lymph nodes (small glands that are part of the immune system)
• An infection may occur if you scratch an insect bite or sting, or it may be introduced at the time you are bitten.

Infections are usually treated with antibiotics.

Lyme Disease

Lyme disease is an infection caused by a species of tick known as Ixodes ricinus. Ticks are not strictly insects, but small arachnids.

Lyme disease is uncommon, there are between 1,000 and 2,000 cases in England and Wales every year. The initial infection is characterised by a red rash that gradually expands outwards from the site of the bite. Antibiotics are usually used to treat the infection.

If untreated, the long-term effects of Lyme disease include problems with the nervous system such as:

• Meningitis
• Facial palsy - weakness of the facial muscles that causes drooping of one or both sides of the face
• Encephalitis

The condition can also damage the joints, which can lead to arthritis and heart problems (occasionally), such as inflammation of the heart muscle (myocarditis) and inflammation of the thin, two-layered, sac-like tissue that surrounds the heart (pericarditis).

West Nile Virus

West Nile virus is an infection with flu-like symptoms spread by mosquitoes.

There have been no reported cases of West Nile virus in the UK, but there have been cases elsewhere in the world. Since 2001, the HPA and the Department of Health have been raising awareness of the infection.

Malaria

Malaria is a tropical disease caused by an infection of the red blood cells. It can be transmitted to humans by the bite of an infected mosquito.

Mosquito On The Skin

Each year, there are around 1,500 cases of malaria in travellers returning to the UK. A certain type of malaria, known as Plasmodium falciparum, is potentially fatal and accounts for over half of all annual cases in the UK.

Sunday, December 27

Treating Insect Bites And Stings

Most insect bites and stings cause small reactions that are confined to the area of the bite (localised reactions). They can usually be treated at home.

However, if your symptoms are severe, see your GP as soon as possible.

Removing A Sting
Removal Of A Sting

As soon as you have been stung by a bee, remove the sting and the venomous sac if it has been left in the skin. Do this by scraping it out, either with your fingernails or using something with a hard edge, such as a bank card.

When removing the sting, be careful not to spread the venom further under your skin and do not puncture the venomous sac.

Do not pinch the sting out with your fingers or a pair of tweezers because you may spread the venom. If a child has been stung, an adult should remove the sting.

Wasps and hornets do not usually leave the sting behind, so could sting you again. If you have been stung and the wasp or hornet is still in the area, walk away calmly to avoid being stung again.

Basic Treatment

Most insect bites and stings cause itching and swelling that usually clears up within several hours.

Minor bites and stings can be treated by:

• washing the affected area with soap and water
• Placing a cold compress (a flannel or cloth cooled with cold water) over the affected area to reduce swelling
• Not scratching the area because it can become infected (keep children's fingernails short and clean)
• See your GP if the redness and itching gets worse or does not clear up after a few days.

Additional Treatment

If the bite or sting is painful or swollen, you can also:

• wrap an ice pack (such as a bag of frozen peas) in a towel and place it on the swellingW
• Take painkillers, such as paracetamol or ibuprofen (children under 16 years old should not be given aspirin)
• Use a spray or cream that contains local anaesthetic, antihistamine or mild hydrocortisone (1%) on the affected area to prevent itching and swelling
• Take an antihistamine tablet to help reduce swelling (antihistamine tablets are available on prescription or from pharmacies)
• If local swelling is severe, your GP may prescribe a short course of oral corticosteroids, such as prednisolone, to take for three to five days.

If you have an allergic reaction after a bite or sting, even if it is just a skin rash (hives), you may be prescribed an adrenaline pen (called an auto-injector) by your GP and shown how to use it. You will also be referred to an allergy clinic to see an immunologist for further tests and treatment.

Blisters

If you develop blisters after being bitten by an insect, do not burst them because they may become infected. Blisters do not often cause pain unless they rupture (burst), exposing the new skin underneath. If possible, use an adhesive bandage (plaster) to protect the blistered area.

Infected Bites

See your GP if the bite or sting fills with pus and feels tender to touch, your glands swell up and you feel unwell with flu-like symptoms.

Your GP may prescribe oral antibiotics (medicines to treat infections caused by bacteria). You will need to take these as instructed, usually two or four times a day for seven days.

Allergic Reaction

If you have swelling or itching anywhere else on your body after being bitten or stung, or if you are wheezing or have difficulty swallowing, you will need emergency medical treatment. Call 999 immediately and ask for an ambulance.

If you have the symptoms of a systemic reaction (SR), it could lead to anaphylactic shock. If you experience anaphylaxis, you may need to have an adrenaline injection, antihistamines, oxygen or an intravenous drip (a drip directly into a vein).

Allergy Clinics

If previous insect bites or stings have caused a large skin reaction, such as redness and swelling of over 10cm (4 inches) in diameter, your GP may refer you to an allergy clinic. The criteria for referring someone to an allergy clinic may vary depending on what is available in your local area.

Immunotherapy (desensitisation or hyposensitisation) is a possible treatment option if you are allergic to insect bites or stings, although it is more commonly used for wasp or bee stings. It involves being injected with small doses of venom every week and being observed to check for an allergic reaction.

Your body soon becomes used to the venom (desensitised) and will start to make antibodies to prevent further reactions.

When a high enough dose has been reached, the injections will be given monthly and could last for a further two or three years.

Your immunologist will decide how much venom is injected and how long the injections need to continue for. This will depend on your initial allergic reaction and your response to the treatment.

Ticks

If you have been bitten by a tick (a small arachnid), remove it as soon as possible to reduce the risk of getting a tick-borne infection, such as Lyme disease (a bacterial infection that causes a rash).

To Remove The Tick:

How To Remove A Tick

• Use tweezers, wear gloves or cover your fingers with tissue to avoid touching the tick.
• Grab the tick as close to the skin as you can, and gently pull straight up until all parts are removed.
• Do not twist or jerk the tick as you are removing it because this may cause the mouthparts to break off and remain in your skin once the tick has been removed.
• Wash your hands with soap and water.
• Using petroleum jelly, alcohol or a lit match to remove a tick does not work.


After the tick has been removed, clean the tick bite with soap and water or an antiseptic, such as an iodine scrub.

Do not scratch the bite because this will cause further swelling and increase the chance of infection. Most tick bites will heal within three weeks. See your GP if you develop:

• A rash
• A temperature of 38C (100.4F) or over (fever)

You may need antibiotics to prevent Lyme disease.

Sunday, December 13

Symptoms Of Insect Bites And Stings

An insect bite or sting often causes a small lump to develop, which is usually very itchy.

A small hole, or the sting itself, may also be visible. The lump may have an inflamed (red and swollen) area around it that may be filled with fluid. This is called a weal.

Insect bites and stings usually clear up within several hours and can be safely treated at home.
Insect Bites And Stings - Bed Bug Bites

Types Of Insect Bite

The symptoms that can occur from different types of insect bites are listed below.

• Midges, mosquitoes and gnats
• Bites from midges, mosquitoes and gnats often cause small papules (lumps) to form on your skin that are usually very itchy. If you are particularly sensitive to insect bites, you may develop:

Bullae (fluid-filled blisters)

weals (circular, fluid-filled areas surrounding the bite)
Mosquito bites in certain areas of tropical countries can cause malaria.

Fleas

Flea bites can be grouped in lines or clusters. If you are particularly sensitive to flea bites, they can lead to a condition called papular urticaria (where a number of itchy red lumps form). Bullae may also develop.

Fleas from cats and dogs can often bite below the knee, commonly around the ankles. They may also affect the forearms if you have been stroking or holding your pet.

Horseflies

A bite from a horsefly can be very painful. As well as the formation of a weal around the bite, you may experience:

• Urticaria - a rash of weals (also called hives, welts or nettle rash)
• Dizziness
• Weakness
• Wheezing
• Angio-oedema - itchy, pale pink or red swellings that often occur around the eyes and lips for short periods of time

Horseflies cut the skin when they bite, rather than piercing it, so horsefly bites can take a long time to heal and can cause an infection.

Bedbugs

Bites from bedbugs are not usually painful, and if you have not been bitten by bedbugs before, you may not have any symptoms. If you have been bitten before, you may develop intensely irritating weals or lumps.

Bedbug bites often occur on your:

• Face
• Neck
• Hands
• Arms

The Blandford fly

The Blandford fly (sometimes called blackfly) is found in:

• East Anglia
• Oxfordshire
• Dorset
• Herefordshire

Blandford fly bites are common during May and June. They often occur on the legs and are very painful. They can produce a severe, localised reaction (a reaction that is confined to the area of the bite), with symptoms such as:

• Swelling
• Blistering
• A high temperature of 38C (100.4F) or over
• Joint pain

Types of Arachnid Bites

Ticks

Tick bites are not usually painful and sometimes only cause a red lump to develop where you were bitten. However, in some cases they may cause:

• Swelling
• Itchiness
• Blistering
• Bruising

Ticks can carry a bacterial infection called Borrelia burgdorferi, which causes Lyme disease. If Lyme disease is not treated, it can be serious.

Mites

Mites cause very itchy lumps to appear on the skin and can also cause blisters. If the mites are from pets, you may be bitten on your abdomen (tummy) and thighs where the pet has been sitting on your lap. Otherwise, mites will bite any uncovered skin.

Spiders

Spider bites are rare in the UK, and tend to be more likely abroad, through keeping an exotic pet, or handling goods from overseas.

Spider bites leaves small puncture marks on the skin and can cause:

• Pain
• Redness
• Swelling

In severe cases a spider bite may cause nausea, vomiting, sweating and dizziness. Very rarely, a spider bite may cause a severe allergic reaction.

Types Of Insect Stings

Wasps and Hornets

A wasp or hornet sting causes a sharp pain in the area you are stung and usually lasts just a few seconds.

A swollen, red mark will often then form on the skin, which can be itchy and painful.

Bees

At first, a bee sting feels similar to a wasp sting.

However, if you are stung by a bee, it will leave its sting and a venomous sac in the wound. You should remove this immediately by scraping it out using something with a hard edge, such as a bank card.

Do not pinch the sting out with your fingers or tweezers because you may spread the venom.

Allergic Reaction

Most people will not have severe symptoms after an insect bite or sting but some people can react badly to them. You are more likely to have an allergic reaction if you are stung by an insect.

The reaction can be classed as:

• A minor localised reaction - this is normal and does not require allergy testing, although the affected area will often be painful for a few days
• A large localised reaction (LLR) - this can cause other symptoms such as swelling, itching and a rash
• A systemic reaction (SR) - this often requires immediate medical attention as it can cause a potentially life-threatening allergic reaction (anaphylaxis)

Although insect bites and stings are a common cause of anaphylaxis, it is rare to experience anaphylaxis after an insect sting, and it is rarely fatal.

Large localised reactions and systemic reactions are described in more detail below.

Large Localised Reaction (LLR)

If you have an LLR after being bitten or stung by an insect, a large area around the bite or sting will swell up. The area may measure up to 30cm (12in) across, or your entire arm or leg could swell up.

The swelling will usually last longer than 48 hours but should start to go down after a few days. This can be painful but the swelling will not be dangerous unless it affects your airways.

If you are bitten or stung many times by one or more insects, your symptoms will be more severe because a larger amount of venom will have been injected.

You may have an LLR several hours after being bitten or stung. This could include:

• A rash
• Nausea
• Painful or swollen joints
• Systemic reaction (SR)

It is more likely that someone will have an SR if they have been bitten or stung before (sensitised), especially if it was recently. People who have been sensitised to bee stings are more likely to have an SR than people who are stung by wasps.

If you have any of the following symptoms after being bitten or stung call 999 immediately and ask for an ambulance:

• Wheezing, hoarseness or difficulty breathing
• Nausea, vomiting or diarrhoea
• A fast heart rate
• Dizziness or feeling faint
• Difficulty swallowing (dysphagia)
• A swollen face or mouth
• Confusion, anxiety or agitation

It is rare for an SR to be fatal, especially in children, although someone with an existing heart or breathing problem is at increased risk.

Tuesday, November 24

Insect Bites And Stings

Insect Bites And Stings

Insect bites and stings are common and usually cause only minor irritation. However, some stings can be painful and trigger a serious allergic reaction.

In the UK, insects that bite include midges, mosquitoes, fleas, bedbugs and - although not strictly insects - spiders, mites and ticks, which are arachnids

In the UK, insects that sting include bees, wasps and hornets.

An insect bites you by making a hole in your skin to feed. Most insects sting as a defence by injecting venom into your skin.

Symptoms Of An Insect Bite Or Sting

When an insect bites, it releases saliva that can cause skin around the bite to become red, swollen and itchy. The venom from a sting often also causes a swollen, itchy, red mark (a weal) to form on the skin. This can be painful, but is harmless in most cases. The affected area will usually remain painful and itchy for a few days.

The severity of bites and stings varies depending on the type of insect and sensitivity of the person.

In rare cases, some people can have a serious allergic reaction (anaphylaxis) to a bite or sting that requires immediate medical treatment.

Should I See A Doctor?

See your doctor if you have a lot of swelling and blistering, or if there is pus, which indicates an infection.

Call the emergency line for an ambulance if you experience any of these symptoms following a bite or sting:

* wheezing or difficulty breathing
* nausea, vomiting or diarrhoea
* a fast heart rate
* dizziness or feeling faint
* difficulty swallowing (dysphagia)
* confusion, anxiety or agitation

Treating Insect Bites And Stings

Most bites and stings are treated by:

* washing the affected area with soap and water
* placing a cold compress (a flannel or cloth soaked in cold water) over the area to reduce swelling
* Try not to scratch the affected area to avoid infection and if you are in pain or the area is swollen, take painkillers, such as paracetamol or ibuprofen.

If you have a more serious reaction, your doctor may prescribe other medication or refer you to an allergy clinic for immunotherapy.

Preventing Insect Bites And Stings

You are more likely to be bitten or stung if you work outdoors or regularly take part in outdoor activities, such as camping or hiking.

Wearing insect repellent and keeping your skin covered will help avoid a bite or a sting.

Try not to panic if you encounter wasps, hornets or bees and back away slowly (do not wave your arms around or swat at them).

Travelling Abroad

There is a risk of catching diseases from insect bites, such as malaria, in other parts of the world such as:

* Africa
* Asia
* South America

It is important to be aware of any risks before travelling and get any necessary medication or vaccination.

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