Exciting news! Our family, including our soon to be two-year-old, is relocating from the US to India for an extended stay. There are a LOT of things to think about as we move across the world from New Jersey to Goa. Of all the logistics and planning, having the knowledge and tools to avoid getting bit by mosquitoes is near the top of our list. Since we are researching the latest on this topic for our own upcoming trip, we thought we would write about what we have discovered so far, and share our family strategy to avoid getting bit.
Mosquitoes have been in the news a lot recently as Zika spreads around the world. According to the US Centers for Disease Control, the risk of Zika to travelers to India is LOW (as of August 2016). In fact, your risk of Zika may be lower in India than in your home country, depending on where you are coming from. This said, mosquitoes in India carry potentially lethal diseases including Chikungunya, Dengue, Elephantiasis, Japanese Encephalitis, and—by far the most common—Malaria.
You should obviously talk to your doctor before you plan any trip to India, especially if you are traveling with children like we are. Your doctor will tell you how to stay safe and about drugs to help prevent Malaria. We have our own opinions about prophylactic (preventative) drugs for Malaria, but that is a topic for another article.
Our Strategy to Avoid Getting Bit by Mosquitoes
The best defense is a good offense. We try really hard to keep mosquitoes outside. We try to stay in places with air conditioning or that use window and door screens. When we don't have screens, we close the windows in the evening before mosquitoes are the most active. This one step, closing the windows at the right time, seems to dramatically reduce mosquito bites. But just closing the windows is not enough. The mosquitoes that carry Dengue and Chikungunya bite mainly from dawn to dusk (day biters). The mosquitoes that carry Malaria and Japanese Encephalitis bite mainly from dusk to dawn. In short, you always have to protect yourself from mosquitoes. But closing the windows at the right time can keep a lot of mosquitoes out of the house which makes a difference.
Mosquito bed nets help a lot too, especially if we are staying at a place without screens. At our flat in Goa, we are installing window screens and we will ALSO sleep under bed nets. If we have learned one thing about bed nets it is to check INSIDE for mosquitoes BEFORE we go to sleep. Our worst mosquito bites have come from bugs inside the net with us.
We are investigating permethrin-treated nets and will probably buy some for our upcoming trip. The permethrin treatment adds an extra layer of protection by killing bugs that land on the net—even ones that manage to get inside.
The health websites always advise you to "wear long-sleeved shirts and long pants" as a way to avoid mosquito bites. Well, that might work fine in the cooler climates, but in many places where we spend time in India, it just is not PRACTICAL advice. It is simply too hot to be fully covered. In the past, even when we have worn long sleeved clothing, we have STILL gotten bites since the long clothes that we can tolerate are thin enough that mosquitoes bite THROUGH them. You can buy clothes pre-treated with permethrin but we have not tried them.
We have gear that we plan to buy before we travel and we have certain items we will purchase in India. Since we have spent many years in India and in the US, we have developed strong opinions about what products are best in each country. For example, the most common on-skin mosquito repellent in India is Odomos. Odomos is an inexpensive cream available anywhere in India, and it does work to keep mosquitos away. It just doesn't work for very long. Our experience is that Odomos has to be reapplied so frequently that it just doesn't make sense when the best DEET and Picaridin-based products we can buy in the US are effective for up to 8 hours. We have a similar opinion about the quality of mosquito nets. Nets are available in India at relatively low cost, but the ones we can buy in the US are simply better made, even if they are MUCH more expensive.
What we plan to do and buy before our trip to India:
- Buy high-quality mosquito bed nets treated with permethrin
- Buy insect repellent with 20% Picaridin (Picaridin is also known as Bayrepel or icaridin outside the United States). In July 2016 Consumer Reports published ratings of insect repellents based on their research with specific types of disease-carrying mosquitoes. Both DEET and Picaridin were shown to be effective, but the top rated repellent contained 20% Picaridin. We took Picaridin with us on our last trip to India and it seemed to work well. Picaridin doesn't dissolve plastics like DEET does, and we like the way that it feels and smells better than DEET. The brand we plan to buy this time is Sawyer 20% Picaridin in a pump bottle, which was the highest rated product in the Consumer Reports study.
What we plan to do and buy in India:
- Install window screens and an air conditioning unit for our flat
- Use plug-in mosquito repellent devices in the house for brief periods to "clear out" the mosquitoes. In India, repellents tend to come in four forms: coils, mats, vaporized liquids and gels. Don't use old-fashioned burning coils in a closed room since they can be poisonous. In fact, of all of these, the only ones we like to use are the vaporized liquids which are sold by Good Knight or All/Out. These are small devices which plug into electrical outlets and heat a bottle of repellent liquid. If you are sleeping with open windows you should locate these away from the bed and they can be kept on all night. If you have closed windows (or air conditioning) these devices should only be used to kill mosquitoes for brief periods when you are not in the room—and then they should be turned off. These work, but we don't depend on them exclusively—if the power goes out so does the bug protection.
- We have used RunBugz Anti Mosquito Patches before with mixed success. These are stick-on patches that you put on the back of children's clothing in an area that they cannot reach. They contain oil of lemon eucalyptus (OLE) which is only mildly effective against mosquitoes, but it does add one more layer of protection even if it is not completely effective. We combine this with Picaridin, bed nets and closed windows as a part of an anti-mosquito strategy.
That's pretty much it. In addition to the gear we are bringing, we plan to use common sense. We plan to reapply repellents as protection fades and mosquitoes start to bite. We plan to be aware of the times of day when mosquitoes are most active and close the windows and take all the precautions we can. If we are using sunscreen lotion, we plan to apply it first and then insect repellent on top.