Why should I use insect repellent?
Insect repellents can help reduce exposure to mosquito bites that may carry viruses such as West Nile virus that can cause serious illness and in some cases, even death. Using insect repellent allows you to continue to play and work outdoors with a reduced risk of mosquito bites.

When should I use mosquito repellent?
Apply repellent when you are going to be outdoors. Even if you don’t notice mosquitoes there is a good chance that they are around. Many of the mosquitoes that carry West Nile virus bite between dusk and dawn. If you are outdoors around these times of the day, it is especially important to apply repellent. In many parts of the country, there are mosquitoes that also bite during the day, and some of these mosquitoes have also been found to carry West Nile virus.

Which mosquito repellents work best?
You should use products that have been registered with the US Environmental Protection Agency (EPA) for use as insect repellents on skin or clothing. When EPA registers a repellent, they evaluate the product for efficacy and potential effects on human beings and the environment. EPA registration means that EPA does not expect a product, when used according to the instructions on the label, to cause unreasonable adverse effects to human health or the environment.

Of the active ingredients registered with the EPA, two have shown to work better according to scientific literature. Products containing these active ingredients typically provide longer-lasting protection than others:

• DEET (N,N-diethyl-m-toluamide)
• Picaridin (KBR 3023)

Oil of lemon eucalyptus, a plant- based repellent, is also registered with EPA. In two recent scientific publications, when oil of lemon eucalyptus was tested against mosquitoes found in the US it provided protection similar to repellents with low concentrations of DEET.

Can insect repellents be used on children?
Since it is the most widely available repellent, many people ask about the use of products containing DEET on children. No definitive studies exist in the scientific literature about what concentration of DEET is safe for children. No serious illness has been linked to the use of DEET in children when used according to manufacturer’s recommendations. (This is government speak for “As far as we know, it is safe!)

The American Academy of Pediatrics (AAP) Committee on Environmental Health has updated their recommendation for use of DEET products on children in 2003, stating: "Insect repellents containing DEET with a concentration of 10% appear to be as safe as products with a concentration of 30% when used according to the directions on the product labels." AAP recommends that repellents with DEET should not be used on infants less than 2 months old.

Parents should choose the type and concentration of repellent to be used by taking into account the amount of time that a child will be outdoors, exposure to mosquitoes, and the risk of mosquito-transmitted disease in the area.

What guidelines are available for using a repellent on children?
First, as always follow the recommendations appearing on the product label when using repellent, also:

• When using repellent on a child, apply it to your own hands and then rub them on your child. Avoid children's eyes and mouth and use it sparingly around their ears.
• Do not apply repellent to children's hands. (Children may tend to put their hands in their mouths.)
• Do not allow young children to apply insect repellent to themselves, have an adult do it for them.
• Keep repellents out of reach of children.
• Do not apply repellent under clothing. If repellent is applied to clothing, wash treated clothing before wearing again.

How else can I protect children from mosquito bites?
Using repellents on the skin is not the only way to avoid mosquito bites. Children (and adults) can wear clothing with long pants and long sleeves while outdoors. DEET or other repellents such as permethrin can also be applied to clothing (but is not registered for use on skin), as mosquitoes may bite through thin fabric.

* Mosquito netting can be used over infant carriers.

Finally, it may be possible to reduce the number of mosquitoes in the area by getting rid of containers with standing water that provide breeding places for mosquitoes.

Can I use an insect repellent and a product containing sunscreen at the same time? What are the recomendations for combination sunscreen/insect repellent products?
Yes. People can, and should, use both a sunscreen and an insect repellent when they are outdoors. Follow the instructions on the package for proper application of each product. In general, the recommendation is to apply sunscreen first, followed by repellent.

It is recommended NOT to use a single product that combines insect repellent containing DEET and sunscreen, because the instructions for use of insect repellents and use of sunscreen are different. In most situations, insect repellent does not need to be reapplied as frequently as sunscreen. While no recommendations are available at this time regarding products that combine other active ingredients and sunscreen, it is important to always follow the label on whatever product you are using.