Rambam: Two are hospitalized in serious condition due to complications of West Nile fever; the National Poisoning Information Center issues recommendations for pregnant women.
A man in his 50s and a woman in her 40s are hospitalized in the neurology department at Rambam after contracting Nile fever. Their condition over the years is defined as severe-moderate and they suffer from various neurological complications related to the virus.
◄ Dr. Shahar Shali reports on the condition of the two patients • Watch
According to the information available to the medical team, the two patients were apparently stung in the central area in recent days. "Despite the large increase in the number of cases in Israel so far, their mere hospitalization at Rambam does not indicate the presence of infected mosquitoes in the northern region at this stage," notes Dr. Michal Paul, director of the Infectious Diseases Institute at Rambam.
According to Dr. Shahar Sheli, director of the neurology department at Rambam, despite the condition of the patients, there is optimism.
My Dr. Shahar
"The two are receiving supportive treatment and are under strict medical supervision. Unfortunately, after people contract the disease, there is not much we can do, but we hope that their condition will improve soon."
◄ Some simple steps to reduce exposure risk - Rambam expert explains • Watch
pregnant? Pay attention: recommendations to protect against mosquito bites among pregnant women
In the meantime, the National Center for Poisoning Information in Rambam has distributed instructions to pregnant women in recent days, due to the large number of cases and the spread of the outbreak in different parts of the country.
"In recent weeks, we have witnessed the outbreak of West Nile fever in several regions of Israel," says Dr. Noa Markowitz, a senior physician at the National Poisoning Information Center in Rambam, and the coordinator of pregnancy and breastfeeding counseling. "The disease is caused by a virus, which is transmitted through mosquito bites. Although the disease is mostly mild, some of the infected may have severe symptoms. Following various inquiries that have reached us, we have decided to gather the relevant information. It is important to emphasize that the information is valid regarding protection against bites in Israel To the extent that a pregnant woman travels to countries where there is a risk of contracting malaria or other diseases transmitted by flying - the authorized officials at the travelers' clinics must be consulted."
What is the best way to protect yourself from mosquito bites?
The best protection is to avoid staying in places where there are accumulations of mosquitoes.
In addition, it is recommended as much as possible to wear long clothes and tuck the shirt into the pants or skirt, thus reducing the area of exposed skin.
What are the ingredients in mosquito repellents?
There are two chemicals that act to disrupt the mosquitoes' sense of smell, so that they are not attracted to humans. The older one is DEET (N,N-Diethyl-meta-toluamide), and the relatively new one is Icaridin. Both substances have similar effectiveness as mosquito repellents. Skin exposure may rarely cause irritation or burning of the skin, but no systemic side effects have been described. In addition For this, there are preparations containing eucalyptus oil (Citriodiol or Citrepel), sometimes in combination with citronella oil.
Can mosquito repellents be used during pregnancy?
Preparations containing Icaridin / DEET are considered safe for dermal use during pregnancy. Despite the lack of information from controlled studies, there have been no reports of special side effects among pregnant women, nor have there been any reports of an increase in the rate of pregnancy complications associated with the use of these preparations (including an increase in the risk of birth defects, an increase in the risk of premature birth, or harm to the baby's development).
Preparations containing eucalyptus and citronella oil are also considered safe in pregnancy, despite the lack of controlled studies regarding them.
What are the recommended preparations for use during pregnancy?
Preparations containing low concentrations of the active substance can be used.
Low concentrations (DEET at a concentration of 9% or Icaridin at a concentration of 10%) are often found in preparations intended for babies and children (check the product label).
Preparations with a low concentration are effective for about two hours, and therefore in case of prolonged exposure it must be re-applied.
You can also use preparations containing eucalyptus/citronella oil, and if they are ineffective - replace them with preparations containing a low concentration of Icaridin / DEET.
If a pregnant woman is stung despite the usual protective measures and despite using a preparation containing Icaridin / DEET at a low concentration, it is recommended to use a preparation containing a higher concentration of the active substance (DEET at a concentration of 26%-25%, or Icaridin at a concentration of 20%). These preparations are expected to be effective for a longer time, up to about 4 hours.
How do you use the different preparations?
Read the manufacturer's instructions before use, and use the product according to the instructions. In addition to using it on the skin, you can - according to the instructions - spray or apply the substance on the edges of the clothes as well.
Do not apply or spray to the parts of skin protected by clothing or the inside of clothing.
It is recommended, when exposed to the sun, to also apply sunscreen against UV radiation. First apply the sunscreen, and only after it has dried can you apply the mosquito repellent.
What about mosquito repellent devices for home use?
There are devices that require electricity, which contain mosquito repellent liquid/steaming plates. The active substance in these devices is an insecticide from the pyrethroid family, and its concentration is low. Home use of these devices, according to the manufacturer's instructions, does not constitute any additional risk for pregnant women.