[Protection against insects]

Successful protection against haematophagous insects and ticks, especially in areas where transmission of diseases occurs, requires a consistent application of a combination of appropriate measures. However, this can never substitute a chemoprophylaxis. Which measures have to be used depends on the circumstances under which they have to work. Indoor, physical means such as mosquito-screens on doors and windows, air-conditioners, and bed nets can be used to keep the insects away. These measures can be supplemented or supported by insecticides used as knock-down sprays, by electrical evaporation or for the treatment of screens and bed nets. In the field, if it is not possible to avoid mosquito-areas during phases of activity, appropriate clothing and repellents must provide the protection. Bright, wide pants and shirts of dense weaving covering as much skin as bearable should be preferred. Repellents are sprays, lotions, milks or creams which are evenly applied to the skin to prevent insects from biting. They contain synthetic or natural active substances of substantially varying effectiveness. The gold standard since about 60 years is diethylbenzamine (DEET). There are a few other active substances with a lower risk of side effects, however, combined with a lower effectiveness mainly on people with a high attractiveness for mosquitoes. Products containing an extract of Eucalyptus citriodora provide the best protection amongst those with natural active substances. Wearing bracelets or necklaces treated with repellents, acoustic devices (buzzers), electrocuters, topical or systemic Vitamin B1 or eating garlic are useless measures to prevent insects from biting.