Ticks and mosquitoes don’t care about COVID-19 safety protocols. They don’t care that people are trying to squeeze out the last moments of this restrictive summer by getting outdoors, hiking, or just sitting on their decks at night and feeling something that’s close to normal.

COVID-19 has commanded our attention and caused people to adapt their behaviors to prevent one major health concern, but it doesn’t mean others have been eliminated. “Masks and social distancing will do nothing to protect you from what ticks and mosquitoes potentially carry,” says Dr. Todd Ellerin, director of infectious diseases and vice chairman of the department of medicine at South Shore Hospital in Weymouth, Massachusetts, and an instructor in medicine at Harvard Medical School.

Ellerin adds another reason to remain vigilant: tick-borne illnesses and COVID-19 share symptoms, such as fevers, achiness, fatigue, sore throats, rashes, headaches, low white blood cell counts, and elevated liver functions. One illness can be confused for the other, and health care resources are used up in the process. “It adds another level of diagnostic confusion,” he says. It means taking the necessary precautions becomes more important now, but the upside is one repellent is effective for both insects.

What are some common tick- and mosquito-borne illnesses?

This list isn’t exhaustive, but common infections associated with ticks include Lyme disease, anaplasmosis, and babesiosis. They all can occur nationwide, but the highest concentrations are in the northeast and Midwest. Borrelia miyamotoi is relatively new and rare, according to the Centers for Disease Control and Prevention, so questions about where it’s most prevalent are still being explored. And with Rocky Mountain spotted fever, over 50% of cases come from five states in the southeast and Midwest.

Common mosquito infections include malaria, Zika, West Nile, and Eastern equine encephalitis (EEE). The CDC calls EEE rare, but Ellerin says that last year there was a spike. Massachusetts, for example, had 12 cases after reporting none from 2014 to 2018. The concern with EEE is that the virus usually runs in two-to-three-year cycles, and approximately 30% of people who become infected will die from it; that’s why mosquitoes shouldn’t be ignored. “Globally, mosquitoes actually are the most dangerous animal, causing the most deaths,” says Ellerin.

Bug spray is a safe and effective prevention strategy

Taken all together, the risks of contracting a serious illness from a tick or mosquito can seem overwhelming. However, it may be reassuring to know that over-the-counter bug sprays work well to repel ticks and mosquitoes through one of three common active ingredients: oil of lemon-eucalyptus, picaridin, or diethyltoluamide, better known as DEET. Permethrin is another one, but it’s an insecticide and is designed to be used on clothing, not skin. Ellerin says that whichever bug spray ingredients you choose, they’re safe and effec

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