The weather is warming up, and after a spring spent staying home, there’s no doubt we’re all itching to get outside. 

But this season brings with it a different kind of concern when it comes to health. Mosquitoes and ticks will arrive with the higher temperatures, and many insect-borne diseases can present serious risks. Fortunately, mosquitoes don’t really start to show up until later spring. However, this year may be a bit different.

“In typical years, mosquitoes begin to hatch in mid-May. Some species hibernate and may appear on a warm winter day, but they tend to be in very low numbers and with an associated lower risk,” said Timothy D. Deschamps, executive director of the Central Mass. Mosquito Control Project. “The current weather pattern has shown to be wetter, and we have had a warm winter, so we may see an earlier hatch than normal. Populations tend to be high with the spring species since they are a single generation species and come out in greater numbers than species that have multiple generations, they hatch in early summer.”

The more pressing concern right now is ticks, said Dr. Christina R. Hermos, a practicing infectious disease doctor and assistant professor at the University of Massachusetts Medical School. If you’re heading into the woods for a stroll, or into any ungroomed outdoor area where ticks may hang out, it is time to start covering up.

“The ticks, particularly the nymphs from the black legged ticks, have already emerged with the thaw,” she said “Tick-borne diseases can be contracted at any time that temperatures allow for a thaw. Nymphs are very effective at transmitting Lyme and other diseases because they are so small, we don't notice when they are embedded. “

Ticks can spread diseases like Lyme Disease, Anaplasma and Babesia, which are all serious. But Hermos said while these conditions can be concerning, it is important not to let fear take over our desire to get outdoors.

“It's important to be careful but in most cases not fearful,” she said. “Lyme is easily treated when recognized in early stages and even in later stages. Anaplasma and Babesia can be severe in the elderly and in other immunocompromised states, but typically presents as a fever illness that can be treated with a short course of antibiotics and many cases may go undetected and resolve without treatment.”   

Calming the bite of EEE and West Nile Virus fears

Mosquitoes carry several other diseases, like Eastern Equine Encephalitis (EEE) and West Nile Virus. Last summer was a particularly difficult one in Massachusetts for the risk of EEE. Twelve people across the state were diagnosed with the rare infection, and three people died after contracting it. 

Deschamps expects EEE will be a concern again this year.

“We do expect and have been planning for EEE to re-emerge this year; EEE tends to show in two to three year cycles, and last year seems to be year one,” he said.

 At the peak of EEE monitoring last year, 35 towns were considered at “critical risk” and many others were classified as high and moderate risk. Sports practices, games and other outdoor events were changed to indoors, when possible, or canceled when necessary in August and September. Many communities had curfews to prevent outdoor activities when mosquitoes are active.

Hermos said it is too early to know whether these actions will be necessary again.

“It's difficult to predict at this time what the human risk of EEE will be this summer. The DPH (Department of Public Health) monitors how much EEE is detected in the bird-biting mosquitoes, which begins earlier in the summer. Higher levels of EEE among bird biting mosquitoes increase the risk of cross-over infection into mammal-biting mosquitoes. The time it takes for mammal-biters to become infected is why the risk to humans typically doesn't exist until at least August.”

However, like tick-borne disease, Hermos says common sense is needed for protection against infections like EEE, but fear should not get in the way of outdoor family fun.

“While the severe cases of EEE are frightening, they are extremely rare,” she said

Tips to protect your family 

The following recommendations from Timothy D. Deschamps of Central Mass. Mosquito Control Project and Dr. Christina R. Hermos of the University of Massachusetts Medical School can help you and your family protect yourself from insect-borne illness this spring and summer:

Avoid outdoor activities between dusk and dawn, if possible, since this is the time when mosquitoes are most active.

If you must be outdoors when mosquitoes are active, wear a long-sleeved shirt and long pants.

Take special care to cover up the arms and legs of children playing outdoors. When you bring a baby outdoors, cover the baby's carriage or playpen with mosquito netting.

Use a mosquito repellent that contains DEET (the chemical N-N-diethyl-meta-toluamide) and follow the directions on the label (never use DEET on infants). 

Fix any holes in your screens and make sure they are tightly attached to all your doors and windows

Clearing standing water from gutters and around the home.

Fans are effective at keeping mosquitoes from small areas, so an outdoor fan will work better than citronella candles.

Perform tick checks every night. Check warm dark areas of the body, like armpits, groin and in hair.

Bathing (ideally within 2 hours of outdoor activity) and using a rough cloth over the entire body can help as this can remove ticks before they have had a chance to embed.

Clothes treated with permethrin can repel ticks and mosquitoes. This can include shoes/hiking boots.