There has been a lot of discussion about types of repellent, but the most widely used and effective ingredient is diethyltoluamide (DEEr). It has been used on the skin of such massive numbers of people world wide, it would be surprising if there had not been rare reports of toxicity possibly associated with it. As a result of this you must take care not to exceed the manufacturers' instructions about applying it, especially for children.
Naturally care should be taken to avoid the eyes. A skin patch test may be a wise precaution for people with sensitive skins. Spray or roll on formulations avoid spills of repellents which can mark plastics, including cameras, and reduces the chance of a child trying to drink them. For those who cannot use DEET, there is a range of other repellent products containing various essential oils. In most cases they do not have quite the same effect. People often ask about the use of vitamin B or garlic pills as insect repellents. They may be effective for some individuals, but when tested, no consistent protection is demonstrated. There is no doubt that differences in skin excretions make some people more attractive to mosquitoes than others.
Some repellents can be sprayed on to clothing, although some may make a slight Marie This can be useful around collars and trouser legs, and can reduce the amount applied directly on to the skin. You also need to prevent bites while you are in bed at night. Most international hotels have modern air conditioning systems which discourage mosquitoes.
However, they could fly in if someone leaves the window open and then you would need to use knockdown insect (fly) killer to spray the room after closing the door and
windows. Where you need to sleep with the windows open (because there is no air conditioning) there should be screens on the windows and, in high risk areas, a mosquito net provided over the beds. Nets are more effective when they are dipped in an insecticide called permethrin. Anyone who has to carry their own net, for example, backpacking off the beaten track, should be aware of this.
Smoke coils are burnt to discourage insects in many tropical countries and may be useful when sitting on a veranda. However, they will not burn reliably all night so there is a better alternative to use if there are electrical sockets in your room: a small plug-in device which vaporizes a tablet of insecticide placed on it. You will need to remember to carry an international adapter as well.
Besides malaria mosquitoes, there are other insects that transmit disease: sand flies, ticks and other mosquitoes, for example, those that carry Dengue fever (not usually as serious as malaria, but certainly very unpleasant). Mosquitoes can also be a real nuisance, but not usually dangerous, in many northern holiday destinations such as Canada, Alaska and Scandinavia. The same information on repellents and coverup clothes applies, but it should be remembered that a lot of insects are daytime biters so the precautions do not only apply to after dark.
Different people and destinations have different requirements, so treat the lists on pages 301 as a guideline. You'll only need a basic selection for a short holiday to a major destination. It's worth discussing any queries with your doctor or pharmacist and make sure you read the packet information supplied with all
medications. Consult your doctor about the suitability of antibiotics for travel away from medical help. You may also want to have a dental checkup, especially before holidays in developing areas.