I like to say that the three Bs of summer are: “barbecue, bathing - sun or pool - and bugs.” My 4- and 2-year-old will come running and crying if they see a bumblebee or ladybug much less the more concerning mosquito or tick. But they always know they're not going outside unless they get sun lotion and bug spray.

In the United States, the mosquito used to be just a nuisance in the outdoors. Worldwide, mosquito born malaria kills three million people annually. In the United States, the mosquito has carried various viral diseases that caused encephalitis. More recently, the introduction of mosquitoes carrying West Nile Virus (WNV) has caused significant concern and disease.

West Nile Virus is most common in late summer and early fall in New York state. In 2005, there were 38 reported cases of WNV and four deaths in New York. Nationwide there were 3,000 cases and 119 deaths, according to the Centers for Disease Control and Prevention Web site. About 1:150 people infected develop serious illness.

But don't despair! You can still have your Fourth of July pool party. Don't cancel that Labor Day picnic. There are very effective ways to help reduce your chances of getting bitten by any mosquito.

The Environmental Protection Agency classifies two mosquito repellents that have scientific data showing they are very effective, DEET and picaridin (I won't bore you with long chemical names). Oil of lemon eucalyptus has also been deemed effective, providing protection similar to low concentrations of DEET. DEET is also effective at repelling ticks.

Apply the product to all exposed skin sparingly as heavy application does not mean greater protection. Do not use sprays directly on the face, spray into your hands. Avoid contact with the mouth, eyes and ears. Don't apply over cuts or irritated skin. Don't let children handle mosquito repellents. The higher concentration of the chemical, the longer it will last, but if you are outside for hours you will need to reapply. Products with greater than 20 percent DEET last longest, but there is no additional benefit for any concentration greater than 50 percent. Most important is to follow the directions on the product you have purchased.

The American Academy of Pediatrics reports that products containing DEET in concentrations as high as 30 percent can be safe in children. They have not made any recommendations regarding other products. Children under 2 months of age should not be exposed to DEET. Draping mosquito netting over a stroller is probably the best prevention if infants are going to spend time out of doors. Oil of eucalyptus is not recommended for children under 3.

Permethrin is a chemical that can be sprayed on clothing, mosquito netting, tents, etc. and provides good protection against mosquitoes and ticks. It is not for use on the skin.

It is OK to use mosquito repellents and sunscreens together. The CDC does not recommend the combination products, as usually sunscreens and repellents need to be applied at different intervals for optimal effectiveness.

The best prevention of mosquito bites is avoidance. Mosquitoes are most active at dawn and dusk. When you can, wear long pants, long sleeved shirts and socks. Keep your window screens in good condition to keep mosquitoes out of your home. Remove mosquito breeding grounds around your home and work. Mosquitoes can breed in the smallest amounts of standing water like that found in flower pots or any kind of container, clogged rain gutters, swimming pool covers and bird baths.

Following these simple steps and product instructions can help make your summer more comfortable and disease free.

Dr. Davidd Levy is a family

physician in Auburn and is

accepting new patients.

Call 282-0525 for an appointment