Why do mosquitoes seem to bite some people more?

Back in 2015, I had an article published at The Conversation on why some people are more likely to be bitten by mosquitoes than others. It is one of the most commonly asked questions I get whenever I give public talks (or friends and family are quizzing me at summer BBQs).

This article was incredibly successful and has currently been read by approximately 1.4 million people. That is a lot of people. Hopefully the science of mosquito bites has got out there and actually helped a few people stop themselves or their family being bitten by mosquitoes!

The warm weather is starting to arrive here in Australia so I am sharing this once more for those wondering why they’re always the “mosquito magnet” among their friends…

Health Check: why mosquitoes seem to bite some people more

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There are up to 400 chemical compounds on human skin that could play a role in attracting mosquitoes.  sookie/Flickr, CC BY-SA

There’s always one in a crowd, a sort of harbinger of the oncoming mosquito onslaught: a person mosquitoes seem to target more than others. What is it about these unlucky chosen few that makes them mosquito magnets?

There are hundreds of mosquito species and they all have slightly different preferences when it comes to what or who they bite. But only females bite; they need a nutritional hit to develop eggs.

Finding someone to bite

Mosquitoes are stimulated by a number of factors when seeking out a blood meal. Initially, they’re attracted by the carbon dioxide we exhale. Body heat is probably important too, but once the mosquito gets closer, she will respond to the smell of a potential blood source’s skin.

Studies have suggested blood type (particularly type O), pregnancy and beer drinking all make you marginally more attractive to mosquitoes. But most of this research uses only one mosquito species. Switch to another species and the results are likely to be different.

There are up to 400 chemical compounds on human skin that could play a role in attracting (and perhaps repulsing) mosquitoes. This smelly mix, produced by bacteria living on our skin and exuded in sweat, varies from person to person and is likely to explain why there is substantial variation in how many mozzies we attract. Genetics probably plays the biggest role in this, but a little of it may be down to diet or physiology.

One of the best studied substances contained in sweat is lactic acid. Research shows it’s a key mosquito attractant, particularly for human-biting species such as Aedes aegypti. This should act as fair warning against exercising close to wetlands; a hot and sweaty body is probably the “pick of the bunch” for a hungry mosquito!

Probably the most famous study about their biting habits demonstrated that the mosquitoes that spread malaria (Anopheles gambiae) are attracted to Limburger cheese. The bacteria that gives this cheese its distinctive aroma is closely related to germs living between our toes. That explains why these mosquitoes are attracted to smelly feet.

But when another mosquito (such as Aedes aegypti) is exposed to the same cheese, the phenomenon is not repeated. This difference between mosquitoes highlights the difficulty of studying their biting behaviours. Even pathogens such as malaria may make us more attractive to mosquitoes once we’re infected.

Only females bite because they need a nutritional hit to develop eggs.
Sean McCann/Flickr, CC BY-NC-SA

Researchers are trying to unscramble the irresistible smelly cocktails on the skins of “mosquito magnets”. But the bad news is that if you’re one of these people, there isn’t much you can do about it other than wearing insect repellents.

The good news is that you may one day help isolate a substance, or mixes of substances, that will help them find the perfect lure to use in mosquito traps. We could all then possibly say goodbye to topical insect repellents altogether.

Attraction or reaction?

Sometimes, it’s not the bite as much as the reaction that raises concerns. Think of the last time the mosquito magnets in your circle of friends started complaining about being bitten after the event where the purported mosquito feast took place. At least, they appear to have attracted more than the “bite free” people who were also at the picnic, or concert or whatever.

But just because some people didn’t react to mosquito bites, doesn’t mean they weren’t bitten. Just as we do with a range of environmental, chemical or food allergens, we all differ in our reaction to the saliva mosquitoes spit while feeding.

People who don’t react badly to mosquito bites may think they haven’t been bitten when they’ve actually been bitten as much as their itchy friends. In fact, while some people attract more mosquito bites than others, there’s unlikely to be anyone who never, ever, gets bitten.

The problem is that people who don’t react to mosquito bites may all too easily become complacent. If you’re one of them, remember that it only takes one bite to contract a mosquito-borne disease.

Finally, there is no evidence from anywhere in the world that there is something you can eat or drink that will stop you being bitten by mosquitoes. No, not even eating garlic, or swallowing vitamin B supplements.

The ConversationPerhaps if we spent as much time thinking about how to choose and use mosquito repellents as we do about why mosquitoes bite our friends and family less than us, there’d be fewer bites all around.

Cameron Webb, Clinical Lecturer and Principal Hospital Scientist, University of Sydney

This article was originally published on The Conversation. Read the original article.

 

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Preserve and protect? Exploring mosquito communities in urban mangroves

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This is a special guest post from Dr Suzi Claflin. Suzi found herself in Sydney, Australia, (via Cornell University, USA) in 2015 to undertake a research project investigating the role of urban landscapes in determining mosquito communities associated with urban mangroves. She was kind enough to put this post together to celebrate the publication of our research in Wetlands Ecology and Management!

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Sometimes you’ve got to make hard choices for the greater good. These situations can arise anywhere, but here – as usual – we are concerned with mosquitoes. There’s a balancing act carried out by public health officials and wetland managers trying to both preserve endangered habitat and protect human health. In this guest post, I’ll explain the science behind research I recently published in collaboration with Dr Cameron Webb, and suggest one way forward for addressing human and environmental health concerns in urban wetlands.

During my PhD, I studied how the landscape surrounding small-scale farms affects the spread of a crop virus and the community of insect pests that carry it. When I came to Australia to work with Cameron, I was surprised to find myself applying the same type of landscape ecology to mosquitoes and mangroves in urban Sydney.

The misfortune of mangroves

Mangroves are real team players. They provide a range of services to the surrounding ecosystem and to the humans lucky enough to live near them. Mangroves are extremely effective at protecting the shoreline (but this can sometimes be a problem). They prevent erosion by gripping the soil in their complex root systems and buffer the beach by serving as a wave break. By filtering sediment out of the water that flows over them, mangroves also prevent their neighbouring ecosystems, such as coral reefs and seagrass forests, from being smothered.

Despite all their good work, mangroves have an almost fatal flaw; they prefer waterfront property. Unfortunately for them, so do humans. Urban and agricultural development has eaten away at mangroves, leaving them highly endangered.

The mosquito menace

Mozzies are a public health menace, because they spread human diseases like Ross River virus (RRV). Because of this, public health officials rightly spend time considering how to supress mosquito populations in order to reduce the risk of disease transmission.

Here’s where things get tricky: mangroves are great for mosquitoes.

That leaves public health officials and wetland managers in a difficult position. On the one hand, mangroves are delicate, at-risk ecosystems that need to be preserved. On the other, mangroves and surrounding habitats potentially harbor both the animal carriers of the RRV (e.g. wallabies) and a load of mosquitoes, which means that people nearby may need to be protected.

How can we do both?

 

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Dr Suzi Claflin trapping mosquitoes in the mangroves along the Parramatta River, Sydney, Australia.

 

The potential power of prediction

This is a hard question to answer. One approach is prediction: using measurements of the environment, like rainfall and tide level, to estimate what the mosquito community will look like in a given region. The mosquito community determines what management actions, like spraying an insecticide, need to be taken, based on the threat it poses to public health.

We set out to explore how the way we use land (e.g. for residential areas or industrial areas) near urban mangroves affects the mosquito communities that live in those mangroves. The project involved dropping over retaining walls, slipping down banks, and tromping through muddy mangroves along the Parramatta River in Sydney. We set mosquito traps (billy cans of dry ice with a container on the bottom) and left them overnight to capture the mozzies when they are most active. We did this at two points in the summer, to see if there was any change over time.

We found that yes, the way we use land around a mangrove makes a difference. Mangroves with greater amounts of bushland and residential land in the surrounding area had fewer mosquitos, and fewer species of mosquitos. On the other hand, mangroves with greater amounts of industrial land surrounding them had a greater number of mosquito species, and those surrounded by greater amounts of mangrove had more mosquitos.

And, just to muddy the waters a bit more (pun intended), several of these relationships changed over time. These results show that although prediction based on the surrounding environment is a powerful technique for mangrove management, it is more complicated than we thought.

Another way forward: site-specific assessments

Our work suggests another way forward: site-specific assessments, measuring the mosquito community at a particular site in order to determine what management approaches need to be used. This is a daunting task; it requires a fair number of man-hours, and mangroves are not exactly an easy place to work. But it would be time well spent.

By assessing a site individually, managers can be confident that they are taking the best possible action for both the mangroves and the people nearby. It turns out that the best tool we have for striking a balance between environmental and public health concerns, the best tool we have for preserving and protecting, is information. In mangrove management—as in everything—knowledge is power.

Check out the abstract for our paper, Surrounding land use significantly influences adult mosquito abundance and species richness in urban mangroves, and follow the link to download from the journal, Wetlands Ecology and Management:

Mangroves harbor mosquitoes capable of transmitting human pathogens; consequently, urban mangrove management must strike a balance between conservation and minimizing public health risks. Land use may play a key role in shaping the mosquito community within urban mangroves through either species spillover or altering the abundance of mosquitoes associated with the mangrove. In this study, we explore the impact of land use within 500 m of urban mangroves on the abundance and diversity of adult mosquito populations. Carbon dioxide baited traps were used to sample host-seeking female mosquitoes around nine mangrove forest sites along the Parramatta River, Sydney, Australia. Specimens were identified to species and for each site, mosquito species abundance, species richness and diversity were calculated and were analyzed in linear mixed effects models. We found that the percentage of residential land and bushland in the surrounding area had a negative effect on mosquito abundance and species richness. Conversely, the amount of mangrove had a significant positive effect on mosquito abundance, and the amount of industrial land had a significant positive effect on species richness. These results demonstrate the need for site-specific investigations of mosquito communities associated with specific habitat types and the importance of considering surrounding land use in moderating local mosquito communities. A greater understanding of local land use and its influence on mosquito habitats could add substantially to the predictive power of disease risk models and assist local authorities develop policies for urban development and wetland rehabilitation.

Dr Suzi Claflin completed her PhD at Cornell University exploring environmental factors driving the spread of an aphid-borne potato virus on small-scale farms. She is now a postdoctoral research fellow at the Menzies Institute for Medical Research in Hobart, TAS. In her spare time she runs her own blog, Direct Transmission, focusing on disease and other public health issues (check it out here). To learn more about her doctoral research, follow this link!

Do outbreaks of mosquito-borne disease always follow floods?

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Water, water everywhere…and mosquitoes soon to follow. It makes sense that with more water you’ll get more mosquitoes and with more mosquitoes you’ll get more mosquito-borne disease. Right? Well, not always.

With floods hitting parts of inland NSW, health authorities have issued warnings about mosquitoes and mosquito-borne disease.

Western NSW, has been substantially impacted by flooding this month and the region has been declared a natural disaster zone. The Lachlan River at Forbes has reached a level not seen for 25 years. There is a lot of water about. 35,000 mega litres of water has also been released from Wyangala dam resulting in further flooding. There could be more to come as “Superstorm 2016” continues to bring rain to south-east Australia. Evacuations continue.

The flooding has come at a time when the weather in warming up and there are already reports of mosquito numbers increasing. The biggest concern is that once the flood water recede, how long will pools of water remain, have mosquitoes got a “jump start”on the season?

On the other side of the world, Hurricane Matthew is threatening Florida. The Bahamas and Haiti have already been hit and more than 2 million people in the US have been told to evacuate their homes. Flooding is expected.

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Mosquitoes need water

There is no doubt that mosquito populations can increase rapidly following flood. There is even a group of mosquitoes commonly called “floodwater mosquitoes“. The desiccation resistant eggs of these mosquitoes are laying dormant in the cracks and crevices of flood plains, just waiting for the water to arrive. When it floods, the eggs hatch and in about a week or so, swarms of mosquitoes emerge.

For the most part, it isn’t immediately following the flooding, but in the weeks and even months following that can provide the most ideal conditions for mosquitoes. If temperatures aren’t high enough to drive rapid evaporation of ponding (or if additional rainfall keeps them topped up), mosquitoes can start building impressing population abundances. With more mosquitoes, the risk of mosquito-borne disease outbreak can increase.

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Rainfall records provided by the Bureau of Meteorology indicate that over the three months to September 2016, some regions of NT, QLD, NSW and Victoria received some of their highest rainfall on record for the period. (Bureau of Meterology)

A look back to floods and mosquito surveillance

In 2011-2012, QLD, NSW and Victoria saw incredible flooding. For those of us working in the field of mosquito-borne disease, we’re well aware of what that flooding can cause. Our attention was sparked when stories starting coming out from locals about this being the biggest flooding since the 1970s. Why was this important? Following flooding in the 1970s, we saw one of the biggest outbreaks of the potentially fatal Murray Valley encephalitis virus Australia has seen. This outbreak, and the response to the actual and potential health impacts, was essentially the genesis of many mosquito-borne disease surveillance programs across the country.

One of those programs was the NSW Arbovirus Surveillance and Mosquito Monitoring Program. Following the flooding in early 2012, there was a huge jump in mosquito populations in western NSW and one of the largest collections of mosquitoes in the history of the program was recorded with over 18,000 mosquitoes collected! Fortunately, we didn’t see any substantial activity of Muray Valley encephalitis virus but elsewhere in Australia, cases were reported.

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Mosquito-borne disease outbreaks need more than just mosquitoes

There is little doubt you need mosquitoes about for pathogen transmission. However, for many mosquito-borne diseases, the pathogens that cause the illness in people are naturally found in wildlife. Person to person transmission may occur but for pathogens such as West Nile virus, Ross River virus or Murray Valley encephalitis virus, the mosquitoes that inject their virus-filled saliva into people have bitten birds or mammals previously.

The role of wildlife is important to consider as the flooding may influence mosquito populations but they can also influence wildlife. While kangaroos and wallabies may be adversely impacted by floods, flood waters can provide a major boost for waterbirds.

In some instances, as is the case for Murray Valley encephalitis virus, floods provide ideal conditions for both mosquitoes and birds!

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Do floods really cause outbreaks of mosquito-borne disease?

There are few studies that have demonstrated that outbreaks of mosquito-borne disease always occur following floods.

Studies in North America had previously concluded that there wasn’t a direct link between hurricanes and flooding and mosquito-borne disease. But, that doesn’t mean there won’t potentially be a boost in nuisance-biting mosquitoes following flooding.There is often widespread spraying to control these pest mosquito populations.

Interestingly, after Hurricane Katrina hit New Orleans in 2005, there was an increase in mosquito-borne disease with more than a 2-fold increase in West Nile neuroinvasive disease. However, other reports noted no significant increase in cases of either West Nile or St. Louis encephalitis viruses. Surveillance for 6 weeks following the hurricane, authorities found no arboviruses circulating in local mosquito populations. These results highlight that much more than water and mosquitoes are required for outbreaks of disease.

In Australia, a recent review looked at the influence of flooding on cases of Ross River virus disease. They found that the evidence to support a positive association between flooding and RRV outbreaks is largely circumstantial. The trouble in predicting outbreaks of Ross River virus disease is that there can be complex biological, environmental and climatic drivers at work and, irrespective of local flooding, there may be other region-specific issues that either increase or decrease the potential for an outbreak.

What should we expect in Australia as summer approaches?

There is no doubt mosquito repellent will come in handy over the coming months. There are already reports of increased mosquito populations in some parts of the country. While nuisance-biting impacts will be a worry, if mosquito populations further increase following flooding, authorities need to remain mindful of a range of other health risks too.

The good news is that unless higher than normal mosquito populations persist into the warmer months, we may not see major outbreaks of disease. It typically isn’t until November-December that we start to see pathogens circulate more widely among wildlife and mosquitoes. Hopefully, if some hot weather arrives, the flood waters will quickly evaporate and abundant mosquitoes populations won’t continue.

Current outlooks suggest that between now and December 2016, south-eastern regions of Australia are likely to receive above average rainfall. Temperatures, though, are likely to be a little cooler than normal. We’re probably lucky that this cooler weather will keep the really big mosquito population increases that we saw a few years ago at bay.

On balance, we’re expecting plenty of mosquitoes to be about as summer starts, hopefully not “mozziegeddon” but enough to ensure the community should stay aware of the health risks associated with mosquito bites and how best to avoid their bites.

Have you seen mosquitoes about already this season? Join the conversation and tweet some shots of local mosquitoes!

Should we mix mosquito repellents and sunscreens?

MosquitoRepellents_childarm_webbCombining mosquito repellents with sunscreens, as well as other cosmetics, sounds like a great idea but perhaps it isn’t to best way to protect ourselves from exposure to both the sun and mosquitoes.

There are formulations that combine mosquito repellents with various skin moisturizers but the most common combination formulations contain sunscreen and repellents. A combined formulation make sense given that Australia has one of the highest rates of skin cancer anywhere in the world. Even the Cancer Council have their own “Repel Sunscreen” formulations.

Combined formulations but conflicting risks

As well as questions regarding the efficacy of these formulations, there have also been some questions regarding their safety. Do they lessen the protection against the sun? Do they lessen the protection against mosquitoes? Do they increase the potential risk of toxic reactions to mosquito repellents?

One study found that the inclusion of mosquito repellent in sunscreen actually reduced the sun protection factor of the sunscreen. In 2009, I published a paper in Australian and New Zealand Journal of Public Health that investigated the efficacy of combined sunscreen and insect repellent formulations. The key finding was that no loss of protection from mosquito bites was provided by these combined formulations when compared to low and high dose “mosquito repellent only” formulations. The finding supported previous studies that indicated sunscreen does not reduce the efficacy of insect repellent. However, where we went further was to try and provide some guidelines for use of these products to maximise mosquito bite protection but also to minimise any potential adverse reactions to repellents.

I've provided plenty of deail of how to choose and use mosquito repellents in the "beating the bite" guidelines freely available for download

I’ve provided plenty of detail of how to choose and use mosquito repellents in the “Beating the Bite” guidelines freely available for download

This issue of conflicted use was highlighted in a review of sunscreen labelling recommendations and combination sunscreen/insect repellent products that outlined concerns that “the application of a combination product too frequently poses the risk of insect repellent toxicity, whereas application too infrequently invites photodamage”.

Could combined formulations raise potential over exposure to mosquito repellents?

It is important to note that many published studies and reviews have shown that DEET does not pose a significant health concern (see here too). A recent review of safety surveillance from extensive humans use reveals no association with severe adverse events. In short, if a DEET-based mosquito repellent is used as recommended, there are no major concerns for health risk.

What if the use of a combined repellent and sunscreen formulations results in the application rate of repellent above and beyond recommended rates?

How much repellent are you using with sunscreen?

The recommended use of sunscreens and repellents are quite different. As well as the frequency of reapplications (sunscreen every two hours; repellent reapplication is determined by the “strength” but may be up to four hours for mid-range formulations), the quantity used will vary. Mosquito repellents require a thin application over all exposed skin to provide effectiveness. When the applications rates providing effective protection in mosquito repellent studies are compared to those for sunscreen use (i.e. approximately 30ml applied across the forearms, legs, torso and back 20 minutes before going outside and reapplied every two hours), application rates for sunscreens are approximately 3-5 times greater.

Are you using repellent when you don’t need to?

It is interesting to note the differences in the use pattern of sunscreen and mosquito repellent use. In many instances, nuisance-biting mosquitoes will generally be more active during periods when sun exposure risk is low (e.g. late afternoon, evening and early morning). However, as I pointed out in this paper on mosquito repellent use to reduce the risk of dengue, protection against these day-biting mosquitoes could call for the use of both products simultaneously. There is also no doubt that under some circumstances in coastal regions of Australia, mosquitoes can be out and about biting in shaded environments (places like mangrove forests and coastal swamp forests) during the day.

The Yellow Fever Mosquito, Aedes aegypti (Photo: Stephen Doggett)

The Yellow Fever Mosquito, Aedes aegypti (Photo: Stephen Doggett)

What should you do?

I’m not aware of any review in Australia to reconsider the registration or recommendations surrounding the use of combined mosquito repellent and sunscreen formulations. In most instances, the advice provided by local authorities is simply to “follow label instructions”.

Combined mosquito repellent and sunscreen formulations are not recommended by the CDC. It is worth noting that also in Canada, combined sunscreen and insect repellents are not recommended. It is suggested to apply the sunscreen first, then the insect repellent over the top. The only problem is that as repellent will generally last longer than sunscreen, you end up alternating application of the two products.

We tested the idea that repellents should be applied first and then sunscreen over the top. While testing the efficacy of sunscreen wasn’t in the scope fo our study, we found that the efficacy of repellent (as measured by the duration of protection) was actually reduced. The reduction, we concluded, was probably due to physical disruption of the original mosquito repellent application during subsequent sunscreen application.

It should be noted once again that repeated reviews have concluded that DEET-based repellents pose a very low risk of adverse health impacts. However, if you were to take a cautious approach, if there is a risk of possible adverse reaction to repellents, this may be more likely to happen when using high dose DEET-based repellents (e.g. “tropical strength” repellents that may contain over 80% DEET) in combination with sunscreen. If you want to lower the risks as much as possible, using a low-dose DEET-based (e.g. containing less than 10% DEET), or picaridin-based, repellent will more closely align the recommended reapplication times of the two products.

If you’re looking for sunscreen advice, visit the Cancer Council website here.

The full reference for our 2009 paper is below:

Webb, C. E. and Russell, R. C. (2009) Insect repellents and sunscreen: implications for personal protection strategies against mosquito-borne disease. Australian and New Zealand Journal of Public Health, 33: 485–490.