It’s the last thing many of us want to think about when going away on holiday: the likelihood, particularly if we’re travelling somewhere hot, of being feasted upon by tiny bugs and critters.

But it’s nonetheless an eventuality we have to prepare for.

Some bites and stings are obviously more troublesome than others. Bed bug bites for instance, often cause little besides an itchy patch of raised spots, and are much more of a nuisance than a significant health risk.

Mosquito and tick bites on the other hand are quite different.

Last week, you may have seen our World Map of Malaria, indicating where in the world mosquito bites carry a very real risk of transmitting this potentially fatal disease. Recently, with a surge in cases in Brazil, the host nation of this year’s Olympics, Zika has been a prominent news item too. This disease which can cause birth defects when contracted during pregnancy is also transmitted by mosquito bites.

There are a host of precautions travellers can take to prepare themselves for environments where hostile insects are present. These include bite prevention products, such as DEET spray, sleeping in a bed fitted with a mosquito net, and packing long sleeved tops and long trousers to cover exposed areas of skin.

Antimalarial drugs and vaccinations are also crucial to have prior to departure. As discussed last week, the Fit For Travel website contains detailed information on which medical precautions against indigenous infections travellers should take.

But obviously it’s impossible to completely eliminate the risk of bites occurring. Even those who take every precaution available to them may still find that they sustain some.

So for this reason, in addition to knowing about bite prevention, it’s also important to know about bite aftercare. We’ve put together a brief guide to identifying bug bites, what you can do to facilitate the healing process, and when you should see a doctor.

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From the perspective of disease transmission, the mosquito bite is the most formidable on our list. Globally, there were 214 million cases of malaria in 2015 according to WHO, of which nearly half a million were fatal.

As discussed in greater depth last week, there are antimalarial drugs which function as prophylactics to prevent the disease from developing in the body. While most importantly these drugs will serve to prevent malaria, they won’t stop the bite from being a source of irritation.

The severity of mosquito bites depends on the person bitten. Most will develop a small red bump at the bite site which is persistently itchy for a number of hours or sometimes longer.

Milder cases may clear up after a few days. The bites will usually not follow any sort of pattern and may appear sporadically on the body; however the more common areas for tourists to find them are on the legs, ankles and feet, as these tend to be the more exposed areas when holidaying in hot countries.

Others may develop a sensitive reaction to bites, and bullae may form (as depicted in the diagram above). This is where an allergic response causes a fluid-filled blister to develop in the region, which can vary greatly in size.

Weals are another sign of an allergic reaction to bites. These are pale, raised patches of skin which form around the irritated region.

How do you treat the bite?

Making sure the area is kept clean is the most basic measure everyone should take after sustaining a bite from a mosquito or a midge. Using a cold compress can help to reduce any resultant inflammation too.

Particularly where bullae or weals are present, covering the affected area with a plaster to protect it from bacteria or bursting will expedite the healing process. Antihistamines and painkillers may also help to lower pain and inflammation.

If the area is particularly painful or is showing signs of infection, it’s important to see a doctor.

It’s vital to take medicinal precautions before going to a country where mosquito-borne infections are present.

That said, even if you have taken every available precaution, any signs of more serious illness which develop after sustaining a mosquito bite, such as fever, difficulty breathing or sickness, should still be treated as a medical emergency.


Ticks are small, eight-legged (technically making them an arachnid) and are usually found in wooded areas and long grass. They can can vary in size: some will be no larger than a couple of millimetres while others can grow to about a centimetre. Often tick bites are harmless and won’t produce any noticeable symptoms. However in other cases, a tick bite may necessitate medical attention.

These creatures latch onto the body and penetrate the skin, also with the intention of feeding on the blood of the host. They can stay attached for days, and bites are usually fairly easy to identify; as demonstrated in the diagram above at stage one, the legs of a tick will remain exposed it is feeding.

Sometimes when the tick becomes dislodged it will leave a small red mark at the bite site, and may provoke sensitivity reactions in some such as itching or swelling (stage two).

In more serious cases, ticks can transmit a condition called Lyme disease. Symptoms may include a distinctive target-like rash similar to the one depicted in the diagram at stage three, which will appear and expand in the days and weeks following being bitten (it is thought however, that as many as one in three with early Lyme disease will not develop this rash); feelings of lethargy; fever; headaches; and other symptoms one might normally associate with flu.

How do you treat the bite?

If you suspect you or someone in your party has been bitten by a tick, it’s important to go to the doctor as soon as possible; particularly if you begin to notice any of the above symptoms.

Lyme disease can be treated with antibiotics when caught early. However it can become more troublesome to tackle during post-infectious stages and potentially be dangerous if left untreated.

If you develop swelling or inflammation after being bitten, it might be a sign of another type of infection which requires a course of antibiotics. In any case, you doctor will advise you on how to make sure the infection does not spread; and if infection isn’t present, they will also guide you on how to keep the area clean and reduce irritation.

Horse flies

Unlike the bites described above, where the insect punctures the skin, horse flies instead lacerate the skin to reach the blood of their host. They perform this action with their mandible talons before feeding, and as such the bite can be significantly painful.

For some the bite may produce a raised red bump, which is again a sign that the immune system is trying to counter what it perceives as a threat.

Horse fly bites don’t transmit illnesses like mosquitos and ticks do, but their bites will take the skin longer to recover from, and consequently can result in infection. People with allergies might also develop more serious reactions such as hives or swelling after being bitten.

How do you treat the bite?

Keeping the area clean is perhaps most important, due to the risk of infection. Using a plaster to cover the wound can help, as can using a dermal antiseptic. Mild analgesics such as paracetamol or ibuprofen can also help to combat associated pain.

Those who experience swelling or a rash due to an allergic reaction may again find that antihistamines provide relief.

If you notice a pustule developing over where the bite was sustained, or if the area becomes very red and warm to the touch, it may be a sign that infection is developing. In these instances, you should approach your doctor for help.


Fleas are most typically be found in the fur of pets or stray cats and dogs. While they’re a domestic pest fairly common in the UK, we may be more likely to run into stray animals when we’re abroad and consequently contract flea bites.

These tend to form in groups of small red bumps. They will most commonly occur on the legs, ankles and feet (particularly if an animal brushes against someone) or on the arms (if stroking an animal). Those who are sensitive to bites may develop bullae or blistering.

Generally, they aren’t as likely to spread disease as other insect bites. But flea bites will itch and cause irritation, which may cause some to scratch and re-open the wound; potentially priming the area for infection.

How do you treat the bite?

Keeping the bite site clean is once again very important. Antihistamines can aid those who develop sensitivity reactions due to allergies, and covering the bite with antiseptic cream and a plaster will also discourage scratching and allow the region to heal.

Bed bugs

Another example of a pest which can be found in some homes here in the UK, bed bugs are however much more likely to be present in short-stay hotel beds you might encounter on holiday. They tend to reside in the nooks and crannies of mattresses, and usually leave behind small black dots (faecal matter).

They cause very similar-sized red raised bumps, usually on the upper body and arms, and it’s very easy to mistake bed bug bites for those of a midge or mosquito. The key difference is the grouping of the bites. Mosquito bites tend to be sporadic, whereas it’s not uncommon to find a straight line of bed bugs bites, or a collection in a tight group (as depicted in the diagram).

How do you treat the bite?

Often you won’t need to. Once more, the bites are very itchy, but will clear up after a few days. The usual precautions, such as keeping them clean and free from bacteria, will help to reduce the chances of infection.

It’s important to note that infestations can easily be spread from one location to another. If you suspect that you’ve encountered bed bugs on holiday, make sure you shower well and wash all the clothes you took with you upon your return to limit the likelihood of transferring them to your own bed.