EPA-Registered Repellents for Mosquitoes Transmitting Emerging Viral Disease

Abstract

In many parts of the United States, mosquitoes were previously nuisance pests. However, they now represent a potential threat in the spread of viral diseases. The Aedes aegypti, Aedes albopictus, and Culex species mosquitoes are endemic to the United States and together may transmit a variety of viral diseases of growing concern, including West Nile virus, chikungunya, dengue fever, and Zika virus. The Centers for Disease Control and Prevention and the Environmental Protection Agency (EPA) recommend N,N-diethyl-meta-toluamide (DEET) as a first-line mosquito repellent, but for patients refusing to use DEET or other conventional repellents, guidance is limited to any EPA-registered product. Therefore, we conducted a systematic review of the literature to identify which EPA-registered personal mosquito repellent provides the best protection from A. aegypti, A. albopictus, and Culex spp. mosquitoes. We abstracted data from 62 published reports of EPA-registered mosquito repellents. The conventional repellent picaridin has the strongest data to support its use as a second-line agent, while IR3535 and oil of lemon eucalyptus are reasonably effective natural products. Citronella, catnip, and 2-undecanone offer limited protection or have limited data. These results can be used by pharmacists and other health care professionals to advise patients on the selection of an EPA-registered mosquito repellent. Regardless of the repellent chosen, it is vital for patients to follow all instructions/precautions in the product labeling to ensure safe and effective use.

Does Zika virus infection affect mosquito response to repellents?

“…It is conceivable that Consumer Reports considered in their overall assessment other properties (e.g., odour, ability to dissolve plastic) for which picaridin ranks better than DEET. Because of these properties and concern raised by patients, dermatologists recommend picaridin as a second-line agent, but concluded based on peer-reviewed literature that DEET demonstrated a strong and consistent ability to reduce mosquito biting relative to other repellents 32 .…”

Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies

“…The use of a mosquito repellant such as DEET, oil of lemon eucalyptus, IR3535, or picaridin is as important as using long sleeves and long pants while in an affected area. DEET and picaridin are safe in pregnancy, and some data support their greater efficacy [ 65 ]. Air conditioning and fans tend to keep mosquitoes away but netting at night is essential in mosquito-prone areas.…”

Reflexion on Bio-Sourced Mosquito Repellents: Nature, Activity, and Preparation

“…The manufacturer Merck claims that IR3535 is inspired from nature (Discover the Insect Repellent IR3535 R | Merck Global, 2019), while Islam et al have classified IR3535 as a natural/synthetic repellent at the same time (Islam et al, 2017). Its chemical structure (Figure 1) is indeed inspired from β-alanine, an amino acid naturally occurring in two peptides carnosine and anserine, and in pantothenic acid (Patel et al, 2016). But this structural analogy with β-alanine causes confusion; the chemical synthesis of IR3535 brings clarity to the situation.…”