How to protect yourself from (and treat) mosquito bites
Fortunately bites from mozzies and gnats in the UK are generally little more than an irritation, but elsewhere they pose a major threat, transmitting infectious diseases such as malaria, dengue, yellow fever, zika virus and chikungunya — all of which can be brought home by returning travellers.
Indeed, the UK Health Security Agency has recently released data on chikungunya — a viral infection that causes fever and joint pain — that shows a threefold increase in cases in England during the first six months of this year. It is still rare at 73 confirmed cases, far fewer than the 1,000 or so people with malaria that you would expect during the same period in the UK.
• Read more from Dr Mark Porter
While anti-malarial drugs and vaccines can help to protect against some of the nastier threats abroad, the most basic defence is simply to avoid being bitten — something that applies here in the UK too, if you want to make the most of your time outside. And, as with any battle plan, the first step is to understand your enemy.
Mosquitoes are a problem at dusk and, in hotter countries, at dawn. Their primary source of energy is nectar from plants, but females have to supplement their diet because of the demands of egg production and so turn to sucking blood. And while they use a combination of sensory cues — visual, olfactory, thermal — to target you, the carbon dioxide in your breath is one of the most important ones.
Put simply, mozzies can detect ambient CO2 levels and fly 'upstream' towards the highest concentration (you). And it's not only your breath that will attract them but also the CO2 in the fumes from your candles and barbeque. And here's where a decent repellent such as Deet can help: not only does it make your skin taste nasty if they do find you, it is also thought to act as a cloaking device, jamming their CO2 sensors and making you harder to locate.Like most people, I don't like plastering myself with chemicals, but I have always favoured Deet over 'natural' repellents such as citronella — and it is a stance backed by research. One study comparing 16 commercially available repellents found that volunteers using 24 per cent Deet were protected for an average of just over five hours when they put their arms in a tank full of mosquitoes. Meanwhile those using 10 per cent citronella (the strongest tested) were bitten within 20 minutes. Some studies have shown citronella in a more favourable light, but I would still stick to Deet or other proven products containing PMD, IR3535 and picaridin.
• Read more expert advice on healthy living, fitness and wellbeing
And be wary of lighting lemon-scented or citronella candles: even if they do contain something that will repel mosquitoes (and many don't), the CO2 they produce may negate that benefit. You should also avoid using too much aftershave and perfume because fragrances may attract bugs. Last but not least, ensure that you cover up — anything from socks and trousers to protect your legs to sleeping under a mosquito net in trouble spots abroad.
If you are still bitten — and you will be — most cause short-lived problems, but if troublesome the best remedy is typically to apply a topical steroid cream (hydrocortisone) and take an antihistamine. If the redness and swelling worsens or the area becomes painful and/or is weeping despite trying both medications, then it may be infected and you should seek medical advice. However, redness and swelling, even if marked, is normally caused by inflammation triggered by a delayed immune reaction to anticoagulants injected by the mosquito. An inflamed bite tends to be itchy, whereas an infected one is more likely to be sore or painful. However it can be hard to tell the difference and antibiotics are often over-prescribed by doctors who prefer to err on the side of caution.
How your body reacts to bites depends to some extent on how often you have been bitten before. If you have never been bitten by a mosquito, then you probably won't react much at all. If, like most of us, you have been bitten numerous times, then you can react quite badly. And at the other end of the spectrum, if you have been bitten frequently for years then the reaction may start to wane — a variation in the immune response that may explain why some people (my wife, Ros) seem to be bitten more than others (me). Alternative explanations are available …
The UK Health Security Agency is concerned about the rise in cases of infection with the chikungunya virus in returning travellers to the UK.
The virus is spread by bites from infected mosquitoes. Affected regions include Africa, southeast Asia, the Indian subcontinent, the Pacific region, the subtropical regions of the Americas and the Caribbean.
Most cases identified this year have been found in travellers returning from Sri Lanka, India and Mauritius.
Chikungunya is normally a self-limiting condition that causes one to two weeks of fever, muscle and joint pain, headaches, and skin rashes. However, the joint pain can be severe and persist for much longer. Rarely, the infection can be fatal.
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The Sun
30 minutes ago
- The Sun
I moved to Spain 4 years ago & will never be bored of it – I don't work & pick my kids up from school & go to the pool
A MUM has shared how her family ditched the UK to live in Spain four years ago and will 'never be bored' of her new life. Jodie Marlow, who shares clips of her new sunny lifestyle online, shared how she doesn't miss the rainy weather at all, and spends her days enjoying the sun. 5 5 Jodie, who is a stay-at-home mum, said her two boys finish school at 1.30pm in summer and they spend afternoons playing in the pool. In a clip on her @jodiemar1ow account, which has over 1,790 likes, she said: 'Four years in & don't think I'll ever get bored of this.' She added that the weather is perfect for her, with temperatures in the top 20s or 30s every day. Jodie said: 'It's not too hot, not too cold. Like, I can wear my nice summer dresses, which I love.' When her kids are at school, she spends her time picking up fruit and veg at the local market, or going for a pamper, including laser hair surgery. She then does housework before picking up the boys and having some lunch with them. Meanwhile, weekends are spent exploring gorgeous nearby beaches and dining out in local restaurants. MOVING TO SPAIN Finally, Jodie advised people on how they can also make the move to Spain. She shared: 'If you hold a UK British passport, you can't just move to Spain like you could pre-Brexit, you do need a visa. 'The working visa you could look into getting dependent on if you've got a specialised job. I quit my job and did a complete 180 moving to Spain - beer is just $3 a pint and my life is so much better 'The self-employed visa, basically they said to us it's just impossible to get, so we didn't even try with that. 'But the digital nomad visa allows anyone that is working online, as long as you are earning a set amount of money that provides for if there's four of you for the family, you can pay for all four of you, and they set out exactly how much that would be.' Since Brexit, UK citizens, and non-EU citizens require a visa to stay longer than 90 days. 5 SOCIAL REACTION Many people were quick to chime in and comment on her new life in Spain, and praise her for making the move. One said: 'It's beautiful there, my sister moved there 26 yrs ago, no regrets.' A second added: 'I don't think you could ever get bored of that lifestyle.' Meanwhile, and a third joked: 'You sure you wouldn't rather be stuck indoors looking out at the rain?' Jodie replied: 'deffo don't miss that side of the uk.' 5 How easy is it to move abroad? Brexit means British citizens now have to apply for visas to move to countries within the EU. While some countries residency restrictions are easier than others, here's what you need to do at home before moving: Notify HMRC about your upcoming move. Let your local authority know and provide a forwarding address. Contact your mortgage and utility providers and bank before leaving. If you have paid enough UK national insurance contributions, you can qualify for a state pension abroad - contact the International Pension Centre. You can sign up to the Royal Mail's redirection service. If you have outstanding student loans, contact the Student Loans Centre. If you have children, give due notice to childcares and schools.
Telegraph
2 hours ago
- Telegraph
What sharing a bottle of wine with your spouse every night really means for your health
Since they first met in 2009, Sarah Wellband and her partner James have settled into a nightly routine which involves, at the minimum, sharing the best part of a bottle of wine together. 'We have a gin and tonic, followed by two or three glasses of wine with dinner and watching TV,' says Wellband, a 62-year-old remedial hypnotherapist. Such a routine, seven nights a week, would probably amount to somewhere between 46 and 62 units of alcohol per week, depending on whether that third glass of wine was consumed – far more than the NHS recommended guidelines of 14 units. However, Wellband says that the drinking habits of her and her 70-year-old partner are far from an issue. Instead, she insists that they form an important part of their general wellbeing. '7pm is news and a drink time,' she says. 'It signals the end of the day and time to wind down and catch up with each other. The routine is more important than the alcohol, but it helps. We are well aware of our limits and will leave a glass rather than finish it for the sake of it, but we just find it a nice way to end the day.' Recently however, the potentially long-term harm from excessive daily drinking has been brought once more to the spotlight. Earlier this year, a study found that consuming more than eight alcoholic drinks a week increases your risk of incurring the brain degeneration commonly linked with dementia, while former TV executive Martin Frizell recently gave an interview about his wife Fiona Phillips's battle with early-onset Alzheimer's, and openly mused as to whether their habit of drinking a bottle of wine a night in their younger years had been a contributing factor. Yet the link between alcohol and chronic diseases is a little more nuanced than often portrayed. While excessive drinking has been identified as a direct cause of at least seven types of cancer and a known risk factor for dementia, the exact risk varies considerably from person to person. As Debbie Shawcross, professor of hepatology and chronic liver failure at King's College London, explains, women have far lower levels of the enzyme that breaks down alcohol compared with men, which makes them more susceptible, and studies have even shown that women are more likely to display signs of 'leaky gut' – a term which characterises greater intestinal permeability, meaning that toxins are more likely to leak out into the bloodstream – following a binge than men. An alcohol 'binge' is characterised as more than six units (a standard-sized glass of wine contains 2.1 units) in a single session for women and eight units for men. Some people do also carry gene variants that improve alcohol metabolism, allowing them to knock back the booze with no apparent ill effects – and Wellband says that she and her partner never get drunk on their nightly routine – while your diet can also be a contributing factor. 'Environmental, social and lifestyle factors also play a role,' says Shawcross. 'For example, being overweight or having an unhealthy diet rich in ultra-processed foods can increase the risk of alcohol harm on the body.' On average though, sharing a bottle of wine every night with your spouse isn't the greatest thing for your long-term health. Here's the very latest on how this amount of daily booze can affect your body, and what some of the UK's leading experts advise in terms of how to still enjoy alcohol in a safer way. What are the effects on the brain? As Anya Topiwala, a senior clinical researcher at the University of Oxford, points out, half a bottle of wine a night works out at a minimum of 35 units per week for white wine and 42 units if you're only drinking red wine, which generally contains more alcohol per volume. 'If sustained, I would say there is a high likelihood of this negatively impacting your brain and memory,' she says. This comes from studies she's conducted which have found that people drinking more than 14 units per week, or seven medium-sized glasses of wine, have small total brain volumes, greater age-related shrinkage of the hippocampus – the brain's memory hub and one of the areas particularly impacted by Alzheimer's – and faster cognitive decline. 'Alcohol is a neurotoxin,' says Topiwala. 'Put simply, it kills brain cells. Additionally, heavy drinking often leads to a deficiency in vitamin B1 which can also damage the brain.' But it's not all doom and gloom. By reducing the amount you drink, even by a glass or two per week, it's possible to mitigate and even reverse some of these issues, something which Topiwala has witnessed first-hand in her practice as an old-age psychiatrist, with various patients seeing their short-term memory and recall improving after reducing their alcohol intake. 'I can think of many patients who have experienced a cognitive benefit from cutting down,' she says. What are the effects on the liver? Between 90 and 98 per cent of the alcohol you consume is broken down by your liver, making it one of the organs most acutely impacted by booze. Based on her own clinical and research knowledge, Shawcross says that people consuming half a bottle of wine per night will be particularly at risk of developing fatty liver – a condition where the liver becomes progressively clogged up with harmful visceral fat. Over time, this makes you more prone to cirrhosis or scarring and liver cancer. But she says that cutting down, even slightly, would undoubtedly help. 'There is no safe level of drinking, but if you didn't drink at all for two to three nights per week, there would be even more benefits,' says Shawcross. 'For example, you'd see a reduction in the amount of liver fat, as measured on a scan.' Shawcross is keen to point out that if you are not getting drunk, as noted by Wellband and her partner, it is not necessarily a sign that you have a protective gene variant which allows you to metabolise alcohol more quickly, limiting its damaging effects on the body. She explains that people can develop a tolerance to higher amounts of alcohol because the liver has a different group of enzymes which kick into action when there are consistently large amounts of alcohol in the bloodstream. This isn't a good thing, as harmful fat and other forms of damage will still be accruing, but it makes you less aware of alcohol's effects. 'When this different set of enzymes is consistently activated, it means you need to drink more alcohol to feel its effects,' she says. What is the effect on the heart? Consuming more than 7.5 units of alcohol a day – or most of a bottle of wine by yourself – is thought to increase risk of hypertension, where the pressure on your blood vessels is too high. Over time, this may lead to other issues such as arrhythmia or abnormal heart rhythms. 'Alcohol increases blood pressure and if this is untreated, it puts strain on the heart,' says Shawcross. Studies have indicated that hypertension risk seems to increase proportionally with the amount you drink. So a glass of wine per day will still make you more susceptible than not drinking at all, but is certainly less problematic than two or three glasses. What are the effects on the muscles and bones? As John Kiely, a researcher at the University of Limerick, puts it, alcohol accelerates many of the ravages of ageing, from loss of muscle to reduced coordination and increased vulnerability to twinges, strains and other injuries. In particular, if you've consumed half a bottle of wine one night, it probably isn't a wise idea to hit the gym or do some vigorous gardening the next day as the alcohol will impair your immune system's ability to reach and repair any damaged muscles or tendons, leaving you feeling all the more tender and sore. If you are drinking half a bottle of wine on a regular basis, Kiely suggests that you will be much more likely to get injured. There's also the matter of the progressive muscle and bone loss which most of us experience as part of ageing. Studies have long shown that regular, heavy drinking in middle age accelerates bone weakness and interrupts normal cycles of muscle repair, making it harder to hold onto the strength we have, as we age. 'An otherwise healthy diet and lifestyle will reduce these risks but persistent heavy drinking drives progressively accumulating issues that a healthy lifestyle alone can't fully counteract,' says Kiely. 'For example, alcohol lowers levels of key hormones [for muscle growth] like testosterone and growth hormone, while cortisol, a key stress hormone that drives muscle breakdown, rises. And because alcohol also reduces the absorption of calcium and suppresses the activity of bone-building cells, you're likely to have a faster decline in bone density, making your bones more fragile.' The good news is that such effects do not seem to be as pronounced with moderate drinking. 'A single glass of wine a night for women, or two for men, is unlikely to cause measurable harm to muscle health and little risk for bone health,' says Kiely. 'This is particularly the case for people who stay active and eat well.' What is the effect on how quickly you age? Drinking too much has long been associated with faster signs of visible ageing, such as more wrinkles, saggy skin and a duller complexion, but we now know that consuming half a bottle of wine each night actually ages you at the DNA level. In 2022, Topiwala carried out a study showing that consuming more than 17 units of alcohol per week – or around eight standard glasses of wine – causes damage to the tips of chromosomes, known as telomeres, which play an important role in keeping your DNA stable. 'Alcohol directly damages DNA, causing breaks and mutations,' says Topiwala. 'This is thought to explain why alcohol increases cancer risk.' What you can do to limit the risks While all of this may seem like something of a downer, all these risks are most apparent when it comes to heavy drinking. Research has also repeatedly shown that we can still enjoy alcohol throughout mid and later life and minimise the negative impacts on our health through having a few non-drinking days each week, eating well and exercising, and, particularly, consuming alcohol with a meal wherever possible. For example, one study of more than 300,000 people in the UK found that people who predominantly drank alcohol with meals had a 12 per cent lower risk of premature death from cardiovascular diseases and cancer, compared with those who mainly consumed their alcohol on its own. But for Wellband, like many others, the idea of changing the nightly drinking routine is not something that she and her partner are willing to contemplate, at least for now. 'We have no intention of changing our ways,' she says. 'Although I was adopted I have since discovered my birth mother is 82 and still drinks two or three glasses of wine every night so I'm following her lead. My partner and I have gradually reduced the amount we drink – on the rare occasion we go out for lunch we'll now have a glass of wine each rather than a bottle. Living on a farm with horses and other animals means that we have to be fit and active, but equally we enjoy our evening drinks and would be loath to give them up.' How can you adjust your drinking habit? For anyone looking to try to switch to drinking less, Dr Richard Piper, chief executive at Alcohol Change UK, offers the following guide: Try to spread your week's alcohol across more days Our bodies and our minds are grateful for any breaks we can give them. Pepper your week with several alcohol-free days. Aiming for fewer than five units in a single day will mean your overall weekly consumption should drop. Replace with lower-strength or alcohol-free alternatives There is a wonderful range and availability of alcohol-free alternatives in shops, pubs and bars now, which are improving year on year. Our taste testers particularly recommend the Mash Gang ranges of alcohol-free beers (Journey Juice and Lesser Evil were given a 5/5 rating), while Nozeco Spritz is an alcohol-free cocktail which stands out from others on the market. For wine, our tasters suggested Lindeman's Cabernet Sauvignon as a reliable alcohol-free red to go with a steak dinner. Download the free Try Dry app Developed by experts using behaviour-change science, this app allows you to track your consumption, take a health quiz to see what your current relationship with alcohol looks like and access tips and ideas on cutting back. Try having some alcohol-free weeks Not every week needs to have alcohol in it. In fact, if this idea feels alien to you, that is a sure sign you might have a stubborn drinking habit. Having one or two whole weeks off alcohol every month is a great way to cut back. Sarah Wellband's hypnotherapy clinic, Out of Chaos Therapy, advises on how to change problematic behaviours from disordered eating to phobias
The Guardian
2 hours ago
- The Guardian
Michael Göpfert obituary
My husband, Michael Göpfert, who has died of cancer aged 77, was a consultant psychotherapist and child psychiatrist in Merseyside. In 1985 he set up a new psychotherapy service at the Royal Liverpool hospital, with integration at its heart, ensuring that therapists from different disciplines each had some training in another therapeutic method. Michael saw that separating adult and child services when a parent had a severe mental illness meant that the effect on the children was often missed. He was an early proponent of this neglected area and edited the book Parental Psychiatric Disorder (1996). He worked closely with Barnardo's Young Carers and its Keeping the Family in Mind service in Liverpool, now well established but innovative when it began. Michael also trained medical students in communication skills, supervised many psychiatric trainees and brought cognitive analytic therapy training to Merseyside. He was always prepared to take on difficult issues that others avoided. Michael was born in Munich in the postwar years, the youngest of the four sons of Herbert Göpfert, a publisher, and his wife, Hildegard (nee Klaiber). As a teenager, he lived in the Bavarian Alps where he felt at home, climbing, walking, swimming, and playing the piano and the harpsichord. He wanted to be a pianist, but when he was 20, his mother died suddenly and he lost direction. He went on to study nursing, then medicine, and became part of the political youth movement confronting the legacy of nazism. Alienated by the oppressive culture in Germany and attracted by the NHS and new developments in community psychiatry, in 1978 he moved to London for training. He completed child psychiatry training in Toronto, where he also discovered the Canadian wilderness, kayaking and First Nations culture. He found that most adult psychiatrists did not even know if their patients had children, a finding repeated when he returned to the UK, and this sparked his interest in parental mental illness. He took up the post in Liverpool and made Merseyside his home, while also studying for a master's in family therapy at the Tavistock Institute in London. Michael had grown up not knowing anyone Jewish and with the Holocaust never talked about. He lived with the huge guilt that many young Germans felt at that time. At the Tavistock he met me, a child of German Jewish political refugees. We both came to understand more the position of the 'other' and how victim and perpetrator roles could alternate. We married in 1989, and I moved to Merseyside to work as a child psychiatrist. There our three children were born. Michael loved music, cycling, foraging and baking – after retirement in 2010 he set up a community bakery. He restored and developed all our family homes. In recent years we lived between Liverpool and north Wales; in Wales, Michael rediscovered some of what he had missed from Bavaria, and there, as a legacy project, he planted a field of truffle trees. Michael is survived by his children, Anya, Max and Leo, his grandchildren, Aria and Luca, his brothers Dieter and Christian, and me.
