Are you one of these people who loathes spending time outdoors at dusk as the weather warms and mosquitoes start biting?

Female mosquitoes need blood to develop their eggs. Even though they take a tiny amount of our blood, they can leave us with itchy red lumps that can last days. And sometimes something worse.

So why does our body react and itch after being bitten by a mosquito? And why are some people more affected than others?

What happens when a mosquito bites?

Mosquitoes are attracted to warm blooded animals, including us. They’re attracted to the carbon dioxide we exhale, our body temperatures and, most importantly, the smell of our skin.

The chemical cocktail of odours from bacteria and sweat on our skin sends out a signal to hungry mosquitoes.

Some people’s skin smells more appealing to mosquitoes, and they’re more likely to be bitten than others.

Once the mosquito has made its way to your skin, things get a little gross.

The mosquito pierces your skin with their “proboscis”, their feeding mouth part. But the proboscis isn’t a single, straight, needle-like tube. There are multiple tubes, some designed for sucking and some for spitting.

Once their mouth parts have been inserted into your skin, the mosquito will inject some saliva. This contains a mix of chemicals that gets the blood flowing better.

There has even been a suggestion that future medicines could be inspired by the anti-blood clotting properties of mosquito saliva.

It’s not the stabbing of our skin by the mosquito’s mouth parts that hurts, it’s the mozzie spit our bodies don’t like.

Are some people allergic to mosquito spit?

Once a mosquito has injected their saliva into our skin, a variety of reactions can follow. For the lucky few, nothing much happens at all.

For most people, and irrespective of the type of mosquito biting, there is some kind of reaction. Typically there is redness and swelling of the skin that appears within a few hours, but often more quickly, after just a few minutes.

Occasionally, the reaction can cause pain or discomfort. Then comes the itchiness.

Some people do suffer severe reactions to mosquito bites. It’s a condition often referred to as “skeeter syndrome” and is an allergic reaction caused by the protein in the mosquito’s saliva. This can cause large areas of swelling, blistering and fever.

The chemistry of mosquito spit hasn’t really been well studied. But it has been shown that, for those who do suffer allergic reactions to their bites, the reactions may differ depending on the type of mosquito biting.

We all probably get more tolerant of mosquito bites as we get older. Young children are certainly more likely to suffer more following mosquito bites. But as we get older, the reactions are less severe and may pass quickly without too much notice.

How best to treat the bites?

Research into treating bites has yet to provide a single easy solution.

There are many myths and home remedies about what works. But there is little scientific evidence supporting their use.

The best way to treat mosquito bites is by applying a cold pack to reduce swelling and to keep the skin clean to avoid any secondary infections. Antiseptic creams and lotions may also help.

There is some evidence that heat may alleviate some of the discomfort.

It’s particularly tough to keep young children from scratching at the bite and breaking the skin. This can form a nasty scab that may end up being worse than the bite itself.

Applying an anti-itch cream may help. If the reactions are severe, antihistamine medications may be required.

To save the scratching, stop the bites

Of course, it’s better not to be bitten by mosquitoes in the first place. Topical insect repellents are a safe, effective and affordable way to reduce mosquito bites.

Covering up with loose fitted long sleeved shirts, long pants and covered shoes also provides a physical barrier.

Mosquito coils and other devices can also assist, but should not be entirely relied on to stop bites.

There’s another important reason to avoid mosquito bites: millions of people around the world suffer from mosquito-borne diseases. More than half a million people die from malaria each year.

In Australia, Ross River virus infects more than 5,000 people every year. And in recent years, there have been cases of serious illnesses caused by Japanese encephalitis and Murray Valley encephalitis viruses.

Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Voluntary assisted dying is now lawful in every Australian state and will soon begin in the Australian Capital Territory.

However, it’s illegal to discuss it via telehealth. That means people who live in rural and remote areas, or those who can’t physically go to see a doctor, may not be able to access the scheme.

A federal private members bill, introduced to parliament last week, aims to change this. So what’s proposed and why is it needed?

What’s wrong with the current laws?

Voluntary assisted dying doesn’t meet the definition of suicide under state laws.

But the Commonwealth Criminal Code prohibits the discussion or dissemination of suicide-related material electronically.

This opens doctors to the risk of criminal prosecution if they discuss voluntary assisted dying via telehealth.

Successive Commonwealth attorneys-general have failed to address the conflict between federal and state laws, despite persistent calls from state attorneys-general for necessary clarity.

This eventually led to voluntary assistant dying doctor Nicholas Carr calling on the Federal Court of Australia to resolve this conflict. Carr sought a declaration to exclude voluntary assisted dying from the definition of suicide under the Criminal Code.

In November, the court declared voluntary assisted dying was considered suicide for the purpose of the Criminal Code. This meant doctors across Australia were prohibited from using telehealth services for voluntary assisted dying consultations.

Last week, independent federal MP Kate Chaney introduced a private members bill to create an exemption for voluntary assisted dying by excluding it as suicide for the purpose of the Criminal Code. Here’s why it’s needed.

Not all patients can physically see a doctor

Defining voluntary assisted dying as suicide in the Criminal Code disproportionately impacts people living in regional and remote areas. People in the country rely on the use of “carriage services”, such as phone and video consultations, to avoid travelling long distances to consult their doctor.

Other people with terminal illnesses, whether in regional or urban areas, may be suffering intolerably and unable to physically attend appointments with doctors.

The prohibition against telehealth goes against the principles of voluntary assisted dying, which are to minimise suffering, maximise quality of life and promote autonomy.

Doctors don’t want to be involved in ‘suicide’

Equating voluntary assisted dying with suicide has a direct impact on doctors, who fear criminal prosecution due to the prohibition against using telehealth.

Some doctors may decide not to help patients who choose voluntary assisted dying, leaving patients in a state of limbo.

The number of doctors actively participating in voluntary assisted dying is already low. The majority of doctors are located in metropolitan areas or major regional centres, leaving some locations with very few doctors participating in voluntary assisted dying.

It misclassifies deaths

In state law, people dying under voluntary assisted dying have the cause of their death registered as “the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying”, while the manner of dying is recorded as voluntary assisted dying.

In contrast, only coroners in each state and territory can make a finding of suicide as a cause of death.

In 2017, voluntary assisted dying was defined in the Coroners Act 2008 (Vic) as not a reportable death, and thus not suicide.

The language of suicide is inappropriate for explaining how people make a decision to die with dignity under the lawful practice of voluntary assisted dying.

There is ongoing taboo and stigma attached to suicide. People who opt for and are lawfully eligible to access voluntary assisted dying should not be tainted with the taboo that currently surrounds suicide.

So what is the solution?

The only way to remedy this problem is for the federal government to create an exemption in the Criminal Code to allow telehealth appointments to discuss voluntary assisted dying.

Chaney’s private member’s bill is yet to be debated in federal parliament.

If it’s unsuccessful, the Commonwealth attorney-general should pass regulations to exempt voluntary assisted dying as suicide.

A cooperative approach to resolve this conflict of laws is necessary to ensure doctors don’t risk prosecution for assisting eligible people to access voluntary assisted dying, regional and remote patients have access to voluntary assisted dying, families don’t suffer consequences for the erroneous classification of voluntary assisted dying as suicide, and people accessing voluntary assisted dying are not shrouded with the taboo of suicide when accessing a lawful practice to die with dignity.

Failure to change this will cause unnecessary suffering for patients and doctors alike.

Michaela Estelle Okninski, Lecturer of Law, University of Adelaide; Marc Trabsky, Associate professor, La Trobe University, and Neera Bhatia, Associate Professor in Law, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.