Summer? No Sweat.

SUMMER HEALTH HAZARDS

Bee, Wasp and Hornet Stings

For most people, a sting from a member of the Hymenoptera order (for example, bees, wasps, hornets, ants, etc.) usually results in nothing more than a painful swelling that disappears in a matter of hours. However, some people suffer allergic reactions to these kinds of stings. Symptoms of allergic reactions include dizziness, headaches, abdominal cramps or extreme nausea.

Other warning signs of an allergic reaction include breathing difficulties and hives or swelling in an area of the body other than where the sting occurred. The first allergic reaction is usually not severe, but should serve as a warning. The first sting sensitizes the victim, and additional stings result in increasingly severe reactions. Consult a physician the first time an allergic reaction occurs. If you are seriously allergic, your doctor may advise desensitization or that you carry a special kit containing emergency medicines to combat the allergic reaction.

If the stinger remains in the skin, remove it by gently scraping away or by gently teasing it out with a clean pointed instrument. Do not squeeze; this may inject more venom into the skin. Thoroughly wash Hymenoptera stings, and all insect bites, with soap and water. Apply an antiseptic anti-inflammatory ointment or cream, or a paste made of baking soda and water, to relieve itching and to prevent infection. If more serious symptoms occur, especially those indicating an allergic reaction, seek medical attention promptly.

Whether or not you are allergic to Hymenoptera stings, they are unpleasant and an experience to avoid. Follow these tips to discourage the attention of bees, wasps and hornets:

• Avoid scented products such as perfume, hair spray, suntan lotion, cosmetics, deodorant, shaving lotion, etc.

• Do not wear brightly colored and patterned clothes.

• Do not go barefoot, especially through vegetation.

• Do not swat at bees and yellow jackets with bare hands. Move slowly and steadily, and gently brush the insects off.

• Do not sit on or handle wet towels, washcloths, etc., without first making sure no insect is drinking the moisture.

• When a bee or a wasp gets into a moving car, remain calm; safely pull the car off the road, open the window and allow it to escape.

• Keep garbage in tightly sealed containers.

• Hypersensitive persons should wear a bracelet or necklace or carry a medical alert card indicating they are susceptible to shock-like symptoms or unconsciousness after a bee sting.

• Insect repellants used to repel mosquitoes and other biting flies will not repel wasps and bees.

Finally, be watchful when cooking, eating, and drinking outdoors, especially during yellow jacket season, which heightens in late summer. Check for insects on food and in open drink containers before eating and drinking. Keep food covered.

Ticks

The bite of a tick is seldom serious, unless the tick is infected with Rocky Mountain spotted fever, ehrlichiosis, Lyme disease or tularemia.

Avoid areas where ticks are likely to be found. Ticks cling to vegetation and are most numerous in brushy, wooded or grassy habitats. They are not typically found on open sandy beaches, but may be found in grassy dune areas.

Rocky Mountain spotted fever, (RMSF) is a serious disease transmitted by ticks. Cases of RMSF occur each year in Illinois. The most common carrier is the American dog tick (wood tick). The adult tick is dark brown or black, with white markings behind the “head” (mouth parts). The lone star tick is involved less frequently.

Symptoms of Rocky Mountain spotted fever generally develop within three to 14 days of the bite of an infected tick. The first symptoms are —

• Sudden onset of fever

• Deep muscle aches

• Ssevere headache

• Eye irritation

About three days after these symptoms appear, a red, spotty rash may develop, usually on the arms and legs and often on the palms of the hands and the soles of the feet. It can include the rest of the body.

If these symptoms develop, seek medical attention immediately. It is important to inform the physician of any recent tick bites or exposure to ticks. This information allows the physician to consider Rocky Mountain spotted fever as a possible diagnosis.

Rocky Mountain spotted fever can be fatal. If diagnosed early, however, it is often successfully treated with antibiotics.

Ehrlichiosis is a disease of humans and animals caused by bacteria that infect white blood cells and are transmitted by the bite of an infected tick. The lone star tick, the American dog tick (wood tick) and the deer tick (black-legged tick) have been associated with ehrlichiosis.

Symptoms typically begin between one and three weeks after exposure to an infected tick. Symptoms can be so mild that no medical care is sought, or the illness can be severe, life threatening or fatal. Symptoms include —

• Fever

• Headache

• Muscle aches

• Loss of appetite

• Nnausea

• Vomiting

A rash may occur but is usually not present.

Any person experiencing illness with a fever after a tick bite should consult his/her physician and advise the physician the tick bite occurred.

Ehrlichiosis can be treated with certain antibiotics. Treatment should be considered if the diagnosis of ehrlichiosis is suspected, since delay in treatment while awaiting laboratory confirmation may increase the risk of severe disease.

Lyme disease is acquired from the bite of a tick infected with the Lyme disease bacterium. The tick that most commonly transmits this disease, the deer tick, acquires the bacteria when it feeds on infected wild animals, such as field mice or other mammals. It can then transmit the bacteria when feeding on a human.

Ticks can be small; they may be about the size of a pin head. Because they are so small you may not notice one that is attached to your body. Therefore, unless you are on the lookout for ticks, you may not realize you have been bitten.

Early Lyme disease symptoms include an expanding red ring-like rash that may appear around the area of the tick bite anywhere from a few days to a month after you have been bitten. The rash expands, often to a large size. It is usually circular but can vary in shape, depending on its location. The center of the rash may clear as it enlarges, resulting in a ring-like appearance. Other symptoms may include fatigue, headache, fever, and achy muscles and joints. Early in its course, Lyme disease can be effectively treated with antibiotics.

If not treated, symptoms may disappear or recur intermittently for several weeks, months or even years. Other complications — such as an irregular heartbeat or problems with the nervous system, including intermittent headaches, stiff neck, poor motor coordination, meningitis or encephalitis — also may occur after several weeks or months. Some patients may develop muscle weakness of the limbs or of the face — a drooping eyelid or corner of the mouth known as Bell’s palsy. Joint pain and swelling (Lyme arthritis) in one or several large joints, especially the knees, may develop in late-stage Lyme disease.

Generally, antibiotic treatment for both early and late-stage Lyme disease is successful.

Tularemia (rabbit fever) is another disease that can be tickborne. It occurs infrequently in Illinois and is usually acquired by direct contact with infected rabbits. However, several cases of tularemia from tick or deerfly bites have occurred in recent years. A deerfly is a large fly, up to ½-inch long, that has a very painful bite and often leaves a drop of blood at the site of the bite. The American dog tick and the lone star tick are the ticks most commonly involved in the transmission of tularemia.

Tularemia is a bacterial infection. The first sign of this infection is a pimple-like bump, or papule, that appears at the site where the bacterium entered the skin. This papule, which may appear about three to five days after the bite of an infected tick or deerfly, usually develops into an open sore. There may be no apparent papule, but one or more swollen and painful lymph nodes may produce pus.

Other symptoms include —

• abrupt onset of fever

• chills

• malaise and fatigue

• headache

• loss of appetite

• swelling of lymph nodes closest to papule or open sore

If these symptoms develop, seek medical attention immediately. Inform the physician of any recent tick or deerfly bites or exposure to rabbit carcasses to help the doctor make a correct diagnosis more quickly.

Tularemia can be treated successfully with certain antibiotics, but can be fatal if not treated.

Preventing Tickborne Disease

The best way to protect yourself against tickborne diseases is to avoid tick bites. Follow these precautions if you live in or visit wooded or grassy areas:

• Wear light-colored, protective clothing — long-sleeved shirts, long trousers, boots or sturdy shoes, and a head covering.

• Apply insect repellent containing DEET to clothes and to exposed skin (except the face). Be sure to wash treated skin after coming indoors. Use repellents containing permethrin to treat clothes (especially pants, socks and shoes) — but not skin. Both repel or kill ticks on contact. Always follow label directions; do not misuse or overuse repellents. Always supervise children in the use of repellents. Do not use products containing DEET on infants.

• Check yourself, children and other family members every two to three hours for ticks. Most ticks seldom attach quickly and rarely transmit disease until they have been attached four to six hours.

• Remove any tick promptly. Do not use bare hands. The mouthparts of a tick are shaped like tiny barbs and may remain embedded and lead to infection at the bite site if not removed properly. The best way to remove a tick is to grasp it with tweezers as close to the skin as possible and gently, but firmly, pull it straight out. Do not twist or jerk the tick. If tweezers are not available, grasp the tick with a piece of tissue or cloth or whatever can be used as a barrier between your fingers and the tick.

• Wash the bite area and your hands thoroughly with soap and water, and apply an antiseptic to the bite site.

• To dispose of ticks, flush them down a toilet, toss them into a nearby stream or burn them in a campfire. Do not try to squash a tick. Squeezing it may release germs from the tick.

Mosquitoes

St. Louis encephalitis, West Nile virus and LaCrosse (California) encephalitis are the most likely mosquito-borne diseases to occur in Illinois. These infections are most prevalent in June through October when mosquitoes are active. Encephalitis is an inflammation of the brain and is often caused by viruses, including mosquito-borne viruses.

Fortunately, these viruses are transmitted only by a few types of mosquitoes, and usually only a small proportion of these mosquitoes actually carry the virus. Most mosquitoes that appear in Illinois are bothersome, but do not carry disease. Mosquitoes do not transmit human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

The northern house mosquito (Culex pipiens), the most common carrier of St. Louis encephalitis virusand West Nile virus, breeds in small, stagnant bodies of water and receptacles that contain water. It is infected with St. Louis encephalitis or West Nile virus by feeding on birds carrying the virus.

The tree-hole mosquito (Ochlertatus triseriatus ), the most common carrier of LaCrosse (California) encephalitis, is found in wooded areas and breeds in discarded tires and other items, as well as in tree holes. This mosquito is infected with LaCrosse encephalitis by feeding on infected chipmunks, squirrels and other small woodland animals carrying the virus.

The vast majority of those bitten by an infected mosquito experience mild or no symptoms of the disease. Only 1 percent to 2 percent develop recognizable symptoms. The symptoms of the three types of encephalitis are similar. Some persons may have mild symptoms such as a slight fever and headache. But severe infection may cause rapid onset of a severe headache, high fever, muscle aches, stiffness in the back of the neck, muscle incoordination, disorientation, convulsions and coma. Symptoms usually occur five to 15 days after the bite of an infected mosquito. These diseases are not transmitted from person to person.

Although anyone can be infected with a mosquito-borne virus serious illness from St. Louis encephalitis or West Nile virus usually occurs in persons older than 50 years of age. Most patients recover fully, although severe infection sometimes results in neurological damage or death. LaCrosse encephalitis most often occurs in children. Although symptoms are generally milder than those of St. Louis encephalitis or West Nile virus, and fatalities rarely occur, approximately 15 percent of those who become ill experience long-term neurological damage.

To prevent mosquito-borne encephalitis, eliminate potential mosquito breeding sites near your home by following these suggestions:

• Remove or empty water in old tires, tin cans, buckets, drums, bottles or other places where mosquitoes might breed. Be sure to check clogged roof gutters that may have poor drainage. Make sure cisterns, cesspools, septic tanks, fire barrels, rain barrels and trash containers are covered tightly with a lid or with 16-mesh screen.
  
  
• Empty plastic wading pools at least once a week and store indoors when not in use. Unused swimming pools should be covered or drained during mosquito season. (Note: If you choose to drain your pool, be sure the hydrostatic relief valve is open in order to keep it from floating out of the ground if the water table rises.)
  
  
• Change the water in bird baths and plant pots or drip trays at least once each week.
  
  
• Store boats covered or upside down, or remove rainwater weekly.
  
  
• Empty your pet’s water bowl daily.
  
  
• Level the ground around your home so water can run off and not collect in low spots. Fill in holes or depressions near your home that accumulate water.
  
  
• Fill in tree rot holes and hollow stumps that hold water.
  
  
• If you have an ornamental water garden, stock it with mosquito-eating fish (e.g., minnows, “mosquito fish,” or goldfish). They eat mosquito larvae.
  
  
• Keep weeds and tall grass cut short; adult mosquitoes look for these shady places to rest during the hot daylight hours. Spray shrubbery and high weeds to kill adult insects. (Check the insecticide label to make sure the spray will not damage flowers or ornamental plants.)
  
  
• Small impoundments of water can be treated for mosquito larvae with “Bti,” a bacterial insecticide. Many hardware stores carry doughnut-shaped Bti briquets for this purpose. Be sure to follow the insecticide label directions exactly.
  
  
• Some mosquito control methods are not very effective. Bug zappers are not effective in controlling biting mosquitoes. Various birds and bats will eat mosquitoes, but there is little scientific evidence that this reduces mosquitoes around homes.
  
  
• Community-wide mosquito abatement efforts can be quite effective if they are conducted as part of an integrated pest management program. This includes monitoring and draining or treating areas where mosquitoes breed – such as swamps and other low-lying areas.

• Avoid places and times when mosquitoes bite. Generally, the peak biting periods occur just before and after sunset and again just before dawn. Each species, however, has its own peak period of biting. Tree-hole and Asian tiger mosquitoes, for example, feed during daylight house in or near shaded or wooded areas.
  
  
• Be sure door and window screens are tight-fitting and in good repair.
  
  
• Wear appropriate clothing. When mosquitoes are numerous, long-sleeved tops and long pants made of tightly woven materials keep mosquitoes away from the skin. Be sure, too, that your clothing is light colored. Keep trouser legs tucked into boots or socks.
  
  
• Use mosquito netting when sleeping outdoors or in an unscreened structure and to protect small babies.
  
  
• Check to see that your mosquito repellent contains DEET, a chemical commonly found in these products. Generally, repellents with about 10 percent to 25 percent DEET work best for adults; use lower concentrations for children. Do not use repellents on infants. When outdoors, use an insect repellent that contains DEET (N,N-diethyl-m-toluamide ), oil of lemon eucalyptus or permethrin and apply according to the instructions on the label. Use repellents only on exposed skin or clothing and never apply over cuts, wounds or irritated skin. Do not use repellents on infants.

Rabies

The risk of encountering rabid animals may increase during the summer months when people spend more time working and relaxing outdoors.

In Illinois, skunks have traditionally been the main reservoir, or source, of rabies. However, most recent cases of human rabies in the U.S. have been caused by bat strains of rabies. Bats now account for the majority of rabid animal cases in Illinois. Rabies is transmitted to wildlife, farm animals, family pets and people through contact with the saliva of a rabid animal, usually after a bite.

An animal need not be “foaming at the mouth” to have rabies. Other signs, such as difficulty walking or a general appearance of sickness, indicate an animal may be in the early stages of rabies.

One of the most important signs of rabies is a change in the animal’s normal behavior. For example, if a wild animal that normally avoids human contact approaches a picnic area, campsite or farm house and appears tame or friendly, it may be rabid and should be avoided. On the other hand, if a domesticated and friendly animal (dog or cat) becomes hostile or aggressive without provocation, it, too, may be rabid.

When in areas where you are likely to encounter wildlife, stay away from all wild animals, as well as stray or unfamiliar dogs and cats. Due to the risk of rabies, make no effort to befriend or provide care for wild or stray animals, even if they appear friendly or in need of help. Call your county animal control office.

If you are bitten, scratched or have contact with the saliva of an animal that may be rabid, wash the wound thoroughly with soap and water, and contact a physician promptly. If exposed to an animal that is likely to be rabid, rabies vaccine and immune globulin should begin immediately. Your local health department will provide consultation on the need for rabies treatment.

Rabies vaccine prevents the disease but it is not a treatment for the disease. Once the symptoms of rabies develop, the disease cannot be treated and is almost always fatal. Fortunately, rabies has a comparatively long incubation period. When vaccine is given soon after exposure, your body has time to build up immunity to the disease before it develops. But the only way to prevent rabies after exposure is to receive the vaccine and immune globulin.

To protect against rabies —

• Avoid contact with all wild or stray animals, especially bats.

• Have the family dog, cat or ferret vaccinated against rabies.

• If bitten, wash wounds immediately.

• Seek medical attention and call your local public health agency. If a bat is found in your home or business, please contact animal control or your local health department for safe methods of capturing.

• If a bat bites someone or is found in the room with a very young child, someone who is sleeping or anyone who may be unaware about whether the bat bit them, the person should contact his/her local animal control and public health agencies. The bat will need to be safely collected and tested for rabies.

Food Poisoning

Picnics and cookouts top the list of summer activities. Keep in mind, however, you must take special precautions when preparing and serving food during warm weather if you are to avoid foodborne illnesses such as salmonellosis.

Foodborne illnesses occur when disease organisms are present on food or introduced by the food handler from unwashed hands or contaminated equipment and utensils. Follow these guidelines to help prevent foodborne illness:

• Wash your hands thoroughly with soap and warm water before handling any food and after handling raw poultry, meat or eggs.
  
  
• Cover cuts or open sores on your hands with a tape bandage and do not allow them to contact food or surfaces that will contact food.

• Thoroughly rinse fresh fruits and vegetables.

• Do not sneeze or cough over food.

• Use separate cutting boards or surfaces for raw meat, salad, vegetables or other foods served without cooking. Thoroughly wash all utensils and cutting boards used for raw meat and poultry. Some cutting surfaces can harbor bacteria in their ridges.

• Use separate bowls for raw poultry, meat or eggs to prevent them from coming into contact with foods served without cooking.

• Cook foods thoroughly, especially ground beef, poultry and pork. While rare beef is sometimes popular, disease-causing organisms can survive in undercooked meat and are especially likely to have been introduced in the slaughter process and mixed through the meat during grinding.

• Keep hot foods hot and cold foods cold.

Make sure to keep raw meat, fish or poultry cold until it is cooked. Be sure it does not come in contact with ready-to-eat food (e.g., cheese, sliced onions, tomatoes or bread). Also, never place cooked meats on the same plate or pan that held raw meats.

Do not serve hot foods until they are properly cooked (see cooking chart). Do not leave food unrefrigerated longer than one hour at a time or the chances of dangerous bacterial growth increase. Store and serve cold foods at temperatures below 40°F. In other words, do not let potentially hazardous foods reach that intermediate temperature at which microorganisms grow best — between 40°F and 140°F. Some popular cold picnic foods are potentially hazardous and require special care. Be particularly careful in handling —

• Any homemade food that contains eggs, meat or poultry such as: deviled eggs, and egg, chicken, tuna and potato salads. Dishes requiring a lot of handling are at greater risk of harboring dangerous bacteria when allowed to reach intermediate temperatures.

• Luncheon meats, sandwich fillings and other ready-to-eat protein foods

• Meat, fish or poultry.

• Milk and other dairy products.

Refrigerate these foods immediately after they are prepared and until they are served. Use insulated coolers with ice or cold packs to transport and store these foods.

After cooking meat, fish or poultry for salads or sandwiches that will be eaten cold (such as roast beef or chicken), cool quickly. Do this by dividing into smaller portions and refrigerating at once.

Foods served hot — especially creamed or scalloped dishes containing milk, eggs, cornstarch or flour — should be cooked just before picnic time and kept hot and covered until served.

Water for drinking, cooking and dishwashing must come from a safe and approved source. Bring water with you if safe water will not be available at the picnic site.

Place leftovers from potentially hazardous hot and cold foods in separate coolers on ice. Serve leftovers either very cold (right from the cooler) or very hot (reheated to 165°F or hotter).

The symptoms of most types of food poisoning include severe cramps, abdominal pain, nausea, vomiting and diarrhea. Symptoms typically begin from 30 minutes to three days after eating contaminated food.

Most cases of foodborne illness are mild, and the symptoms disappear in a day or two. If symptoms are severe or last longer than two days, contact a physician.

Home Canning

Home-canned foods can be a source of foodborne illnesses that may range from very mild to severe and, in extreme cases, result in death.

Botulism, caused by a bacterium, is the most serious of foodborne illnesses. In recent years, the source of nearly all botulism cases has been home-canned foods.

Bacterial spores are common in the soil and can be found on vegetables, fruits and even meat and fish. If home-canned food is not processed at a high enough temperature and pressure, bacterial spores can grow and produce a lethal toxin.

Acids help destroy bacteria, so foods high in acidity (most fruits) do not require as much heat during canning as do foods with low acid content (most vegetables).

To preserve low acid foods (vegetables), heat-process them under pressure at 240°F. Ten pounds of pressure in a steam-pressure canner corresponds to 240°F. Every particle of food in each jar must reach 240°F and stay at that temperature long enough to destroy all disease-causing organisms, usually at least 10 minutes.

Certain hybrid varieties of fruits and vegetables, especially tomatoes, have a lower acid content. You may need to add vinegar or increase the processing time for these hybrids.

High acid foods (fruits) must be boiled at 212° F to destroy disease-causing organisms.

Take the following precautions when canning foods:

• Wash hands, work and cutting surfaces and all utensils thoroughly.

• Use only high quality, unbruised and unspoiled products for canning.

• Thoroughly scrub raw fruits and vegetables.

• Check jars and lids for chips or defects and do not use those that are defective.

• Use only lids, seals and jars manufactured specifically for home canning.

• Follow proper canning procedures carefully.

• Do not reuse sealing lids. Purchase new seals, rings and lids.

• Test the seal according to the manufacturer's instructions. If any lids fail to seal, read the instructions again and reprocess the food until the lids seal properly.

Maintain equipment and properly store home-canned foods:

• Clean the gauge on a pressure cooker periodically.

• Check the dial gauge regularly.

• Clean the canner's petcock and safety valve openings regularly by pulling a string or narrow strip of cloth through them.

• Store canned goods in a cool, dry place away from heat sources, such as hot water pipes or sunlight, and from moisture that could rust lids.

Generally, signs of spoilage are easy to spot: mold, leaks, bubbling, bulging lids, marked discoloration or unpleasant odors. If any of these signs appear, destroy the food or dispose of it out of the reach of children and pets. Do not taste this food.

Heat-related Conditions

Heat exhaustion, one of the more mild summer health problems, results from spending too much time in the heat. It occurs when perspiration leads to excess loss of fluids and salts (electrolytes). Even if not directly in the sun, a person can lose too much fluid staying outdoors too long on a hot day or spending too much time in an overly hot house. It is not necessarily caused by excessive body temperatures, because the body's core temperature remains normal or falls below the norm. When exposure to extreme heat is combined with strenuous physical activity, the risk of heat exhaustion becomes even greater.

Symptoms of heat exhaustion are —

• dizziness

• nausea

• light-headedness

• severe headache

• cool, clammy skin

• heavy perspiration

• shallow breathing

• muscle tremors, cramping

If these symptoms occur, lay the person on his back in the coolest nearby place, loosen any tight clothing, lower his head slightly, raise his feet and get medical attention immediately.

To prevent heat exhaustion, drink extra amounts of liquids to replace body fluids lost through perspiration. Water, fruit juices or fruit-based drinks, such as lemonade, are preferable to tea, soft drinks, coffee or alcohol. Beverages that contain caffeine or alcohol often result in more frequent urination, which increases the body's loss of fluids.

Other precautions can help you to avoid heat exhaustion:

• Stay indoors in a cool place as much as possible.

• If possible, schedule strenuous activity — jogging, bike riding, lawn mowing, etc. — during morning or evening hours when the temperature is cooler.

• If you must spend time outdoors, pace yourself and take frequent water breaks. Plan breaks in the shade or coolest place available and make sure ample supplies of water or fruit drinks are handy.

• Wear lightweight, loose-fitting clothing that does not interfere with the evaporation of perspiration.

If you begin to feel dizzy or nauseated or develop a headache, go immediately to the nearest shaded or cool place and sit or lie down. If the symptoms are not relieved within a few minutes, or if they become worse, seek medical attention immediately.

Heatstroke is caused by prolonged exposure to high temperatures. Just sitting or lying too long in the heat can result in heatstroke, which can be fatal and should be considered a medical emergency.

Symptoms of heatstroke are —

• Headache

• Red, dry face

• Skin hot to touch

• Body temperature of 105° F or more

• Strong pulse

• Loss of consciousness in extreme cases

• Seizures, irregular heartbeat

If any of these symptoms occur, place the person in a semi-sitting position to reduce the amount of “hot” blood going to the head. Loosen or remove patient’s clothing, spray body and head with tepid (not cold) water, and cool by large fans to maximize evaporative heat loss. Seek medical attention immediately. If the person has a seizure, protect him or her from striking objects and DO NOT put anything in the mouth.

Heatstroke occurs most often in the spring and early summer, before the body adapts to higher temperatures. High humidity can increase the risk because it keeps the body from cooling itself as effectively.

Heat exhaustion does not always precede heatstroke. Athletes and the elderly are more prone to heatstroke.

To avoid heatstroke during the hot summer months, stay out of the sun as much as possible and keep cool — preferably in an air conditioned place. If air conditioning is not available, use fans or open windows to circulate the air. (However, keep blinds or curtains closed when sunlight is coming directly in the windows.) Take frequent cold baths or showers and try to avoid cooking or baking during the hottest part of the day.

Heat cramps are muscle pains or spasms — usually in the abdomen, arms or legs — that affect people who sweat a lot during strenuous activity. This sweating depletes the body's salt and moisture. The low salt level in the muscles causes the painful cramps. Heat cramps also may be a symptom of heat exhaustion. If you have heart problems or are on a low sodium diet, get medical attention for heat cramps.

If medical attention is not necessary, take these steps:

• Stop all activity and sit quietly in a cool place.

• Drink clear juice or a sports beverage.

• Do not return to strenuous activity for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke.

• Seek medical attention for heat cramps if they do not subside in one hour.

Sun Exposure

Did you know that just a few serious sunburns can increase the risk of a child, teen or young adult developing skin cancer later in life? A person doesn’t have to be at the pool, beach or on vacation to get too much sun. Their skin needs protection from the sun’s harmful ultraviolet (UV) rays whenever they are outdoors.

There are five easy options for protection from the sun:

• Seek shade – UV rays are strongest and most harmful during midday -- 10 a.m. to 4 p.m. -- so it is best to play indoor activities then. If this is not possible, seek shade under a tree, an umbrella or a pop-up tent. Use these options to prevent sunburn, not to seek relief once it has happened. UV rays, of course, are present on bright and sunny days, but UV rays can also penetrate through cloud and haze cover, making cloudy and overcast days dangerous as well.

• Cover up -- Clothing that covers the skin helps protect against UV rays. Although a long-sleeved shirt and long pants with a tight weave are best, they are not always practical. A T-shirt, long shorts or a beach cover-up are good choices, too, but it’s wise to double up on protection by applying sunscreen or keeping in the shade when possible.

• Get a hat -- Hats with a wide brim to shade the face, head, ears and neck give great protection. Baseball caps are popular, but they do not protect the ears and neck. If wearing a cap, be sure to protect exposed areas with sunscreen.

• Grab shades -- Sunglasses protect your eyes from UV rays, which can lead to cataracts later in life. Look for sunglasses that wrap around and block as close to 100 percent of both ultraviolet A (UVA) and ultraviolet B (UVB) rays as possible.

• Rub on sunscreen – Use sunscreen with at least Sun Protection Factor (SPF) 15 or higher and both UVA and UVB protection. For most effective protection, apply sunscreen generously 30 minutes before going outdoors. Don’t forget to protect ears, noses, lops and tops of feet.

Skin cancer is the most common kind of cancer in the United States. Research indicates it may be related to increased voluntary exposure to the sun’s UV rays. Unprotected skin can be damaged by the sun’s UV rays in as little as 15 minutes, yet it can take up to 12 hours for skin to show the full effects of sun exposure. So, skin that looks “a little pink” now may actually progress into “red” sunburn hours later.

Serious sunburns, especially during childhood and adolescence, can also increase the chances of developing malignant melanoma – one of the most serious forms of skin cancer and the one that causes most skin cancer-related deaths. Although most people are aware of the danger of UV exposure, it is estimated that only one third take steps to protect their skin from the sun.

For more information related to sun exposure, visit www.cdc.gov/ChooseYourCover/index.htm.