Some travelers report nighttime mosquito bites despite spraying their room with insecticide and/or permethrin. If you are asleep, mosquitoes can bite your exposed face and neck. What to do?
I suggest treating your pillow case and the foldover top of your bedsheet with permethrin. This involves bringing a permethrin pump spray with you on your next trip to any tropical area where there is the risk of malaria. (Pump spray only if flying to your destination, otherwise an aerosol spray is OK). On arrival in your room, spray the pillow cases and the top of your bedsheet and allow 2 hours for drying. There will be no odor at all on the fabric, but any mosquito landing on it will be killed or "knocked down."
While I haven’t seen this use of Permethrin before, it certainly is consistent with directed uses. My grandson had several bites during the night while in the Dominican Republic, despite the room being sprayed; after his parents sprayed the bedding and pillows, the biting stopped. There is no safety issue with this use of permethrin, but I recommend trying this; its much more comfortable than sleeping while covered in DEET.
Note: The incubation period of malaria is about 12-14 days. Most cases will be symptomatic in 3-4 weeks. If you get an unexplained fever after return from a malarious area (especially if not on an antimalarial while there) get checked ASAP. Untreated malaria can be fatal!
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