When we lived in Thailand, we once were careless with the insect nets. The morning after my daughter was so blotched and swollen that my wife rushed to the hospital we used, so the doctor could check out what was wrong.
Luckily, it turned out that she was only bitten by mosquitoes, and there were no bad aftereffects. Luckily, since in Thailand mosquitoes carry both dengue fever and malaria. While all mosquitoes are not carriers (as we found out) you have no way of knowing which insects will carry disease, and which do not.
Nowadays, all the talk is about the Zika virus, but Zika is actually only dangerous if you are pregnant. In other persons, it causes a mild fever and goes away. West Nile virus, which now is endemic to the United States, is much more dangerous (although the effects are not as hard to deal with). And it is carried by mosquitoes, too. Although it still pales compared to malaria, one of the oldest scourges of humanity.
You do not want to find out the hard way which disease is the most deadly. While malaria can be cured, it is still debilitating while it lasts, and to cure it you have to take medication which while generally safe always carry the risk of side effects. You do not want your children exposed even to the smallest risk, so better be careful with those insect nets.
That is even more true for dengue fever, also known as breakbone fever - because the muscle contractions can be so bad they break the bones of the diseased person. You can guess how painful it can be. It is definitely not something you want your children to have, especially since the immunity you get from being exposed to one strain of the virus does not give you immunity to the other strains. And the second time you catch the disease, it may be lethal.
In most big cities, mosquitoes keep away. There is simply no places for them to live, although in Hong Kong the authorities warned against small pools of water, like flowerpots orthe inside of discarded tires, which can serve as breeding grounds for mosquitoes. But in most big cities, there are no bodies of standing water.
Bangkok is a flagrant exception, as the city is built in a (poorly drained) swamp. The explosion of condominiums (none of which come with screen windows) are all built for you to keep the air conditioning on high. If you want to avoid placing your kids in a cold draught of dried out air and use some natural ventilation, which is perfectly feasible in the Thai winter, you are out of luck. Most people actually keep the windows closed because they not only want to keep the cold air in, but also since they want to avoid the smell of swamp gas, which can get in even where mosquitoes can not.
But mosquitoes are everywhere In the world, even in the Hawaiian islands (where there were none when Europeans arrived). Most of them do not carry either malaria or Dengue fever, but all bloodsucking varieties create itchy blotches (like the ones that scared my wife so much). Add itchy blotches in places where the sun does not go to red and itchy flaking skin blisters where the sun shone too much, and you are in for a night without sleep thanks to a crying baby. Not the thing you were hoping for during your vacation.
Nowadays the big scare is Zika virus, which is also easily spread by mosquitoes (and through sexual contact). The virus can affect anyone but is really dangerous to pregnant women, as it can cause birth defects in their babies.
This is why you can be a danger if you are bitten and get infected but does not get sick (or at least not so sick you can tell it from a common cold). You can spread the virus if you get bitten. This means the virus can suddenly appear in areas where it did not exist before, if you are not careful. Epidemics work like that - the reverse of immunization, which causes small spots where the infection can not spread.
Since being infected means a risk to pregnant women in the area, the risk is very real and you should be careful. You do not want the responsibility of babies being born with microencephaly weigh on your conscience. And you need to be extra careful of your children. Even if the symptoms can be mild and hardly distinguishable from an influenza, the pain can be severe. And the child will be a carrier. So you want to be sure the children do not get bitten, either abroad or at home.
The best way of keeping mosquitoes away is to keep all doors and windows closed, and keep a higher air pressure inside than outside. This is of course easier said than done if you live in an ordinary house.
A second best are insect nets and screen doors and windows. If you want to sleep in the natural breeze of your destination (hard to resist in many places, especially by the beach where the sound of waves will lull you to sleep), you need insect nets. And not just one layer, but several. You need screen windows and you need insect nets over your beds - one net inside the bed, and a bigger net outside that. Infants can not swat mosquitoes away, so you have to help them.
When you take infants for walks, you can put insect nets on the stroller so they are protected. You have to make sure there are no holes and gaps, especially not around the back if you have a sitting stroller. It may be quite difficult and you should factor into the decision to buy the stroller.
But once your kids start walking, you need to consider insect repellents. The Centers for Disease Control (CDC) in the US do not recommend insect repellents for children under 2 months, but you really want to avoid chemicals at all for as long as you can. Do not use insect repellents with oil of lemon eucalyptus or para-methane-diol on kids under three.
Insects identify their prey by smell (yes, despite the difference in size, that is what you are to them). Insect repellents block some smells better than others, which means different insect repellents work better for certain types of insects. Flies are attracted to certain smells (not pleasant to humans), which means the same goes for mosquitoes. But not all mosquitoes are the same. Different species are attracted to different parts of the smells humans give off.
Almost all diseases which affect humans, but zika and dengue fever in particular, are spread by the Aedes Aegypti and Aedes Albopictus. One of the consequences of climate change is that these species, which require higher temperatures, are spreading northwards. Aedes Aegypti was behind the dengue fever scare in Tokyo a few years ago - before then, nobody had ever got dengue fever from a mosquito bite in southeastern Japan. But this summer, there is a very real risk.
So insect repellent is necessary for your kids. If you do not forget any spots, they are safe from the different insect-bourn diseases. Not ticks, though, they are actually not insects.
The trick is not to miss any spots. The key to doing that is not to have to slather your kids in insect repellent first and sun tan lotion later, or the other way around. If you use a combined sun lotion and insect repellent you have a much easier time of it.
I am Wisterian Watertree, recently moved from Bangkok to Tokyo, with a brief visit to Honolulu on the way. I write about travel, especially with our three beautiful kids (two girls and one boy, soon turning four and a half - yes. they are triplets). Travel is education and fun rolled into one, and if you are like me, that is something you want to give to your kids. If you want more tips and want to find out when I will publish something, get it from my email list. If you want to be personal, drop me a note on firstname.lastname@example.org, or if you want general tips, follow me on Twitter @wisterianw.