5 This product is not actually the extract from the plant

5 This product is not actually the extract from the plant BAY 80-6946 but a by-product of the hydrodistillation process known as p-menthane-3,

8-diol (PMD). This is the first plant-derived repellent to be included in public health messages issued by the Centers for Disease Control (CDC) in North America following the recent outbreaks of West Nile virus.5 However, despite the potential effectiveness of this product, it is currently not included in personal protection advice provided by health authorities. The concentration of active ingredients is directly related to the period of time an individual is protected from biting mosquitoes, not necessarily the proportion of mosquitoes repelled. While formulations containing approximately 10% DEET have been shown to provide protection against A aegypti for over 100 minutes, formulations containing 80% provide protection for over 800 minutes in laboratory tests.9 While low-dose (eg, <10% DEET or picardin) repellents may provide effective protection, they must be reapplied more frequently than formulations containing >20% DEET or picaridin. Products containing botanical extracts,

due to their lower mean protection times,8 C646 clinical trial will generally need to be reapplied twice as often as the low-dose DEET or picaridin formulations. One of the recent advancements in commercial insect repellents is the availability of formulations that combine topical repellents with Diflunisal cosmetics including sunscreen

and skin moisturizers. Laboratory testing of combined sunscreen and mosquito repellent formulations found that there was no reduction in mean protection times when tested against A aegypti.9 However, when there was concurrent use of sunscreen, reapplied at 2-hour intervals on top of a 17% DEET-based topical repellent, mean protection times were significantly reduced following subsequent applications, possibly due to disturbance of the layer of repellent.9 Some questions regarding long-term use of these formulations have been raised considering the different application rates recommended for sunscreen and insect repellents. Where a combined sunscreen and insect repellent formulation are required against day-biting mosquitoes, regular reapplication of a repellent/sunscreen formulation with a low DEET concentration (<20%) is recommended to minimize any risk of overexposure to DEET.9 A range of non-topical products that purport to repel mosquitoes are widely available. Wrist bands and patches impregnated with botanical-based repellents are currently registered in Australia, but these products have been shown to be ineffective at providing protection.7 Similarly, electronic devices that emit sound have also been shown to be ineffective at repelling mosquitoes.

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