Increased cases of mosquito-borne diseases demand greater public awareness.

Dr. Anthony Fauci’s hospitalization last summer with West Nile virus – and subsequent account of it published this week in The New York Times – have helped raise public awareness of mosquito-borne illness ranging from Zika and malaria, dengue, and West Nile virus infections. As reported by the Centers for Disease Control and Prevention (CDC), mild winters, early springs, warmer temperatures give mosquitoes and ticks ample opportunity to reproduce quickly, spread disease quickly across their habitat, expand further throughout United States’ territories due climate change- driven epidemics spread by mosquito-borne viruses are becoming ever more frequent.

As of Oct. 1, according to the Centers for Disease Control (CDC), 880 United States cases of West Nile virus had been recorded this year and remain the leading insect-borne viral cause for viral illness in this country. West Nile virus is not the only mosquito-borne illness making headlines; earlier this month in California public health officials warned about “an unprecedented” rise of dengue fever while, earlier in August a New Hampshire resident died due to Eastern Equine Encephalitis or EEE (CNN noted this summer there has been “flurry warnings about cases originating in mosquito-borne illnesses such as malaria, dengue fever or EEE.” Accordingly this summer has brought warnings about cases including malaria, dengue fever as well as EEE; both were eventually declared under control.” CNN concluded:

Few (15%) among American adults worry that they or their families might contract dengue or West Nile virus within three months, according to Annenberg Public Policy Center’s (APPC) health knowledge survey conducted mid-late September by over 1,700 adults nationwide. Public awareness regarding mosquito-borne illnesses like dengue or West Nile virus as well as ways to avoid contracting them remains limited.

Dr. Fauci’s experience serves as a timely reminder that mosquitoes that pose serious threats don’t need to reside exclusively in exotic locales – they could very well be lurking right outside our own front doors.”
Kathleen Hall Jamieson of Annenberg Public Policy Center’s Survey Committee.

Learn ways of contracting dengue fever and West Nile virus infection.

People can become infected with dengue fever and West Nile virus through being bitten by an Aedes mosquito that has been exposed to dengue, West Nile or Zika viruses; almost three quarters (74%) of those surveyed realize this threat vector can likely spread these viruses to them.

Sneezing and Coughing (no): Many are confused as to whether scientists believe someone can become infected with dengue fever or West Nile Virus by being exposed to someone already carrying these viruses by way of being sneezed on or coughed upon. According to CDC estimates, people do not get infected through such exposure, yet only three-fourths (34%) say scientists do not consider it likely they would get it this way, while one quarter (26%) incorrectly believes this might actually become infected, while 39% remain uncertain of this matter altogether.

Knowledge of West Nile virus symptoms

While most individuals understand they can become infected with dengue fever or West Nile virus via mosquito bite, many remain unfamiliar with its symptoms. When presented with a list of possible West Nile symptoms identified by CDC, only half chose those of which they were true for West Nile virus infection.

CDC-identified symptoms for West Nile virus. Here’s what people selected from:

42% reported fever, 37% muscle and joint pain, 36% headaches, 29% nausea/vomiting/rash as symptoms associated with West Nile virus; while 18% selected incorrect symptoms: fever (42), muscle and joint pain (37%), headache (29%), nausea and vomiting (19%) or rash (18%) as being indicative.

29% experienced dizziness or lightheadedness and 11% suffered firm, round soreness which were nonpainful and without discomfort.

Beliefs about contracting dengue fever and West Nile virus vary.

Scientists are turning to genetically modified (GM) mosquitoes in parts of the world like Brazil, Panama and India in order to control mosquito populations and limit mosquito-borne illness transmission. GM mosquitoes produced so that female offspring do not survive into adulthood can help limit population sizes while helping protect from mosquito-borne illness transmission.

At 16 percent, our survey respondents believe genetically modified mosquitoes have caused dengue fever outbreaks; 36% know this to be false, while 48% remain uncertain whether this claim is true or false. Furthermore, more respondents believed genetically modified mosquitoes could help curb dengue virus transmission: 36% stated this statement as true while 16% claimed otherwise; like with negative side-effects of genetically modified mosquitoes though 48% remain uncertain whether either is true.

According to the Centers for Disease Control (CDC), Aedes mosquitos carrying dengue virus do not inhabit every state within continental US borders; yet nearly four in ten (38%) incorrectly believe they do, with over two fifths (22%) agreeing this statement is false and 40 % being uncertain of this fact.

Preventing dengue and West Nile virus: Nearly eight out of ten (79%) accurately believe the best defense against dengue and West Nile virus lies with reducing mosquito bites and controlling mosquito populations within or around their homes, with 17% uncertain and 4% believing this statement to be false.

Precautionary steps against mosquito bites.

CDC advises individuals to take measures to safeguard themselves against mosquito bites that could make them sick, as evidenced in our survey of 6 out of 10 (59%) respondents indicating that they take preventative steps against mosquito bites at any time of year – significantly lower than what two thirds (67%) stated during 2016’s Zika outbreak survey conducted by APPC; over one third (37% today) say they do not regularly take such precautions.

At an ongoing survey on security measures taken today by individuals who regularly take precautionary steps, we asked each of them to select an action from a list of measures:

Most respondents indicated they take preventive steps against mosquito bites by eliminating standing water (80%) and using insect repellent (72%), with both figures remaining constant from when we conducted our previous poll in July 2016.
Seven in 10 (70%) adults now avoid activities or areas likely to bring them in contact with mosquitoes, an increase from 63% who reported this behavior back in July 2016 (63% said this in July 2016). Meanwhile 64% regularly replace or repair window screens; no change was seen there between July 2016 and 2017.
57% reported wearing long-sleeved shirts or other protective clothing when going outdoors in July 2016, significantly more than the 52% who reported this practice back then. About one out of every twelve (12%) regularly use mosquito netting – roughly on par with July 2016.

Applying insect repellent over sunscreen could provide additional protection.

Bug repellent is one of the primary tools available for protecting against mosquito bites; when out and about in the sun it is also crucial that sunscreen be worn to shield from harmful UV rays. We asked respondents what recommendations were made by CDC when applying both repellent and sunscreen simultaneously.

At least 29% of respondents correctly recognize the CDC advice: one should apply sunscreen first and let it dry, before using insect repellent. While only five percent say otherwise (insect repellent first, then sunscreen), 16% think the guidance suggests no matter which order one applies either sunscreen or mosquito repellent in, both products must be used if in areas prone to mosquitos; these responses contradict what the CDC suggests and fifty percent (50%) remain uncertain of this matter.

Apply insect repellent only on exposed skin – do not put insect repellent under clothing!

The Centers for Disease Control (CDC) advises people against applying insect repellent under clothing; yet only 13% know this advice from them. Nearly half either believe the CDC advises using insect repellent directly onto body areas then covering these with clothing (19%), or say there was no matter whether repellent was applied under clothing (29%) but recommended usage was necessary in areas with mosquitoes (1%). Four in ten (39%) remain uncertain of what the CDC advises in such matters.

Avoiding insect repellent on infants when possible

Just over half (52%) correctly report that they understand CDC recommendations regarding insect repellent use on infants younger than 2 months, preferring instead clothing which covers arms and legs in addition to placing mosquito netting over cribs, strollers, and baby carriers as forms of protection from mosquitos. A further 44% indicated they weren’t sure of the specific CDC recommendation regarding insect repellent applications on an infant while three percent incorrectly believed the CDC advised using insect repellent on babies younger than two months, contrary to what the CDC advised against.

Assuring an EPA-registered insect repellent product can protect from these risks is recommended.

Only about 1 out of 5 (21%) know this recommendation of the Centers for Disease Control (CDC), while almost one-third (29%) assume its meaning involves using products with over 50% DEET; another 6% think it means looking for natural repellents instead; but many (43%) remain uncertain of this advice from their government agency.

DEET is the active ingredient found in many insect repellents. While products containing higher concentrations may provide longer protection from mosquito bites, according to the Centers for Disease Control (CDC) those containing 50% or higher DEET offer no more benefit than products containing lesser concentrations of DEET.

Annenberg Public Policy Center’s ASAPH Survey

This survey data comes from SSRS’ 21st wave of its national representative panel survey of 1,744 U.S. adults for Annenberg Public Policy Center conducted since April 2021. Most were empaneled since then. To account for attrition, periodic replenishment samples have been introduced using random probability sampling designs; with the most recent round coming into force on September 20,2024 with 360 respondents added to our pool of respondents. This wave of Annenberg Science and Public Health Knowledge (ASAPH) survey was fielded September 13-22 and 26-30 2024 and had an MOE of +-3.5 percentage points at 95% confidence levels; all figures are rounded to their nearest whole number and may not add up 100%; combined subcategories may also not equal 100% due to rounding errors.

Ken Winneg, Ph.D., the managing director of survey research for APPC conducted this data analysis for this news release.

Jamieson and Winneg lead an Annenberg Public Policy Center team on the Annenberg Science and Public Health (ASAPH) Knowledge Survey comprised of data analysts Laura Gibson, Ph.D. and Shawn Patterson Jr., Ph.D. of APPC as well as Patrick E. Jamieson, Ph.D. director of Annenberg Health and Risk Communication Institute of which ASAPH Knowledge Monitor project falls. It was funded through an endowment set aside for it by Annenberg Foundation.
Sources for Information Include the Annenberg Public Policy Center of Penn.