The CDC has received a record number of reports of West Nile virus infection this year – 1993 as of September 4, including 87 deaths – and strongly recommends use of insect repellents to prevent transmission of West Nile virus and other mosquito-borne diseases. Insect repellents have been used on the skin for many years to prevent mosquito bites, which can transmit malaria, dengue, and various types of encephalitis. In recent years, insect repellents have also been recommended as protection against ticks, which transmit Lyme disease.

The FDA has approved a new Japanese encephalitis vaccine (Ixiaro - Intercell/Novartis). It will replace JEVax (Sanofi Pasteur), which has had tolerability and safety problems and is no longer being manufactured.

Picaridin (KBR 3023), which has been used as an insect repellent for years in Europe and Australia (Autan Repel, and others), is now available in the US in 7% solution as Cutter Advanced (Spectrum Brands). The US Centers for Disease Control and Prevention (CDC) is recommending it as an alternative to DEET.

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Insect repellents have been used on the skin for many years, primarily to prevent mosquito bites, which transmit malaria, West Nile virus infection, and various types of encephalitis. With increased concern about Lyme disease in recent years, skin and clothing repellents are now also recommended for protection against ticks. This review describes the effectiveness of the most widely used repellents DEET and permethrin , as well as some alternatives, and a new product called picaridin that may be available soon. The safety of these products is also discussed. The review concludes with an overall assessment of safety and efficacy and a recommendation on how to achieve the best protection.