With all the bugs that come out to bite, it's a wonder anyone goes outside in the summer.

But, the warmer weather is a siren on the sandbar beckoning people outdoors. A few precautions and a few spritzes of insect repellent can keep summer fun relatively painless.

The State Department of Health issues some tips for mosquito protection as it starts surveillance for West Nile virus. The virus is spread primarily by the culex tarsalis mosquito. Last year, 369 people were reported to have West Nile. An infection results in a high fever, stiff neck, severe headache and altered mental state. Severe cases can require hospitalization, and some people have died from the disease.

Mosquitoes can be avoided by wearing an insect repellent with DEET or an equivalent repellent like eucalyptus oil or pyrethrin. Also, loose clothing, and avoiding outdoor activities at dawn and dusk, when mosquitoes are most active, lowers the chance of getting the virus. Habitat for mosquitoes can be reduced by eliminating standing water around the home and keeping grass mown.

Insect repellent also will help deter ticks. The summer months bring this blood-seeking insect out. It can be found in high grasses and wooded areas. The most common tick in North Dakota is the dog tick. Ticks can spread tularemia, Rocky Mountain spotted fever and lyme disease. Ticks can be removed by grasping the bug with a pair of tweezers close to the head and pulling.

Light colored clothing makes ticks easier to see, and tucking in shirts and tucking long pants into socks or boots helps keep them off the skin.

In the last five years, there have been three cases of tularemia, five cases of Rocky Mountain spotted fever and 22 cases of lyme disease, the health department reported.

The state will track West Nile virus reports weekly at www.ndhealth.gov/wnv. Counts will be updated each Wednesday. So far, no positive cases have been reported in the state.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid.) @bismarcktribune.com