Jennifer Strangman, a mother of three from Gloucester, tries not to worry too much when it comes to protecting her children from mosquitoes.

"I'm trying not to be too conscious about it because kids will get mosquito bites," she said.

Her 3-year-old son has had his fair share of bites, and Strangman said it is not unusual for those bites to swell. She had taken him to the doctor on past occasions, and each trip yielded a clean bill of health. This July, however, the scenario was different.

"It looked a little different than it usually did," Strangman said of a mosquito bite her son got the first week in July. This time the bite was hot to the touch, looked like a bulls-eye and oozed. Her son also had a low fever.

It would be the first of two mosquito bite-related infections in two months. Now, Strangman says, she brings her son to the doctor's office right away if she suspects anything is wrong. While it's difficult to determine if her son's infections, which both healed, were caused by mosquitoes or the introduction of bacteria through broken skin, she remains concerned about mosquito-borne infections and the amount of mosquito protection Gloucester offers its residents.

Although summer is almost over, the risk of mosquito-borne infections remains. According to the state Department of Public Health Web site, mosquitoes recently tested positive for West Nile virus in Danvers and Merrimac. However, there have been no human cases of West Nile or Eastern equine encephalitis in Massachusetts this year.

Strangman, who works at a pediatrician's office, said parents of children of all ages have come in with concerns about mosquito bite infections.

"It seems to me there are a lot of kids this is happening to," she said.

Max Schenk, the city's public health sanitarian, said there has never been a confirmed case of EEE or West Nile virus in humans or animals in Gloucester. Both are transmitted through the bite of an infected mosquito, and both can affect people of all ages.

Schenk said there haven't been reports of other mosquito-borne infections in humans or animals, either. Because of the lack of history of infections in the city and the high cost of mosquito spraying, the city Health Department has never considered starting a mosquito spraying program.

"The cost-benefit analysis for us has shown personal protection works best," Schenk said. The state Department of Public Health recommends applying insect repellent with DEET and wearing long sleeves and pants when outdoors to prevent mosquito bites. It also recommends avoiding outdoor activity from dusk to dawn, which is peak biting time.

Strangman says she is "adamant" about using protective measures like bug spray; however, her son was still bitten and still got infections.

"If someone is bitten, they need to take proper care," Schenk said. This includes preventing infection by keeping the bite clean and avoiding excessive itching.

Dr. Jeffrey Stockman of Cape Ann Pediatrics said mosquito bite infections are a common complaint.

"Children, when they get bitten by insects, react with large areas of redness and swelling," Stockman said. This is called a local reaction, and does not necessarily indicate an infection. He said while infections and local reactions are red, swollen, and warm to the touch, infections are very tender and often have pus and red lines. The mosquito bite cases he treats tend to be local reactions, he said.

Dr. Brian Orr, also of Cape Ann Pediatrics, said if the bite site hurts more than it itches, it is likely an infection. He said in his opinion there has been a rise in mosquito bite infections, as well as skin infections in general.

According to Strangman, the doctor diagnosed her son's first mosquito bite infection as a potential case of MRSA, an aggressive, potentially life-threatening skin infection that can spread throughout the body. The doctor prescribed two types of antibiotics, and with proper care the infection cleared.

At the time, Strangman didn't think to ask whether the infection was mosquito-related. It was only during a doctor's visit in mid-August for the second mosquito bite infection that the thought crossed her mind.

The second time her son was bitten by a mosquito, the bite didn't ooze but there was a great deal of swelling. Also, she said, the reaction happened immediately; the first infection had developed over a few days.

"His face was so swollen it looked like he had the mumps," she said.

This time a different doctor prescribed two antibiotics. According to Strangman, the doctor diagnosed it as cellulitis, a bacterial skin infection. The doctor said it was possible that bacteria from her son's hands could have infected the bite if he had scratched it.

Determining whether an infection is due to a mosquito can be difficult because it is not clear from the look of the infection site which type of insect is responsible for the bite, Dr. Orr said. Also, infection can be introduced if a child scratches the bite and breaks the skin, making it unclear whether the mosquito or another factor is responsible for the infection.

Whether or not the mosquitoes themselves transmitted the infections, Strangman is being cautious. She said her son likes to play at Stage Fort Park, but she doesn't usually take him there because they can only go in the evening because of her work schedule.

"It's sad," Strangman said. "You can't let them out too late."

Amanda Flitter can be reached at gt_reporter@gloucestertimes.com.