Americans understand mosquito control but remain uncertain about applying insect repellent

Americans overwhelmingly understand that avoiding mosquito bites and controlling mosquito populations around the home is the most effective protection against mosquito-borne illnesses such as West Nile virus and dengue fever, yet far fewer know how to correctly select, apply, or combine insect repellent with other products like sunscreen, according to a new nationally representative survey from the Annenberg Public Policy Center (APPC) of the University of Pennsylvania. The findings, drawn from the Annenberg Science and Public Health (ASAPH) survey fielded August 4 through 17, 2026, among 1,904 empaneled U.S. adults, reveal a persistent and troubling gap between broad public awareness of the threat and specific, actionable knowledge about the preventive tools that public health agencies recommend.

The survey found that 82 percent of U.S. adults correctly identified preventing mosquito bites and controlling mosquitoes in and around the home as the best defense against dengue fever and West Nile virus, the two mosquito-borne diseases of greatest concern in the continental United States. That figure has remained remarkably stable over time, essentially unchanged from 81 percent in 2025 and 79 percent in 2024. Nearly two-thirds of Americans, 64 percent, reported routinely taking precautions to avoid mosquito bites, an increase from 61 percent in August 2025 and 59 percent in September 2024. That level of precautionary behavior is consistent with responses recorded in July 2016, during the height of the U.S. outbreak of mosquito-borne Zika virus, when 67 percent of Americans said they routinely took precautions against mosquito bites.

The specific precautions that Americans report taking vary considerably. Among those who said they routinely protect themselves from mosquitoes, 81 percent reported removing standing water from around their homes, a critical measure because standing water serves as the breeding habitat where mosquitoes lay their eggs. Seventy-one percent said they avoid activities or areas that would bring them into contact with mosquitoes, a figure unchanged from the past two years but significantly higher than the 63 percent recorded in July 2016. Sixty-four percent reported wearing insect repellent, statistically unchanged from 2025 but significantly lower than the 72 percent who said so in September 2024 and the 73 percent who reported repellent use in July 2016. Just over half, 55 percent, said they wear long-sleeved shirts or other protective clothing outdoors, while 54 percent reported routinely replacing or repairing window screens, substantially lower than the 64 percent reported in September 2024 and the 67 percent in July 2016. Only 11 percent reported using mosquito netting, a figure that has not changed since July 2016.

The Centers for Disease Control and Prevention recommends a comprehensive approach to mosquito bite prevention: using insect repellent, wearing loose-fitting long-sleeved shirts and pants, taking steps to control mosquitoes both indoors and outdoors, and eliminating standing water where mosquitoes can lay eggs. While the survey demonstrates that most Americans are aware of these general strategies, the picture changes dramatically when people are asked about the specific mechanics of insect repellent use. When asked about applying sunscreen and insect repellent together, only 31 percent of respondents correctly said that the CDC recommends putting on sunscreen first, allowing it to dry, and then applying insect repellent. Nearly half of respondents, 49 percent, said they were unsure in which order to apply the two products. The percentage answering correctly is statistically unchanged from the 33 percent recorded in 2025, suggesting that public knowledge on this point has not improved despite ongoing guidance from federal health agencies.

Knowledge about where insect repellent should and should not be applied is even scarcer. Just 15 percent of respondents correctly said that the CDC recommends not putting insect repellent on skin that is covered by clothing, essentially unchanged from 14 percent in 2025, while 41 percent said they were unsure. A somewhat larger share, 53 percent, correctly knew that insect repellent should not be used on babies younger than 2 months old, statistically unchanged from 54 percent in 2025, though another 42 percent remained uncertain about this guidance. These findings indicate that even among Americans who do use repellent, a substantial portion may be applying it incorrectly or inappropriately, potentially reducing its effectiveness or creating unnecessary exposure.

Confusion also extends to how people choose a repellent in the first place. Only 18 percent of survey respondents correctly identified the CDC recommendation to look for a repellent that is registered with the Environmental Protection Agency, compared with 19 percent in 2025. Nearly half, 45 percent, said they were unsure which type of repellent to look for, while 30 percent incorrectly chose a repellent containing more than 50 percent DEET and 6 percent chose one described as natural. The CDC recommends EPA-registered insect repellents containing active ingredients such as DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. The agency’s guidance notes that concentrations above 50 percent DEET generally do not provide additional protection against mosquito bites, meaning that the 30 percent of Americans who believe higher DEET concentrations are the right choice may be spending more money without gaining additional protection. Patrick E. Jamieson, director of APPC’s Annenberg Health and Risk Communication Institute, which oversees the health survey, said the CDC needs to do a better job of informing the public about how to choose and apply insect repellent.

The survey findings arrive at a time when mosquito-borne disease remains an active public health concern in the United States, even if the immediate threat appears lower than in the previous year. According to the CDC, West Nile virus is the leading cause of mosquito-borne disease in the continental United States, and dengue is also spread through the bites of infected mosquitoes. As of September 8, 2026, the CDC had reported 504 human cases of West Nile virus across 41 states through ArboNET, the agency’s national surveillance system, including 363 cases of the more serious neuroinvasive form of the disease. That total, while significant, is substantially lower than the number of reported cases at the same point in 2025. West Nile virus infection most commonly occurs through the bite of an infected mosquito, and most infected people do not develop symptoms, although some develop febrile illness and a small proportion develop serious disease affecting the central nervous system.

Despite this ongoing disease burden, public worry about mosquito-borne illness remains remarkably low and stable. In August 2026, just 16 percent of U.S. adults said they were worried that they or someone in their family would contract dengue fever or West Nile virus during the next three months, compared with 15 percent who were worried in August 2025 and 15 percent in September 2024. Ken Winneg, APPC’s managing director of survey research, emphasized that despite the drop in West Nile virus cases relative to 2025, taking precautions to prevent mosquito bites and control mosquitoes remains important to upholding community public health. The persistence of low worry alongside generally high awareness of preventive strategies suggests that many Americans view mosquito-borne disease as a distant or abstract threat rather than an immediate personal risk.

Compounding the low level of concern, the survey found that knowledge of West Nile virus symptoms has actually declined over the past year. When respondents were presented with a list of possible symptoms and asked to identify those associated with West Nile virus, 56 percent said they were unsure, an 8-percentage-point increase from 48 percent in August 2025 and statistically unchanged from the 53 percent recorded in September 2024. Among those who did offer answers, fever was selected by more adults than any other symptom, chosen by 39 percent, but that was a significant decline from the 45 percent who selected it in 2025. Similar downward patterns appeared across other correct symptoms relative to 2025: 34 percent selected muscle and joint pain, a 7-point drop from 41 percent the previous year, and 32 percent selected headache, a significant 6-percentage-point drop from 38 percent. Twenty-nine percent selected nausea and vomiting, a 4-point drop from 33 percent that was not statistically significant. No change was seen in the percentage who selected rash, at 22 percent in 2026 versus 23 percent in 2025. Respondents also incorrectly selected two items as West Nile symptoms: dizziness or lightheadedness, incorrectly chosen by 23 percent in 2026, an improvement from 31 percent in 2025, and firm, round painless sores, incorrectly chosen by 9 percent, roughly the same as the 12 percent in 2025.

The overall picture painted by the survey is one of a public that has absorbed the general message about mosquito-borne disease prevention but has not internalized the finer points of the guidance that would make their preventive efforts fully effective. The stability of the headline figures over three consecutive years, and in some cases back to 2016, suggests that these knowledge gaps are structural rather than transient. With more than a third of Americans unsure how to layer sunscreen and repellent, four in ten unsure whether repellent belongs under clothing, fewer than one in five knowing to seek an EPA-registered product, and more than half unable to identify any symptoms of West Nile virus, the survey’s authors argue that clearer, more sustained public communication from the CDC and other health authorities is needed to close the gap between what Americans know in general terms and what they need to know to protect themselves and their families effectively during mosquito season.

The latest wave of the Annenberg Science and Public Health survey was conducted for the Annenberg Public Policy Center by SSRS, an independent research company. Interviews were conducted by web and telephone among a nationally representative probability sample drawn from the SSRS Opinion Panel, with data weighted to represent the U.S. adult population. The survey was fielded August 4 through 17, 2026, among 1,904 U.S. adults, with a margin of sampling error of plus or minus 3.2 percentage points at the 95 percent confidence level. In addition to Winneg and Jamieson, APPC’s ASAPH survey team includes research analysts Laura A. Gibson and Shawn Patterson Jr. The Annenberg Public Policy Center, established in 1993, tracks American public knowledge, beliefs, and behaviors regarding vaccination, Covid-19, flu, RSV, climate, and other consequential health issues through its survey panel.