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Stinging Insect Allergies
(Bee Stings, Wasp Stings, Others)
POWER POINTS
Severity of reactions to stings varies greatly.
Avoidance and prompt treatment are essential.
In selected cases, allergy injection therapy is highly effective.
The three "A's" of insect allergy are Adrenaline, Avoidance and Allergist.
What are stinging insects?
The majority of stinging insects in the United States are from Bees, Yellow Jackets, Hornets, Wasps and Fire Ants.
Who is at risk?
Most people are not allergic to insect stings and most insect stings result in only local itching and swelling. Many, however, will have severe allergic reactions. Up to a million hospital visits result form insect stings. If you are known to be allergic to insect stings, then the next sting is 60% likely to be similar or worse than the previous sting. Since most stings occurring in the summer and fall, you are at greatest risk during these months.
What types of insect sting reactions occur?
Most insect sting reactions are not allergic and result in local pain, itching, swelling and redness at the site of the sting. Some extension of the swelling is expected. Local treatment is usually all that is needed for this type of reaction. Disinfect the area, keep clean and apply ice. If the swelling increases antihistamines and possibly steroids may be needed. Occasionally, the site will become infected and antibiotics are needed. Large local non allergic reactions (occurring 10% of the time) are often alarming and can persist for days. This is usually not a cause for concern and are best treated as above.
The most serious reaction is the allergic reaction. The allergic reaction to insect sting varies from person to person. The most serious is called anaphylaxis and as indicated above can be fatal. Severe reactions are suspected if a person experiences hives and intense itching at sites other than the sting site. Difficulty breathing, swallowing, hoarseness, swelling of the tongue, dizziness and fainting are signs of a severe allergic reaction. These types of reactions usually occur within minutes of the sting, but have been known to be delayed for up to 24 hours. Prompt treatment is essential and emergency help is often needed.
How is a severe allergic reaction immediately treated?
Honey bees stingers are barbed stingers which are left behind in the person's skin and then the bee dies, a bee sacrifice! If the stinger is removed by pinching the stinger, more venom is injected into the skin. It is better to remove the stinger by gently lifting the stinger using a finger nail or knife edge to 'flick' the stinger out of the skin. Other stinging insect do not leave stingers behind and this technique does not apply.
An allergic reaction is treated with epinephrine (adrenaline). Several self-injectable devices are available by prescription including EPI PEN, ANA KIT, and others. These devices are filled with the epinephrine to be injected in to the subcutaneous tissue or muscle, preferably into the front of the thigh. These self-injected devices usually contain only one dose and, on occasion, more than one dose is needed.
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