Most people are not allergic to insect stings and should recognize the difference between an allergic reaction and a normal reaction. This will reduce anxiety and prevent unnecessary medical expense.
A severe allergic reaction known as anaphylaxis occurs in 0.5 percent to 5 percent of the U.S. population as a result of insect stings. At least 40 deaths per year result from insect sting anaphylaxis.
The majority of insect stings in the United States come from wasps, yellow jackets, hornets and bees. The red or black imported fire ant now infests more than 260 million acres in the southern United States, where it has become a significant health hazard and may be the number one agent of insect stings.
What is a normal reaction to an insect sting and how is it treated?
The severity of an insect sting reaction varies from person to person. A normal reaction will result in pain, swelling and redness confined to the sting site. Simply disinfect the area (washing with soap and water will do) and apply ice to reduce the swelling.
A large local reaction will result in swelling that extends beyond the sting site. For example, a sting on the forearm could result in the entire arm swelling twice its normal size. Although alarming in appearance, this condition is often treated the same as a normal reaction. An unusually painful or very large local reaction may need medical attention. Because this condition may persist for two to three days, antihistamines and corticosteroids are sometimes prescribed to lessen the discomfort.
What are symptoms of insect sting allergy?
The most serious reaction to an insect sting is an allergic one. This condition requires immediate medical attention. Symptoms of an allergic reaction may include one or more of the following:
- Hives, itching and swelling in areas other than the sting site.
- Tightness in the chest and difficulty in breathing.
- Hoarse voice or swelling of the tongue.
An even more severe allergic reaction, or anaphylaxis, can occur within minutes after the sting and may be life-threatening. Symptoms may include:
- Dizziness or a sharp drop in blood pressure.
- Unconsciousness or cardiac arrest.
How are allergic reactions to insect stings treated?
Insect sting allergy is treated in a two-step approach. The first step is the emergency treatment of the symptoms of a serious reaction; the second step is preventive treatment of the underlying allergy with venom immunotherapy.
Life-threatening allergic reactions can progress very rapidly and require immediate medical attention. Emergency treatment usually includes administration of certain drugs, such as epinephrine, antihistamines, and in some cases, corticosteroids, intravenous fluids, oxygen and other treatments. Once stabilized, these patients are sometimes required to stay overnight at the hospital under close observation.
Injectable epinephrine for self-administration is often prescribed as emergency rescue medication for treating an allergic reaction. People who have had previous allergic reactions and rely on epinephrine must remember to carry it with them at all times. Also, because one dose may not be enough to reverse the reaction, immediate medical attention following an insect sting is recommended.
What is venom immunotherapy?
The long-term treatment of insect sting allergy is called venom immunotherapy, a highly effective program administered by an allergist-immunologist, which can prevent future allergic reactions to insect stings.
Venom immunotherapy involves administering gradually increasing doses of venom which stimulate the patient's own immune system to reduce the risk of a future allergic reaction to the same as the general population. In a matter of weeks to months, people who previously lived under the constant threat of severe reactions to insect stings can return to leading normal lives.
Ask your doctor to send a consult to an allergist-immunologist, a physician who is a specialist in the diagnosis and treatment of allergic disease. Based on your past history and certain tests, the allergist will determine if you are a candidate for skin testing and immunotherapy.
How can I avoid insect stings?
Knowing how to avoid stings from fire ants, bees, wasps, hornets and yellow jackets leads to a more enjoyable summer for everyone.
Yellow jackets will nest in the ground and in walls. Hornets and wasps will nest in bushes, trees and on buildings. Use extreme caution when working or playing in these areas. Avoid open garbage cans and exposed food at picnics. Also, try to reduce the amount to exposed skin when outdoors.
Allergists-immunologists recommend the following additional precautions to avoid insect stings:
- Avoid wearing sandals or walking barefoot in the grass. Honeybees and bumblebees forage on white clover, a weed that grows in lawns throughout the country.
- Never swat at a flying insect. If need be, gently brush it aside or patiently wait for it to leave.
- Do not drink from open beverage cans. Stinging insects will crawl inside a can attracted by the sweet beverage.
- When eating outdoors, try to keep food covered at all times.
- Garbage cans stored outside should be covered with tight-fitting lids.
- Avoid sweet-smelling perfumes, hair sprays, colognes and deodorants.
- Avoid wearing bright-colored clothing.
- Yard work and gardening should be done with caution.
- Keep window and door screens in good repair. Drive with car windows closed.
- Keep prescribed medications handy at all times and follow the attached instructions if you are stung. These medications are for immediate emergency use while en route to a hospital emergency room for observation and further treatment.
- If you have had an allergic reaction to an insect sting, it's important that you see an allergist-immunologist.
This Article is taken in whole or in part from the American college of allergy, asthma, and immunology. For further information visit www.acaai.org