Dr. Troy Baker, DO, is a board-certified allergist with the Mid-Atlantic Permanente Medical Group. He sees patients at the Kaiser Permanente Caton Hill Medical Center.
You’re outside enjoying a nice day when you get stung by a paper wasp. Or you are drinking a soft drink at a picnic and get stung by a yellow jacket and your lip swells.
These types of incidents occur all too often. In fact, approximately 90 percent of people will be stung by an insect at some point in their lives. And roughly 100 people die each year from insect sting anaphylaxis, according to the American College of Allergy, Asthma & Immunology. Adults are more likely to die than children.
Reactions to stinging insects vary from person to person. Some have normal, mild reactions, characterized by redness and swelling around the sting site. Others, however, have severe allergic reactions that can lead to anaphylaxis, a life-threatening situation.
As the weather gets warmer and the bugs come out from their winter hiding places, it’s important to know how to avoid insect stings and when to seek emergency medical treatment.
Which insects sting?
The five types of insects most likely to cause serious allergic reactions in the mid-Atlantic are paper wasps, yellow jackets, hornets, fire ants, and honeybees.
Why are some people allergic to insect stings?
We do not know exactly why some people become allergic to stinging insects. An allergy develops when a person is stung and the immune system creates an allergy antibody against the protein within the insect venom. This antibody is called IgE and coats allergy cells throughout the body. When the immune system meets this venom protein again, an allergic reaction will occur quickly. About 3 to 4 percent of individuals who get stung will have a serious allergic reaction.
Males are more likely to have a venom allergy than females.
What are the symptoms of an insect sting allergy?
A mild insect sting reaction is known as a local reaction because it generally affects only the part of the body that has been stung. Symptoms of a mild insect sting reaction include the following:
- A red, itchy bump at the site of the sting;
- Swelling at the sting site;
- Warmth at the sting site.
These symptoms may last as long as a week before they clear up. The swelling may get worse for two or three days before it gets better.
While mild reactions to insect stings are fairly common, severe allergic reactions are much less common. Here are the symptoms of a serious allergic reaction:
- Hives or facial swelling;
- Difficulty breathing, wheezing, chest tightness, or coughing;
- Nausea, vomiting, or diarrhea;
- Painful cramps in the pelvic area;
- Drop in blood pressure;
- Feeling lightheaded or dizzy;
- Losing consciousness.
These anaphylaxis symptoms tend to develop within minutes of the insect sting and can be life- threatening. Anyone with symptoms of a severe allergic reaction to an insect sting should call 911 or be taken to an emergency room immediately. Anyone with a severe allergic reaction who has an epinephrine auto-injector available should use it, but still should be taken to an emergency room, even if symptoms improve.
How are insect stings treated?
Mild reactions to insect stings usually can be treated at home, and the treatment is the same for children and adults. Remove the stinger (generally honeybee only) as soon as possible to avoid the body getting more venom. Then wash the area with soap and water to prevent infections. Apply ice to reduce swelling and pain. Use over-the-counter pain medications to alleviate discomfort. I also recommend taking an antihistamine to relieve itching.
Severe allergic reactions usually are best treated with intramuscular epinephrine auto-injectors and antihistamines. Antibiotics and steroids usually are not necessary to treat insect sting allergies.
Are allergy shots helpful for insect stings?
Allergy shots (venom immunotherapy) are extremely helpful in treating venom allergy and are considered the gold standard in treatment. Stinging insects are small and unpredictable. They can sting when you least expect it, so allergy shots are vital to those who become allergic.
Allergic individuals may have serious reactions about 50 to 70 percent of the time, if they are re-stung. However, with allergy shot desensitization, the risk is lowered to about 2 percent.
Allergy shots are given weekly for four to six months, then monthly. Over one to two years, this therapy can be spaced out to a venom shot every two to three months. We offer these treatments at Kaiser Permanente.
How can I avoid insect stings?
Of course, the best way to avoid an insect sting allergic reaction is to try to avoid getting stung in the first place. Easier said than done, but here are some tips.
- Be careful about drinks outside. Some insects will find their way into liquids, especially sweet drinks. Then when you take a sip of your beverage, you can get stung on the mouth.
- Don’t disturb insect nests or hives. Leave them alone. Hire a professional to remove them.
- Avoid going barefoot outdoors. Wear closed-toed shoes when possible.
- Wear long sleeves. Wear long pants and socks in areas that are buggy. Cover your arms and legs when doing yard work or mowing the lawn.
- Remove fallen fruit or pet feces from your yard. Insects love to hang out near fruit and pet feces.
You may have heard that avoiding certain fragrances and avoiding brightly colored or floral clothing can help avoid insect stings. Evidence shows, however, that these strategies aren’t effective.
As you enjoy the outdoors, keep these tips in mind, but be prepared on the chance you do get stung. And remember, if you have a severe allergic reaction, seek immediate medical attention.
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