Stinging Insect Allergies
(Bee Stings, Wasp Stings, Others)
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Allergy to Stinging Insects...Can Be Life-Threatening
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: Barbara
K. Hecht, PhD
When warmer weather arrives, it is time to think about the return of
stinging insects. Over 2 million Americans are allergic to stinging insects.
While the severity of these allergic reactions varies greatly, they cause up to
150 deaths each year in the U.S. alone.
Stinging insects belong to the class Hymenoptera and include bees, hornets,
yellow jackets, wasps, and fire ants. Fire ants, which inflict a painful sting that belies their small size, are most common in the U.S. in the southeastern states, but they may have been introduced to other geographic areas throughout the country. All of the other stinging insects are found throughout the U.S. and Canada.
Most insect stings do not cause an allergic reaction,
but simply result in
pain, itching, redness, and swelling at the site of the sting. Cleaning the area
and application of ice packs to reduce swelling are often the only treatment
needed.
Most people who do have an allergy to stinging insects
have mild reactions, such as extension of the area of swelling around the sting. In a more serious
reaction, a person develops hives and itching all over the body.
What are stinging insects?
Stinging insects found in the United States include honeybees, yellow jackets, hornets, wasps, and fire ants. While not everyone is allergic to insect venom, reactions in the skin such as mild pain, swelling, and redness may occur with an insect sting.
Who is at risk for insect sting allergies?
Over 2 million Americans are allergic to stinging insects. The degree of allergy varies widely. 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. Severe allergic reactions to insect stings are responsible for at least 50 deaths each year in the U.S.
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 occur in the summer and fall, you are at greatest risk during these months. Males under the age of 20 are the most common victims of serious insect-sting allergic reactions, but this may reflect a greater exposure to insects of males, rather than a true predisposition.
What types of insect sting reactions occur?
Nonallergic reactions
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 it clean, and apply
ice. Topical corticosteroid creams are sometimes used to decrease inflammation, and antihistamines can help control itching.
Large local reactions may involve increased swelling (that lasts for 48 hours up to one week) that may be accompanied by nausea and vomiting. Large local reactions occur in about 10% of insect stings and are not allergic in origin. Occasionally, the site of an insect sting will become infected, and antibiotics are needed.
Allergic reactions
Systemic (body-wide) reactions are allergic responses and occur in people who have developed antibodies against the insect venom from a prior exposure. It is estimated that between 0.3%-3% of stings trigger a systemic allergic reaction.
The allergic reaction to an insect sting varies from person to person. Symptoms of an allergic reaction can include itching, hives, flushing of the skin, tingling or itching inside the mouth, and nausea or vomiting. The most serious allergic reaction is called anaphylaxis, which can be fatal. 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.
Next: How is a severe allergic reaction immediately treated? »
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