Many Americans are stung by insects every year. For most, these stings mean pain and discomfort generally
lasting several hours or a day or two. Symptoms may include redness, swelling and itching at the site of the sting
and are caused by the chemicals in insect venom. Large local reactions are not a true allergic reaction.
However, some people are allergic to insect stings. After the first sting, the allergic person's body produces
an allergic substance called Immunoglobulin E (IgE) antibody, which reacts with the insect venom. This is the
same allergy mechanism that causes other allergies such as hay fever. If an insect of the same or similar
species stings that person again, the insect venom interacts with the IgE antibody produced in response to
the earlier sting. This triggers the release of histamine and other chemicals that cause allergic symptoms.
Severe allergic reactions to insect stings can involve many body organs and may develop rapidly and may be
life-threatening.. This reaction is called anaphylaxis. Symptoms of anaphylaxis may include itching and hives
over large areas of the body, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps,
nausea or diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness.
Anaphylaxis is a medical emergency, and may be fatal. If you or anyone else experiences any of these symptoms
after an insect sting, obtain emergency medical treatment immediately. After your symptoms are treated in
the emergency room, you should also obtain referral to an allergist/immunologist to learn about treatment
options.
For those with allergies, avoidance is best. Don't look or smell like a flower - avoid brightly colored
clothing and perfume when outdoors. If you encounter any flying stinging insects, remain calm and quiet,
and move slowly away from them. Because the smell of food attracts insects, be careful when cooking, eating,
or drinking sweet drinks like soda or juice outdoors. Keep food covered until eaten. Try to stay away from
trashcans in a park. Wear closed-toe shoes outdoors and avoid going barefoot. Also, avoid loose-fitting
garments that can trap insects between material and skin.
If stung by a honeybee that has left its stinger (and attached venom sac) in your skin, remove the stinger
within 30 seconds to avoid receiving more venom. A quick flicking of a fingernail removes the stinger and sac.
Avoid squeezing the sac - this forces more venom through the stinger and into the skin. Other steps that
can help minimize local reactions include ice, topical steroids, oral antihistamines and elevating the sting
site if on an extremity.
If you have a history of a severe reaction to insect venom, carry an auto-injectable epinephrine (adrenalin)
device, called an Epi-Pen. This is for short-term treatment for severe allergic reactions. Learn how to
self-administer the epinephrine according to instructions, and replace the device before the labeled expiration
date. Injectable epinephrine is rescue medication only, to give you enough time to get to the closest ER.
You must still have someone take you to an emergency room immediately if you are stung. Additional medical
treatment may be necessary. Those with severe allergies should consider wearing a special bracelet or necklace
that identifies the wearer as having severe allergies and supplies other important medical information.
Anyone who has had a serious adverse reaction to an insect sting should be evaluated by an allergist/immunologist,
who will take a thorough history, perform an examination and recommend testing to determine whether you have
an allergy, and which type of stinging insect caused the reaction. Skin and/or blood (RAST) testing for insect
allergy is used to detect the presence of significant amounts of IgE antibody.
People who have severe allergies to insect venom should consider receiving insect venom immunotherapy, a
highly effective vaccination program that actually prevents future allergic sting reactions in 97-99% of
treated patients. During immunotherapy, the allergist/immunologist administers gradually stronger doses of
venom extract initially every week, but as maintenance doses are reached the interval will be expanded to
one month or more. At KCAA we utilize a modified rush schedule so that you can be at maintenance within 4-6
weeks.
Please feel free to contact our office for further information on this subject.
Information is adapted from AAAAI
website materials.
For Appointments:
To schedule an appointment with Allergy & Asthma Center of SW Washington call: 1 (866) 206-1780 Toll Free
