Stinging Insect Allergy

By Andrew S. Kim, MD

Allergy & Asthma Center Of Fairfax

. http://www.allergyasthmadoctors.com/

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Stinging Insect Allergy

Each year there are approximately 50 deaths in the United States due to stinging insects. The vast majority of these deaths are due to an allergic reaction to a single sting.

For a normal healthy adult it would take over 500 stings to cause death from the actual poison in the venom; 30-50 stings could be fatal in a child. Most stings occur in the summer when stinging insects are more aggressive at defending their nests, however warm winter days may bring wasps out of the woodwork.

In our region the most important stinging insects are yellow jackets, wasps, hornets, and honey bees. Fire ants have invaded Virginia and are becoming more common. Bee keepers and their families are especially at risk because of the frequent stings. The tendency to be allergic to stinging insects runs in families.

The normal reaction to an insect sting is a small itchy-stingy welt, which disappears within a few hours. Large local allergic swellings usually increase in size for 2-3 days and then disappear in 5-7 days.
The most worrisome reactions are the systemic reactions, which cause symptoms at parts of the body more distant from the site of the sting. These generalized reactions may consist of rash, abdominal pains, intestinal upset, swelling, difficulty breathing, drop in blood pressure, and possibly death.
Anyone at risk for a severe sting reaction should have an epinephrine injector such as Epipen or Twinject with him at all times in case a systemic reaction occurs. The quick administration of epinephrine can be life-saving. Then the patient should be rushed to the nearest emergency department to continue treatment.

An antihistamine may be taken for local swelling, rash or itching. People with severe insect allergies should carry a Medic-Alert card or bracelet to identify themselves as having this severe allergy. Family members, associates, teachers, babysitters, and daycare workers must be instructed on how and what medications to give and must be supplied with the appropriate medication.

Anyone who has a general reaction should be referred to an allergist for evaluation. Adults with any generalized symptoms should be tested for venom allergy, however children may not need to be tested if their only general symptom is a rash. Allergy desensitization for stinging insect venoms is very effective at preventing future systemic reactions.

People with insect allergies need to practice insect avoidance by not going barefoot outdoors, shaking out clothes before putting them on, avoiding food and drinks outdoors, and avoiding fragrances and bright flowery clothing outdoors.