Coping with Allergies and Asthma Magazine - May/June 2003 issue
Insect allergies most frequently occur after being stung by a bee, wasp, yellow jacket, hornet, or fire ant. Most people, however, are not allergic to insect stings and may mistake a normal or local reaction for an allergic reaction. By knowing the difference, you can prevent unnecessary worry and visits to the doctor's office. The severity of an insect sting reaction varies from person to person. There are three types of reactions:
Symptoms of an Allergic Reaction Symptoms of a severe allergic reaction or “anaphylactic” reaction may include one or more of the following: difficulty breathing; hives that appear as a red, itchy rash that spreads to areas other than the immediate area stung; swelling of the face, throat or mouth tissue; wheezing or difficulty swallowing; restlessness and anxiety; rapid pulse; dizziness; or a sharp drop in blood pressure.
Although severe allergic reactions are not that common, they can lead to shock, cardiac arrest and unconsciousness in 10 minutes or less. This type of reaction can occur within minutes after the sting and may be life threatening or even fatal. Get emergency treatment as soon as possible. A mild allergic reaction to an insect sting may cause one or more of the following symptoms at the site of the sting: pain, redness, pimple-like spots; mild to moderate swelling, warmth at the sting site, or itching. People who have experienced an allergic reaction to an insect sting have a 60 percent chance of a similar or worse reaction if they are stung again.
Treating Normal or Localized Reactions First, if stung on the hand, remove any rings on your fingers immediately. If stung by a bee, the bee usually leaves a sac of venom and stinger in the victim's skin. If the sac is still in the skin, gently scrape tout with a fingernail or a stiff-edged object like a credit card. Do not pull-on the stinger as this will cause the release of more venom into the skin.
Wash the stung area with soap and water then apply an antiseptic. Apply soothing ointment, like a hydrocortisone cream or calamine lotion and cover the area with a dry, sterile bandage. If swelling is a problem, apply an ice pack or cold compress to the area. Take an oral antihistamine, like Benadryl®, to reduce itching, swelling and hives. However, this medication should not be given to children under three years of age or to a pregnant woman without prior approval from her doctor.
Treating Allergic Reactions An allergic reaction is treated with epinephrine (adrenaline), either self-injected or administered by a doctor. Usually, this injection will stop the development of a severe allergic reaction. In some cases, intravenous fluids, oxygen and other treatments are also necessary. Once stabilized, the person is sometimes required to stay overnight at the hospital under close observation. People who have had previous allergic reactions and rely on the protection of epinephrine must remember to carry it with them wherever they go. Also, because one dose may not be enough to reverse the reaction, immediate medical attention following an insect sting is recommended.
How to Avoid Being Stung You can lessen your chances of an insect sting by taking certain precautionary measures. Learn to recognize insect nests and avoid them. Yellow jackets nest in the ground in dirt mounds or old logs and in walls. Honeybees nest in beehives. Hornets and wasps nest in bushes, trees and on buildings. Wear shoes and socks when you are outdoors. Wear long-sleeved shirts, long pants, socks and shoes, when in country or woodsy areas. Limit wearing perfumes or brightly colored clothing, they tend to attract insects. People who have severe allergies should never be alone when hiking, boating, swimming, golfing or otherwise involved outdoors, as they may need prompt medical treatment if stung. A severely allergic person should always wear a MedicAlert® bracelet and keep a self-care kit like EpiPen® on hand for emergency use in the case of severe symptoms. You will need a prescription from your doctor to purchase one of these kits.
Source: The Cleveland Clinic