Every year more than half a million people seek care at a hospital emergency room because of insect stings. As many as 5% of Americans suffer from a severe allergy to insect stings called anaphylaxis which can be fatal. The major causes of severe insect stings in central Virginia are hornets, yellow jackets, wasps and honeybees. Stinging insects are most active in the summer and early fall.
A normal reaction to a sting may consist of pain, swelling and redness confined to the sting site and can be treated with ice to control swelling. A large local reaction consists of pain, redness and swelling that extends beyond the sting site. For example, a sting on the foot could result in the entire lower leg swelling. Large local reactions are not a risk factor for anaphylaxis but can be uncomfortable and alarming in appearance. Large local reactions can be treated with ice, antihistamines and sometimes oral corticosteroids.
A severe allergic reaction to insect stings can involve hives, itching and swelling at a site other than the sting site, tightness in the chest, difficulty breathing, swelling of the tongue or airway, abdominal or uterine cramps, nausea or vomiting, or feeling like you are about to pass out. These types of reactions are usually due to the presence of allergic antibodies to the insect venom. Patients with severe allergic reactions to insect stings have about a 60% chance of having another reaction if stung again.
Severe allergic reactions should be treated immediately with antihistamines for skin symptoms and epinephrine for airway, respiratory or cardiovascular involvement. Anyone who has suffered from a severe allergic reaction should have epinephrine available for self-administration. An allergy evaluation can be helpful to identify the presence of allergic antibodies to insect venom. Allergy shots to the venoms can help take away the sensitivity and prevent future sting reactions.
Insect repellants do not work for stinging insects, but there are some simple steps you can follow to help avoid insects. Avoiding wearing sandals or walking barefoot in the grass Do not drink from open beverage cans. Use caution around open trash cans and recycling bins. Avoid wearing sweet smelling colognes or perfumes, and avoid wearing brightly colored clothing.
by Dr. Charles "Joey" Lane of Allergy Partners of Lynchburg