Bee Sting Allergy: Stinging Insects are more than an Annoyance.

Most allergies are downright bothersome. They are aggravating, persistent, and wear us down. Some allergies are more than a bother, they are life threats. Among the most dangerous are reactions to penicillin, seafood, peanuts, shell fish, aspirin, horse serum (antitoxins), and insect stings.

The stinging insects include the honeybee, yellow jackets, hornets, and wasps. In California, reactions to the honeybee far outnumber the others. Elsewhere the yellow jacket is likely to be the main culprit. At least one percent of us are vulnerable. Interestingly, reactions occur equally in the allergic and non-allergic population.

The honeybee alone leaves its calling card. It leaves its stinger at the sting site and then dies since this is a vital part of its body structure.

Stings have a diversity of local swellings. These range from a small bump to major inflammation extending considerable distance up and down a limb. However unsightly and painful, these are not life threatening. They are classified as toxic rather than allergic. The reaction is to the foreign venom protein. Swelling progresses over hours and may last for several days. The doctor may need to be called. Ice packs, antihistamines, Tylenol, and elevation of the affected limb, alone are recommended.

Allergic reactions are different. Signs occur at a distance from the sting. Symptoms and signs can consist of hives (welts), edema (swelling) of the eyelids and throat, stomach distress, asthma, low blood pressure, fainting, unconsciousness, seizures, and even death.  

The more serious the reaction, the earlier the onset. The allergy is to certain chemicals found in the venom, essentially to enzymes. The main one in Phospholipase A. Nowhere in medicine is there a clearer mandate for medical management. Your doctor will want to see you immediately following this allergic reaction, termed, anaphylaxis.

There is no test available to predict the susceptibility of developing an allergic reaction. A physician consultation is indicated only for those suffering a systemic (general) reaction.

Injection therapy to desensitize a susceptible patient is indicated for all adults and many children sustaining a generalized (anaphylaxis) reaction. Immunotherapy (immunization) to stinging insects is virtually 100% protective. Injection therapy may be a lifetime affair, though commonly

injections may later be spaced to two or three month intervals.

What can John  Q. Public do for prevention? Those most victimized are young boys who get stung in a typical way – running barefoot on the lawn.

The unmistakable lesson – don’t leave home without them – shoes.

The sweet smelling stuff – cologne, hair spray, lotions – may be iffy in attracting the opposite sex, but it’s a winner with honey bees all the time.

Drab and dark colored outfits are best; bright, white, and pastel clothing are not.

Carrying an emergency adrenaline syringe is a must. Serious reactions including death are not to be overlooked. It does no good having one on hand unless one knows how to use it –  every second may count. It is imperative each patient be adequately trained. Practicing by injecting an apple or orange is one common office procedure.

Bill Ziering

Rx365  A Year of Tips for the Successful Medical Practice