wasp sting

Wasp sting

Wasp sting is an injury caused by sting from a wasp. Wasps belong to the Order Hymenoptera in the family Vespidae (wasps) and include yellowjackets, aerial yellowjackets, hornets and paper wasps; family Apidea (bees); and family Formicidae (ants) 1. A wasp or hornet sting causes a sudden, sharp pain at first. A swollen red mark may then form on your skin, which can last a few hours and may be painful and itchy. Sometimes a larger area around the sting can be painful, red and swollen for up to a week. This is a minor allergic reaction that is not usually anything to worry about. Currently, there are more than 6,000 species of wasps in the world 2. Wasp stings are common in the world. Epidemiological surveys in the United States show that wasp stings account for 27.4%–29.7% of all animal injuries and the annual mortality is 0.14–0.74/million population 3, 4. Proper recognition of the insect responsible for the sting is important for appropriate management; however, most victims cannot identify the sting culprit 1.

A sting will be painful and annoying, but otherwise pretty harmless (non-allergic reaction). Most people only have mild reactions at the site of a sting from a bee, wasp, or hornet. These can include:

  • Sharp, burning pain
  • Redness and a warm feeling
  • Mild swelling
  • Itching

Most insect bites and stings result in a localized itch and swelling that settles within a few days 5, 6. Unless you are allergic to the venom of bees, wasps, or hornets. Severe allergic reactions (life-threatening allergic reaction) is called anaphylaxis. Anaphylaxis causes your immune system to release a flood of chemicals that can cause you to go into shock — blood pressure drops suddenly and the airways narrow, causing breathing difficulties, dizziness and a swollen face or mouth. Signs and symptoms include a rapid, weak pulse; a skin rash; and nausea and vomiting. Anaphylaxis can occur within seconds or minutes of exposure to something you’re allergic to, such as wasp or bee stings. Call your local emergency services number for an ambulance immediately if you have these symptoms. Anaphylaxis occurs when you are exposed to something you are severely allergic to. Anaphylaxis requires an injection of epinephrine (adrenaline) and a follow-up trip to an emergency room. If you don’t have epinephrine (adrenaline), you need to go to an emergency room immediately. If anaphylaxis isn’t treated right away, it can be fatal, it can stop your breathing or your heartbeat resulting in death. It has been estimated that potentially life-threatening allergic reactions occur in 0.4% – 0.8% of children and 3% of adults. At least 90 – 100 deaths per year result from insect sting anaphylaxis 7. However, most wasp or hornet sting don’t lead to anaphylaxis.

An allergic reaction occurs when your immune system overreacts to an allergen. In stinging insect allergy, the allergen is venom from a sting. Most serious reactions are caused by five types of insects:

  • Yellow jacket wasps are black with yellow markings, found in various climates. Their nests are usually located underground, but sometimes found in the walls of buildings, cracks in masonry or in woodpiles.
  • Paper wasps are slender with black, brown, red and yellow markings. They live in a circular comb under eaves, behind shutters or in shrubs and woodpiles.
  • Hornets are black or brown with white, orange or yellow markings. Their nests are gray or brown and are usually found in trees.
  • Honeybees have round, fuzzy bodies with dark brown and yellow markings. They can be found in honeycombs in trees, old tires or other partially protected sites.
  • Fire ants are reddish-brown ants living in large mounds, mostly in warmer climates. Fire ants are aggressive and they attack with little warning, inserting highly concentrated toxins that cause burning sensation and pain. Red bumps form at the sting, and within a day or two they become white fluid-filled pustules.

Bees, wasps, fire ants and hornets are found throughout the United States. The majority of insect stings in the United States come from wasps, yellow jackets, hornets and honeybees. The red or black imported fire ant now infests more than 260 million acres in the southern United States, where it has become a significant health hazard and may be the number one agent of insect stings.

Generally, insects such as bees and wasps aren’t aggressive and only sting in self-defense. In most cases, this results in one or perhaps a few stings. In some cases a person will disrupt a hive or swarm of bees and get multiple stings. Some types of bees — such as Africanized honeybees — are more likely than are other bees to swarm, stinging in a group.

Most insect bites will improve within a few hours or days and can be treated at home. To treat an insect bite or sting:

  • Remove the sting if still in the skin to prevent any more venom being released. Scrape it out sideways with something with a hard edge, such as a bank card, or your fingernails if you don’t have anything else to hand. Don’t pinch the sting with your fingers or tweezers because you may spread the venom.
  • Wash the affected area with soap and water.
  • Apply a cold compress (such as a flannel or cloth cooled with cold water) or an ice pack to any swelling for at least 10 minutes.
  • Raise or elevate the affected area if possible, as this can help reduce swelling.
  • Avoid scratching the area or bursting any blisters, to reduce the risk of infection – if your child has been bitten or stung, it may help to keep their fingernails short and clean.
  • Take an over-the-counter pain reliever as needed. You might try ibuprofen (Advil, Motrin IB, others) to help ease discomfort.
  • Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
  • If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine.

The pain, swelling and itchiness can sometimes last a few days. See your doctor if these treatments don’t help. They may prescribe stronger medicines such as steroid tablets.

If you think you might be allergic to insect stings, see an allergist (immunologist). Based on your past history and certain tests, the allergist will determine if you are a candidate for skin testing and immunotherapy (venom immunotherapy).

People with a history of severe allergic reactions to insect bites or stings should consider carrying an epinephrine auto injector (EpiPen) and should wear a medical identification bracelet or necklace stating their allergy.

Figure 1. Paper wasp

Paper wasp

Figure 2. Yellow jacket wasp

yellow jacket wasp

Figure 3. European hornet

European hornet

Figure 4. Honeybee

Honeybee

Figure 5. Fire ant

Fire ant
When to see a doctor

Seek emergency medical help if you, your child or someone else you’re with has a severe allergic reaction. Don’t wait to see if the symptoms go away.

Symptoms of a severe reaction may include the following:

  • wheezing or difficulty breathing
  • a swollen face, mouth or throat
  • feeling sick or being sick
  • a fast heart rate
  • dizziness or feeling faint
  • difficulty swallowing
  • loss of consciousness

If you have an attack and you carry an epinephrine autoinjector, administer it right away. Even if symptoms improve after the injection, you still need to go to an emergency room to make sure symptoms don’t recur, even without more exposure to the allergen. This second reaction is called biphasic anaphylaxis.

Make an appointment to see your family doctor if you or your child has had a severe allergy attack or signs and symptoms of anaphylaxis in the past.

The diagnosis and long-term management of anaphylaxis are complicated, so you’ll probably need to see a doctor who specializes in allergies and immunology.

Who is affected by allergies to insect stings?

Allergic reactions to stings can occur even after many normal reactions to stings, and at any age. Estimates show that potentially life-threatening allergic reactions to insect venom occur in 0.4 percent to 0.8 percent of children and 3 percent of adults.

How do I know if I’ve had an allergic reaction to an insect sting?

Symptoms of an allergic reaction can range from mild to severe. They may include the following (either alone or in combination):

  • Hives (urticaria or welts) are bumps or patches on the surface of your skin.
  • Itchiness
  • Flushing
  • Swelling in areas away from the sting
  • Dizziness or a sharp drop in blood pressure
  • A hoarse voice, coughing, swelling of the tongue or difficulty swallowing
  • Hives, itching and swelling in areas other than the sting site
  • Abdominal cramping, vomiting, intense nausea or diarrhea
  • Unconsciousness or cardiac arrest
  • Anaphylaxis is a severe life-threatening allergic reaction that impairs breathing, causes a sudden drop in blood pressure and can send the body into shock. It can occur within minutes of a sting. A dose of epinephrine (adrenaline), typically administered in an auto-injector, and immediate medical attention are required.

Can I get rid of my insect sting allergy?

Yes. For long-term protection, an allergist can treat you with allergy shots (immunotherapy), which builds tolerance over time and provides up to 98% protection if you get stung again. In addition to reducing the risk of systemic reaction to future stings, venom immunotherapy significantly improves quality of life. This is especially true for active individuals where jobs or recreational activities take them outdoors. The length of venom immunotherapy is usually three to five years, but it can be continued indefinitely depending on how severe past reactions have been, and the risk of future stings.

Do I need to have an epinephrine auto-injector?

It depends on your risk factors including your history of reaction to an insect sting. Your allergist will determine if you are at high risk of a severe allergic reaction and prescribe an epinephrine auto-injector if needed.

Wasp sting symptoms

Wasp or bee stings can produce different reactions from person to person, ranging from temporary pain and discomfort to a severe allergic reaction (anaphylaxis). Having one type of reaction doesn’t mean you’ll always have the same reaction every time you’re stung or that the next reaction will necessarily be more severe.

A normal reaction will result in pain, swelling and redness confined to the sting site. You can disinfect the area (washing with soap and water will do) and apply ice to reduce the swelling.

A large local reaction will result in swelling that extends beyond the sting site. For example, a sting on the forearm could result in the entire arm swelling. Although alarming in appearance, this condition is often treated the same as a normal reaction. An unusually painful or very large local reaction may need medical attention. Because this condition may persist for two to three days, antihistamines and corticosteroids are sometimes prescribed to lessen the discomfort.

Fire ants, yellow jackets, hornets and wasps can sting repeatedly. Honeybees have barbed stingers that are left behind in their victim’s skin. These stingers are best removed by a scraping action, rather than a pulling motion, to avoid squeezing more venom into the skin.

Almost everyone stung by fire ants develops an itchy, localized hive or lump at the sting site, which usually goes down within 30 to 60 minutes. This is followed by a small blister within four hours. This usually appears to become filled with pus-like material by eight to 24 hours. However, what is seen is really dead tissue, and the blister has little chance of being infected unless it is opened. When healed, these lesions may leave scars.

Mild reaction

Most of the time, wasp or bee sting symptoms are minor and include:

  • Instant, sharp burning pain at the sting site
  • A red welt at the sting area
  • Slight swelling around the sting area

In most people, the swelling and pain go away within a few hours.

Moderate reaction

Some people who get stung by a bee or other insect have a bit stronger reaction, with signs and symptoms such as:

  • Extreme redness
  • Swelling at the site of the sting that gradually enlarges over the next day or two

Moderate reactions tend to resolve over five to 10 days. Having a moderate reaction doesn’t mean you’ll have a severe allergic reaction the next time you’re stung. But some people develop similar moderate reactions each time they’re stung. If this happens to you, talk to your doctor about treatment and prevention, especially if the reaction becomes more severe each time.

Anaphylaxis (severe allergic reaction)

A severe allergic reaction (anaphylaxis) to wasp or bee stings is potentially life-threatening and requires emergency treatment. A small percentage of people who are stung by a bee or other insect quickly develop anaphylaxis. Anaphylaxis symptoms usually occur within minutes of exposure to something you’re allergic to, such as wasp or bee stings. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure. In rare cases, anaphylaxis may be delayed for hours.

Signs and symptoms of anaphylaxis include:

  • Skin reactions, including hives and itching and flushed or pale skin
  • Low blood pressure (hypotension)
  • Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
  • Swelling of the throat and tongue
  • A weak and rapid pulse
  • Nausea, vomiting or diarrhea
  • Dizziness or fainting
  • Loss of consciousness

People who have a severe allergic reaction to a bee sting have a 25% to 65% chance of anaphylaxis the next time they’re stung. Talk to your doctor or an allergy specialist about prevention measures such as immunotherapy (“allergy shots”) to avoid a similar reaction in case you get stung again.

Fire ant sting symptoms

The severity of a fire ant sting reaction varies from person to person. One of the main differences between fire ants and other insects is that a usual sting event consists of multiple fire ants stinging. This is because when a fire ant mound is disturbed hundreds to thousands of fire ants respond. In addition, each ant can sting repeatedly. Each ant will bite and hold on with its mandibles (jaw) and sting several times. If not removed, this results in a little semi-circular pattern of stings. Since fire ants hold on with their mandibles, they often have to be pulled off individually and are not easily brushed off when they are stinging.

Almost all people stung by fire ants develop an itchy, localized hive or lump at the sting site, which usually subsides within 30 to 60 minutes. This is followed by a small blister within four hours. This usually appears to become filled with pus-like material by eight to 24 hours. However, what is seen is really dead tissue, and the blister has little chance of being infected unless it is opened. When healed, these lesions may leave scars.

Wasp sting prevention

There are some simple precautions you can take to reduce your risk of being bitten or stung by insects. It’s particularly important to follow this advice if you’ve had a bad reaction to an insect bite or sting in the past or you’re traveling to an area where there’s a risk of picking up a serious illness.

Stinging insects are most active during the late spring, summer, summer and early fall. Insect repellents do not work against stinging insects.

Yellow jackets will nest in the ground and in walls. Hornets and wasps will nest in bushes, trees and on buildings. Use extreme caution when working or playing in these areas.

The following measures can help you avoid insect bites and stings:

  • remain calm and move away slowly if you encounter wasps, hornets or bees – do not wave your arms around or swat at them
  • cover exposed skin – if you’re outside at a time of day when insects are particularly active, such as sunrise or sunset, cover your skin by wearing long sleeves and trousers
  • wear shoes when outdoors
  • apply insect repellent to exposed skin – repellents that contain 50% DEET (diethyltoluamide) are most effective
  • avoid using hair or body products with strong perfumes especially if it has a fruity or floral scent, such as soaps, shampoos and deodorants – these can attract insects
  • be careful around flowering plants, rubbish, compost, stagnant water, and in outdoor areas where food is served
  • never disturb insect nests – if a nest or hive is in your house or garden, arrange to have it removed
  • move slowly and quietly away from areas where you see bees, wasps, or hornets.
  • avoid camping near water, such as ponds and swamps – mosquitoes and horseflies are commonly found near water
  • keep food and drink covered when eating or drinking outside, particularly sweet things – wasps or bees can also get into open drink bottles or cans you’re drinking from
  • stay away from open trash containers outdoors. Toss your garbage in and then move away quickly.
  • keep doors and windows closed or put thin netting or door beads over them to prevent insects getting inside the house – also keep the windows of your car closed to stop insects getting inside
  • effective methods for insecticide treatment of fire ant mounds use attractant baits. These baits often contain soybean oil and corn grits combined with chemical agents. The bait is picked up by the worker ants and taken deeper into the mound to the queen. It can take weeks for these insecticides to work.

Anaphylaxis prevention

Below are ways to help prevent or avoid anaphylaxis.

  • Alert all doctors about any allergies you have.
  • Tell your doctors if you have had anaphylaxis in the past. This should be noted in your medical chart.
  • Avoid eating or touching foods you are allergic to. Even tiny amounts can cause a severe reaction. Read the ingredient list on packaged foods. When eating out, tell the server or chef about your allergy.
  • If you are allergic to insect stings, wear protective clothing and insect repellent when you are outside.
  • Wear or carry a medical alert bracelet, keychain, or card. This will help doctors and health professionals who treat you in an emergency.
  • Carry an emergency anaphylaxis kit with you at all times. Your doctor can prescribe this. It contains medicine to reduce an allergic reaction once it starts. The medicine is called an epinephrine injector (EpiPen). Family, friends, and coworkers should know how to use it. A kit may also include an antihistamine, such as diphenhydramine (Benadryl).

Wasp sting diagnosis

If you are concerned that you may have an allergy to insect venom, your best option is to see an allergist.

Your allergist should take a detailed medical history, including questions about previous stings (how many there have been and where you were stung), your reaction to those stings (what you experienced, how long the reaction lasted and what you did to get relief) and any additional symptoms.

If you’ve had a reaction to wasp or bee sting that suggests you might be allergic to wasp or bee venom, your doctor may suggest one or both of the following tests:

  • Skin test. During skin testing, a small amount of allergen extract (in this case, wasp or bee venom) is injected into the skin of your arm or upper back. This test is safe and won’t cause any serious reactions. If you’re allergic to wasp or bee sting, you’ll develop a raised reddish bump on your skin at the test site within 15 to 20 minutes, that can indicate an allergy.
  • Allergy blood test. A blood test can measure your immune system’s response to wasp or bee venom by measuring the amount of allergy-causing antibodies (presence of immunoglobulin E [IgE] antibodies) in your bloodstream. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.

If the skin prick test is negative or inconclusive your allergist will likely recommend an intradermal skin test, in which a small amount of venom extract is injected just under the skin. The site is examined after about 15 minutes for signs of an allergic reaction. This test is considered more accurate than the skin-prick or blood tests in determining the presence of IgE antibodies. If both skin prick and intradermal skin tests are negative then your allergist may recommend a blood test.

Allergy skin tests and allergy blood tests are often used together to diagnose insect allergies. Your doctor may also want to test you for allergies to yellow jackets, hornets and fire ants — which can cause allergic reactions similar to those of wasp or bee stings.

The strength of a reaction to a skin or blood test does not indicate how severe your allergic reaction will be the next time you are stung.

Wasp sting treatment

For ordinary wasp or bee stings that do not cause an allergic reaction, home treatment is enough. Multiple stings or an allergic reaction, on the other hand, can be a medical emergency that requires immediate treatment.

The following steps may help ease the swelling and itching after an insect bite or sting:

  • If you can, remove the stinger as soon as possible, such as by scraping it off with a fingernail. Don’t try to remove a stinger below the skin surface. A stinger may not be present, as only bees leave their stingers. Other stinging insects, such as wasps, do not.
  • Wash the affected area with soap and water.
  • Apply a cold compress for at least 10 minutes.
  • Take an over-the-counter pain reliever as needed. You might try ibuprofen (Advil, Motrin IB, others) to help ease discomfort.
  • If the sting is on an arm or leg, elevate it, as this can help reduce swelling.
  • Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
  • If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine.
  • Avoid scratching the sting area. This will worsen itching and swelling and increase your risk of infection. If your child has been bitten or stung, it may help to keep their fingernails short and clean.

See your doctor if these treatments don’t help. They may prescribe stronger medicines such as steroid tablets.

People with a history of severe allergic reactions to insect bites or stings should consider carrying an epinephrine auto injector (EpiPen) and should wear a medical identification bracelet or necklace stating their allergy.

Anaphylaxis treatment

During an anaphylactic attack, you might receive cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. You might also be given medications, including:

  • Epinephrine (adrenaline) to reduce the body’s allergic response
  • Oxygen, to help you breathe
  • Intravenous (IV) antihistamines and cortisone to reduce inflammation of the air passages and improve breathing
  • A beta-agonist (such as albuterol) to relieve breathing symptoms

What to do in an emergency

If you’re with someone who’s having an allergic reaction and shows signs of shock, act fast. Look for pale, cool and clammy skin; a weak, rapid pulse; trouble breathing; confusion; and loss of consciousness. Do the following immediately:

  • Call your local emergency number for medical help.
  • Use an epinephrine autoinjector (EpiPen, Auvi-Q, others), if available, by pressing it into the person’s thigh.
  • Make sure the person is lying down and elevate the legs.
  • Check the person’s pulse and breathing and, if necessary, administer CPR (cardiopulmonary resuscitation) or other first-aid measures.

Using an autoinjector

Many people at risk of anaphylaxis carry an autoinjector. This device is a combined syringe and concealed needle that injects a single dose of medication when pressed against the thigh. Replace epinephrine before its expiration date, or it might not work properly.

Using an autoinjector immediately can keep anaphylaxis from worsening and could save your life. Be sure you know how to use the autoinjector. Also, make sure the people closest to you know how to use it — if they’re with you in an anaphylactic emergency, they could save your life. Medical personnel called in to respond to a severe anaphylactic reaction also may give you an epinephrine injection or another medication.

Consider wearing an alert bracelet that identifies your allergy to bee or other insect stings.

Long-term treatment

If insect stings trigger an anaphylactic reaction, a series of allergy shots (immunotherapy) might reduce the body’s allergic response and prevent a severe reaction in the future.

Unfortunately, in most other cases there’s no way to treat the underlying immune system condition that can lead to anaphylaxis. But you can take steps to prevent a future attack — and be prepared if one occurs.

  • Try to stay away from your allergy triggers.
  • Carry self-administered epinephrine. During an anaphylactic attack, you can give yourself the drug using an autoinjector.

Allergy shots (venom immunotherapy)

Allergy shots are a form of treatment called venom immunotherapy. Each allergy shot (venom immunotherapy) contains a tiny amount of the specific substance or substances that trigger your allergic reactions. These are called allergens. Allergy shots contain just enough allergens to stimulate your immune system — but not enough to cause a full-blown allergic reaction.

Allergy shots are regular injections over a period of time — generally around three to five years — to stop or reduce allergy attacks.

Over time, your doctor increases the dose of allergens (venom) in each of your allergy shots. This helps get your body used to the allergens (desensitization). Your immune system builds up a tolerance to the allergens (venom), causing your allergy symptoms to diminish over time.

Allergy shots may be a good treatment choice for you if:

  • Medications don’t control your symptoms well, and you can’t avoid the things that cause your allergic reactions
  • Allergy medications interact with other medications you need to take or cause bothersome side effects
  • You want to reduce your long-term use of allergy medication
  • You’re allergic to insect stings

Allergy shots can be used to control symptoms triggered by:

  • Insect stings. Allergic reactions to insect stings can be triggered by bees, wasps, hornets or yellow jackets.
  • Seasonal allergies. If you have seasonal allergic asthma or hay fever symptoms, you may be allergic to pollens released by trees, grasses or weeds.
  • Indoor allergens. If you have year-round symptoms, you may be sensitive to indoor allergens, such as dust mites, cockroaches, mold, or dander from pets such as cats or dogs.

Allergy shots aren’t available for food allergies or chronic hives (urticaria).

Allergy symptoms won’t stop overnight. They usually improve during the first year of treatment, but the most noticeable improvement often happens during the second year. By the third year, most people are desensitized to the allergens contained in the shots — and no longer have significant allergic reactions to those substances.

After a few years of successful treatment, some people don’t have significant allergy problems even after allergy shots are stopped. Other people need ongoing shots to keep symptoms under control.

Allergy shots risks

Most people don’t have much trouble with allergy shots. But they contain the substances that cause your allergies — so reactions are possible, and can include:

  • Local reactions, which can involve redness, swelling or irritation at the injection site. These common reactions typically begin within a few hours of the injection and clear up soon after.
  • Systemic reactions, which are less common — but potentially more serious. You may develop sneezing, nasal congestion or hives. More-severe reactions may include throat swelling, wheezing or chest tightness.
  • Anaphylaxis is a rare life-threatening reaction to allergy shots. It can cause low blood pressure and trouble breathing. Anaphylaxis often begins within 30 minutes of the injection, but sometimes starts later than that.

If you get weekly or monthly shots on a regular schedule without missing doses, you’re less likely to have a serious reaction.

Taking an antihistamine medication before getting your allergy shot can reduce the risk of a reaction, particularly a local reaction. Check with your doctor to see if this is recommended for you.

The possibility of a severe reaction is scary — but you won’t be on your own. You’ll be observed in the doctor’s office for 30 minutes after each shot, when the most serious reactions usually occur. If you have a severe reaction after you leave, return to your doctor’s office or go to the nearest emergency room. Administer epinephrine if recommended by your physician.

Bee sting treatment

A bee sting feels similar to a wasp sting, but the sting will often be left in the wound. You should remove it as soon as possible to prevent any more venom being released. Scrape it out sideways with something with a hard edge, such as a bank card, or your fingernails if you don’t have anything else to hand. Don’t pinch the sting with your fingers or tweezers because you may spread the venom.

Wash the area gently with soap and water.

Use ice (wrapped in a cloth) or a cold compress to reduce swelling at the site of the sting.

Do not scratch the sting as this may increase swelling, itching, and risk of infection.

The following steps may help ease the swelling and itching after an insect bite or sting:

  • If you can, remove the stinger as soon as possible, such as by scraping it off with a fingernail. Don’t try to remove a stinger below the skin surface. A stinger may not be present, as only bees leave their stingers. Other stinging insects, such as wasps, do not.
  • Wash the affected area with soap and water.
  • Apply a cold compress for at least 10 minutes.
  • Take an over-the-counter pain reliever as needed. You might try ibuprofen (Advil, Motrin IB, others) to help ease discomfort.
  • If the sting is on an arm or leg, elevate it, as this can help reduce swelling.
  • Apply hydrocortisone cream or calamine lotion to ease redness, itching or swelling.
  • If itching or swelling is bothersome, take an oral antihistamine that contains diphenhydramine (Benadryl) or chlorpheniramine.
  • Avoid scratching the sting area. This will worsen itching and swelling and increase your risk of infection. If your child has been bitten or stung, it may help to keep their fingernails short and clean.

Make an appointment to see your doctor if:

  • Bee sting symptoms don’t go away within a few days
  • You’ve had other symptoms of an allergic response to a bee sting

Multiple bee stings

If you get stung more than a dozen times, the accumulation of venom may induce a toxic reaction and make you feel quite sick. Signs and symptoms include:

  • Nausea, vomiting or diarrhea
  • Headache
  • A feeling of spinning (vertigo)
  • Convulsions
  • Fever
  • Dizziness or fainting

Multiple stings can be a medical emergency in children, older adults, and people who have heart or breathing problems.

Seek prompt medical care if you’ve been swarmed by bees and have multiple stings.

Call your local emergency services number if you’re having a serious reaction to a bee sting that suggests anaphylaxis, even if it’s just one or two signs or symptoms. If you were prescribed an emergency epinephrine autoinjector (EpiPen, Auvi-Q, others), use it right away as your doctor directed.

Fire ant sting treatment

Fire ant sting treatment is aimed at preventing secondary bacterial infection, which may occur if the pustule is scratched or broken. Clean the blisters with soap and water to prevent secondary infection. Do not break the blister. If a blister is accidentally opened, careful attention to keeping the area clean with soap and water should still prevent infection. Topical corticosteroid ointments and oral antihistamines may relieve the itching associated with these reactions.

Fire ant sting allergy treatment

Fire ant sting allergy is treated in a two-step approach:

  1. The first step is the emergency treatment of the symptoms of a serious reaction when they occur.
  2. The second step is preventive treatment of the underlying allergy with whole body extract immunotherapy, which contains the entire body of the fire ant, not just the venom, as is the case with other stinging insects. It is a highly effective program administered by an allergist-immunologist, which can prevent future allergic reactions to fire ant stings. At this time, scientists are not able to isolate venom from fire ants.

Life-threatening allergic reactions (anaphylaxis) can progress very rapidly and require immediate medical attention. Emergency treatment usually includes administration of certain drugs, such as epinephrine, antihistamines, and in some cases, corticosteroids, intravenous fluids, oxygen and other treatments. Once stabilized, these patients sometimes require close observation in the hospital overnight.

Injectable epinephrine is often prescribed as emergency rescue medication for treating an allergic reaction. People who have had previous allergic reactions and rely on epinephrine must remember to carry it with them at all times.

Also, because one dose may not be enough to reverse the reaction, recent guidelines recommend keeping two doses of injectable epinephrine available and to activate emergency medical services if used. Even if symptoms improve after a single dose of epinephrine, immediate medical attention following an insect sting is recommended.

The long-term treatment of fire ant sting allergy is called whole body extract immunotherapy. Whole body extract immunotherapy involves administering gradually increasing doses of extract to decrease a patient’s sensitivity to the fire ant sting. This can reduce the risk of a future allergic reaction to that of the general population. In a matter of weeks to months, people who previously lived under the constant threat of severe reactions to fire ant stings can return to leading normal lives.

If you think you might be allergic to fire ant stings, see an allergist. Based on your history and certain tests, the allergist will determine if you are a candidate for skin testing and immunotherapy.

References
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  2. Walker AA, Robinson SD, Yeates DK, Jin J, Baumann K, Dobson J, Fry BG, King GF. Entomo-venomics: The evolution, biology and biochemistry of insect venoms. Toxicon. 2018 Nov;154:15-27. doi: 10.1016/j.toxicon.2018.09.004
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