Topic of the Month: September 2006: Tips to prepare for stinging insect season
In this month's topic you will learn:
- Common stinging insects
- How to avoid being stung
- How to treat the sting
- Information on anaphylaxis
- Other resources
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As summer comes to an end, stinging insect season begins. People who have severe allergic reactions to insect stings need to take precautions to avoid being stung, and know the necessary steps to take if stung.
Up to 5% of Americans are at risk for a severe, potentially life-threatening allergic reaction from insect stings, called anaphylaxis, and most people don't even know that they are allergic to insect stings until experiencing a reaction.
The most common stinging insects in the United States include:
- Yellow jackets
- Honey bees
- Bumble bees
- Paper wasps
- Hornets
- Fire ants
Avoidance
It is important for anyone with severe allergies to insect stings to take precautions to avoid a potentially dangerous reaction. Below are steps to follow when encountering stinging insects:
- Avoid the "territory" of the stinging insect's nest. These insects are most likely to sting if their homes are disturbed, so it is important to have hives and nests around your home destroyed. Since this activity can be dangerous, hire a trained exterminator.
- Remain calm and quiet, and slowly move away from the stinging insects.
- Avoid brightly colored clothing and perfume when outdoors. Many stinging insects are searching for food and could confuse you with a flower.
- Be careful when cooking, eating or drinking sweet beverages like soda or juice outdoors. Also be sure to keep food covered until eaten.
- Wear closed-toe shoes outdoors and avoid going barefoot to avoid stepping on a stinging insect.
- Avoid loose-fitting garments that can trap insects between material and skin.
 Treatment
Allergic or not, insect stings cause discomfort. It is important to properly take care of the sting to ease the pain. Use the following tips to help:
- Elevate the affected area and apply ice or a cold compress to reduce the pain and swelling.
- Gently clean blisters with soap and water to prevent secondary infections; do not break the blisters.
- Use topical steroid ointments or oral antihistamines to relieve itching.
- Monitor carefully for symptoms of anaphylaxis. If you experience symptoms, call 911 to get emergency medical treatment immediately.
- Do not pinch the area to remove the stinger. This can result in more venom being released into the skin.
- If severely allergic, inject epinephrine immediately and call 911.
Anaphylaxis
Anaphylaxis is a severe allergic reaction that may involve the entire body. It can result in trouble breathing, loss of consciousness and even death. Anaphylaxis is a medical emergency that requires immediate medical treatment, and later follow up care by an allergist/immunologist.
Anaphylaxis occurs in people after they are exposed to a substance to which they are severely allergic. The most common substances that trigger anaphylaxis are insect stings, foods and medications. Symptoms of anaphylaxis include:
- Itching and hives all over the body
- Swelling in the throat or tongue
- Difficulty breathing
- Dizziness
- Stomach Cramps
- Nausea
- Diarrhea
- In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness
 Anaphylaxis is a medical emergency and may be fatal. If you or anyone else experiences any of these symptoms after an insect sting, call 911 to get emergency medical treatment immediately. After your symptoms are treated, contact your allergist/immunologist to learn about ongoing treatment options.
Anyone who has had a severe reaction to an insect sting should receive follow-up testing from an allergist/immunologist to determine the type of stinging insect that caused the reaction and receive a recommended treatment.
When to see an allergy/asthma specialist
If you have experienced a severe reaction to insect stings or you think you may be allergic, consult with an allergist/immunologist to accurately diagnose your condition. An allergist/immunologist is the best qualified medical professional trained to manage the prevention, diagnosis and treatment of allergies and asthma.
An allergist/immunologist might also suggest allergy shots, also known as immunotherapy treatment. Venom immunotherapy shots take effect within just a few months. Venom immunotherapy is the closest thing to a "cure" for allergic reactions. It is shown to be 97% effective in preventing future allergic reactions.
The AAAAI's How the Allergist/Immunologist Can Help: Consultation and Referral Guidelines Citing the Evidence provide information to assist patients and health care professionals in determining when a patient may need consultation or ongoing specialty care by the allergist/immunologist. Patients should see an allergist/immunologist if they:
- Have reactions possibly due to insect stings for accurate identification of specific allergen and consideration for immunotherapy (allergy shots).
- Have systemic reactions possibly due to biting insects, for accurate identification of specific allergen.
- Have a severe allergic reaction (anaphylaxis) without an obvious or previously defined trigger.
- Have had anaphylaxis attributed to food, drugs, or insect stings.
- Have had exercise-induced anaphylaxis or food-dependent exercise induced anaphylaxis.
To find an allergist/immunologist in your area, call the AAAAI Physician Referral and Information line at (800) 822-2762 or visit http://www.aaaai.org/physref/.
Additional Resources
This topic was reviewed on 9/1/2006 by Stuart Friedman, MD, FAAAAI, Patients & Consumers Web Editor
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