Asthma & Allergy of Idaho: Stinging Insect Allergy

As the weather warms and people spend more time outdoors, encounters with stinging insects become more common. While most stings cause only minor redness, swelling, and itching, some people are allergic to insect venom and may experience serious or even life-threatening reactions. With outdoor activity increasing this time of year, it is important to recognize the signs of insect sting allergies and know how to respond safely.

When most people are stung, the area becomes red, swollen, and itchy. However, in people with insect sting allergies, the immune system overreacts to the venom. After an initial sting, the body may produce antibodies called Immunoglobulin E (IgE). If stung again by the same type of insect, the venom interacts with these antibodies, triggering the release of chemicals that cause an allergic reaction.

Symptoms of Severe Reaction

For a small number of people with venom allergy, stings may be life-threatening. This reaction is called anaphylaxis (an-a-fi-LAK-sis). Symptoms may include two or more of the following: hives or itching, swelling of the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea, or diarrhea. In severe cases, a rapid drop in blood pressure may result in shock or loss of consciousness.

Anaphylaxis is a medical emergency and can be fatal. If these symptoms occur after an insect sting, seek emergency medical treatment immediately. After emergency treatment, patients should request a referral to an allergist to discuss testing, prevention, and possible treatment options.

Common Stinging Insects

There are four major types of winged stinging insects commonly encountered in our region:

• Yellow jackets usually build paper-like nests underground, but they may also be found in wall cavities, masonry cracks, or woodpiles.
• Honeybees and bumble bees are generally non-aggressive and usually sting only when provoked. Honeybees live in hives or colonies in hollow trees or building cavities.
• Paper wasps build paper-like nests that form open circular combs, often found under eaves, on play equipment, or in shrubs and woodpiles.
• Hornets are larger than yellow jackets and build gray or brown football-shaped nests in trees, shrubs, or tree hollows.

Preventing Stings

Stinging insects are most likely to sting when their nests are disturbed, so nests around the home should be professionally removed when possible. If insects are nearby, remain calm and move away slowly. Avoid bright clothing and perfume outdoors. Food and sweet drinks attract insects, so keep food covered and check straws or cans before drinking. Wear closed-toe shoes outdoors and avoid loose clothing that can trap insects against the skin.

Treating Stings

If a stinger is left in the skin, remove it within 30 seconds to reduce the amount of venom injected. A quick scrape with a fingernail is usually the best method. Avoid squeezing the venom sac, as this can push more venom into the skin. Clean the area, apply a cold pack to reduce swelling, and consider an antihistamine for itching and swelling.

Understanding insect sting allergies, recognizing severe reactions, and knowing how to respond can help keep you and your family safe while enjoying the outdoors.

For all stinging insects, try to remain calm and brush these insects from the skin. Then immediately leave the area.

If you are stung, consider the following for local reactions to insect stings:

• Raise the affected limb and apply a cold compress to reduce swelling and pain.
• Gently clean area with soap and water to prevent secondary infections; do not break blisters.
• Use topical steroid ointments or oral antihistamines to relieve itching.
• See your physician if swelling progresses or if the sting site seems infected.

If you are severely insect-allergic, carry auto-injectable epinephrine. Remember that epinephrine is a rescue medication only, and you must still have someone take you to an emergency room immediately if you are stung. Those with severe allergies may want to consider wearing a bracelet or necklace that identifies the wearer as having severe allergies.

Consult Your Allergist

If you have had a serious reaction to an insect sting, make an appointment with an allergist. With proper testing, an allergist can properly diagnose your allergy and determine the best form of treatment. Those with the more severe reactions can be treated with venom allergy shots that actually stop future allergic reactions to stings giving people the confidence to again enjoy the outdoors without fear. Many people, including doctors, are not aware of this treatment. It can truly be lifesaving preventive therapy!

In Summary…

• Symptoms of a non-allergic insect sting include redness, swelling and/or itching at the site of the sting.
• Symptoms of an allergic reaction may include itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea.
• An allergist is the best physician to diagnose stinging insect allergy and provide a treatment plan designed to keep you safe and healthy.
• If you have a serious reaction, get emergency medical treatment and then follow-up with your local allergist.