Insect Stings

It is estimated that 1 of every 125 Americans is allergic to insect stings. Approximately 40 people in the United States die every year from a severe allergic reaction to insect stings. The incidence of deaths is low because most people know they need to obtain medical attention im­mediately if an allergic reaction begins.

Almost all the insects whose venom can cause allergic reactions belong to a group called Hymenoptera, which includes honeybees and bumblebees, wasps, yellow jackets, and hornets. When a honeybee stings, its stinger remains embedded in the victim's skin, causing the bee to die as it tries to tear itself away. Wasps, yellow jackets, and hornets are more aggressive than bees and can sting repeatedly. Hornets are the most aggressive of the group and may sting even when not provoked. Yellow jackets are close behind in aggressiveness, and wasps usually sting only if someone interferes with them near their nest.

If an insect sting does not cause an allergic reaction within 30 minutes, chances are excellent that no problem will occur. A normal reaction to an insect sting includes localized pain, redness, swelling, and itching lasting 1 to 2 days. Any generalized reaction not arising directly from the area of the sting is almost certain to be an allergic reaction, which begins with such symptoms as sneezing, hives, itching, angioedema, erythema, and disorientation and progresses to difficulty in breathing, dizziness, faintness, and loss of consciousness.

Medical care should be sought immediately because these are the symptoms of an anaphylactic reaction, and most fatalities occur within 2 hours of the sting. Because time is a factor, individuals known to have a severe allergy to insect stings carry an anaphylactic emergency treatment kit containing injectable epinephrine and oral antihistamines (see Figure 21-2). With this kit, treatment for a severe allergic reaction can be started immediately.