Allergies Honeybees, Wasps, and Hornets – Oh My!

What Everyone Should Know About Stinging Insect Allergy

Closeup of bee on flowerMost of us develop redness and swelling at the site of an insect bite. Yet people who are allergic to stinging insect venom are at risk for a much more serious, life-threatening reaction – anaphylaxis.

Understanding the differences in symptoms between a normal reaction and an allergic reaction can bring you peace of mind. It is also important to have an accurate diagnosis so you can manage your condition and be prepared for an emergency.

An allergic reaction occurs when the 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 jackets – Black flying insects with yellow markings, found in various climates. Their nests are usually found underground, but sometimes they can be found in the walls of buildings, cracks in masonry, or in woodpiles.
Honeybees – Bees that 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.
Paper wasps – Slender flying insects with black, brown, red, and yellow markings. They live in a circular comb under eaves, behind shutters, or in shrubs and woodpiles.
Hornets – Black or brown flying insects with white, orange, or yellow markings. Their nests are gray or brown and are usually found in trees.
Fire ants – Reddish-brown ants living in large mounds, mostly in warmer climates. They attack with little warning, inserting highly concentrated toxins that cause burning and pain.
Most serious reactions are caused by five types of insects: yellow jackets, honeybees, paper wasps, hornets, and fire ants.
Symptoms & Diagnosis  Most people develop pain, redness, and swelling at the site of an insect sting. This is a normal reaction that takes place in the area of the bite.

A serious allergic reaction – or anaphylaxis – occurs when the immune system gets involved and overreacts to the venom, causing symptoms in more than one part of the body. Symptoms of anaphylaxis may include

• Swelling of the face, throat, or tongue
• Difficulty breathing
• Dizziness
• Stomach cramps
• Nausea or diarrhea
• Itchiness and hives over large 
areas of the body

Insect stings can also cause serious symptoms that are not allergic. A toxic reaction occurs when the insect venom acts like a poison in the body. A toxic reaction can cause symptoms similar to those of an allergic reaction, including nausea, fever, swelling at the site of the sting, fainting, seizures, shock, and even death. A toxic reaction can happen after only one sting, but it usually takes many stings from insects.

Serum sickness is an unusual reaction to a foreign substance in the body that can cause symptoms hours or days after the sting. Symptoms include fever, joint pain, other flu-like symptoms, and sometimes hives.

If you think you might be allergic to stinging insects, an accurate diagnosis is essential. Your allergist will conduct a thorough health history followed by allergy testing to figure out what, if any, allergens put you at risk for serious reactions to stinging insects.

Treatment & Management  Avoiding contact with stinging insects is the key to successfully managing this allergy. These tips can help:

• Insects are most likely to sting if their homes are disturbed, so have hives and nests around your home destroyed. Because this activity can be dangerous, you should hire a trained exterminator.
• If you spot stinging insects, remain calm and quiet, and slowly move away.
• Avoid wearing brightly colored clothing or perfume when outdoors. Many stinging insects are searching for food and could confuse you with a flower.
• Be careful outdoors when cooking, eating, or drinking sweet beverages like soda or juice. Cover food and drinks to keep insects out.
• 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.

If you have an anaphylactic reaction, inject epinephrine at once and call 911. After a serious reaction to an insect sting, make an appointment with your doctor. With proper testing, your doctor can diagnose your condition and decide on the best form of treatment.

Immunotherapy, or allergy shots, may be an effective long-term treatment for stinging insect allergy. With this type of treatment, your allergist will give you shots containing small doses of your allergen, allowing your body to build a natural immunity to the trigger.


Source: American Academy of Allergy, Asthma & Immunology, aaaai.org

This article was published in Coping® with Allergies & Asthma magazine, Spring/Summer 2018.