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Contents

Features of Sting Allergy

Emergency Treatment

Avoidance Measures


Prophylactic Management

 

During the summer months insects of the order Hymenoptera, which include the Honey bee (Apis mellifera), the Yellow jacket wasp (Vespula germanica), and the Paper wasp (Polistes emarginata) may sting people and if allergic to the sting venom, they will develop mild to life threateningly severe allergic reactions.

 

These social insects do not normally attack people, but will sting them only in self defence if disturbed (the African hone bee is however rather aggressive). Once stung, if the stinger remains in the skin, a Honey bee is responsible, while if no stinger is present, a Wasp is likely to be the culprit. The female worker hone bee carries the stinger and dies soon after discharging a sting.

Features of Sting Allergy

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Normally some redness and swelling will result from the sting, but this usually resolves in a few hours.

In the allergic individual, a more long lasting and severe reaction will occur. A mild reaction will include intense redness, swelling spanning two joints, itching and pain all occuring within minutes. More severe reactions include generalised swelling and itching, faintness, sweating, a pounding headache, stomach cramps or vomiting, a feeling of impending doom, a tight chest or choking sensation with swellin of the throat and in extreme cases anaphylactic shock with death resulting.

 

Emergency Treatment

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Honey bee venom allergy is much commoner than wasp allergy in South Africa.

A tourniquet can be very useful if applied immediately and briefly to a limb, if stung, while one is getting adrenaline or antihistamines or steroids on board.
Applying ice to the sting will also reduce blood folow to the areas
and spread of the venom.

Preloaded adrenalin syringes (Ana-Guard or Epipen) are available for emergency use. Three to six puffs of an adrenalin inhaler (Medihaler-Epi) will relieve chest tightness and swelling of the throat. With less severe reactions, antihistamines may be administered by injection or given orally. A rapidly acting antihistamine such as Phenergan is best. Cortisone is also very effective, but takes a few hours to act.

 

Avoidance Measures

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People allergic to bee and wasp stings should try to avoid being stung and stay away from areas that bees and wasps frequent. Remember that bees fly in straight lines between flower and hive, hence collision with unsuspecting individuals occurs. If a wasp or bee approaches, STAY STILL, do not try to swat the insect as this may frighten it! If it lands, gently try to blow it off the skin.

If stung, try to look for the barbed stinger in the case of a bee sting and carefully remove it by flicking it or scratching it out of the skin from the stinger sack. Stings to the head and neck are more dangerous.

Life threatening reactions are more likely to accur in people who are already known to be very allergic to bee venom, older people with pre-existing heart and chest complaints or with multiple stings. When stung immediately apply ice or cold compresses to the sting site. If a swarm of bees approach – run for shelter as bees are slow fliers and can normally be outrun.

Keep an insecticide spray in the kitchen or car and always have a “bee cloth” handy to trap insects and prevent being stung. Certain allergic individuals seem more prone to bee stings and appear to “attract” bees. Wasps and bees are drawn to flower fragrances and clothing with bright colours (white is safest), perfumes, uncovered cold drinks, fruit juices and eating fruit out of doors, hair tonics, suntan lotion and floral odours.

Never walk in orchards in blossom or flowering field especially not barefoot or in open shoes. Avoid walking barefoot or in open shoes. Avoid walking barefoot on clover covered lawns. Carefully shake out any cloting left on the ground. Cover dustbins and any food out of doors. Do not mow lawns, trim hedges or prune trees in mid summer. Bees and wasps tend to frequent clover fields, picnic areas and soiled dirtbins in particular.

If one comes across a bee hive, don’t disturb it – bee keepers will be glad to come and remove it. Wasp nests should have petrol or kerosene applied to them and destroyed.

 

Prophylactic Management

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Patients who are prone to severe reactions to bee stings should carry an adrenalin injection with them for self administration. Others should carry antihistamine pills. All bee allergic patients should wear a Medic Alert bracelet.

Hyposensitisation injections (Specific Immunotherapy – SIT) used to treat severe bee and wasp sting allergies are most effective. These injections are carried out weekly initially, then 6 weekly for 3 to 5 years and confer 96% protection against bee stings.

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Copyright: Allergy Society of South Africa 1993
Written by Dr Adrian Morris
Endorsed by Professor Eugene Weinberg

This information sheet is obtainable from:

ALLSA
P.O. Box 88
Observatory, 7935
Cape Town, R.S.A.

Sable
Background: Grey Rhebuck