When most people are stung by an insect, the site develops redness, swelling and itching. However, some people are actually allergic to insect stings. This means that their immune systems overreact to the venom.
When Should I Be Concerned?
If you are insect-allergic, after the first sting, your body produces antibodies called Immunoglobulin E (IgE). If stung again by the same kind of insect, the venom interacts with this specific IgE antibody, triggering the release of substances that cause an allergic reaction. These reactions can be caused by honey bees, yellow jackets, wasps, hornets and fireants. Allergic reactions are more severe than the usual localized swelling and can be a warning that the next sting could be anaphylactic or life-threatening.
Symptoms of a Severe Bee Sting Reaction
For a small number of people with venom allergy, stings may be life-threatening. This reaction is called anaphylaxis. Symptoms may include two or more of the following. Unless epinephrine is administered immediately death may ensue.
- Itching and hives
- Swelling in the throat or tongue
- Difficulty breathing
- Stomach cramps
- Nausea or diarrhea
- Fall in blood pressure and shock
Role of the Allergist
Anyone who experiences a severe allergic reaction to a bee sting should be referred to an allergist for diagnosis and management. The evaluation consists of skin testing to the venom of honeybee, yellow jacket, wasp, yellow and white faced hornet. In the southern US, fire ant may be tested. The venom for testing is highly diluted and will not cause a reaction. A positive skin test will confirm the allergy and identify which stinging insect was responsible.
At the minimum, an epinephrine injector such as the EpiPen or AuviQ will be prescribed. However, you must carry the injector at all times, and in some cases, epinephrine alone is not sufficient to reverse an anaphylactic reaction. For that reason, allergy desensitization is always recommended. A series of venom injections from that specific insect will immunize you against future sting reactions and is potentially life saving.