Bees and wasps belong to the Hymenoptera order and together cause approximately 50 deaths per year in the United States. For most, the sting results in minor irritation, but in susceptible individuals the injected venom can trigger a severe allergic reaction, or anaphylaxis, that is life-threatening. It is important to be aware of the different presentations in order to determine which category one falls and when to seek proper medical attention.
Bee and wasp stings result in different reaction types depending on the individual’s response; these can be divided into local reactions and systemic reactions. The insect injects venom under the skin, which is poisonous and may cause direct injury to the area near the sting. This results in a local inflammatory reaction that causes mild pain, swelling, itching and redness at the site. Systemic or allergic reactions are life-threatening and require prompt medical treatment as 50% of deaths occur within 30 minutes of being stung, and 75% of deaths occur within 4 hours. Systemic reactions can result in hives, which appear as a raised, red rash on the skin that itches. Swelling of the mouth and airway may occur, which can impair breathing. Shortness of breath and chest pain may result. Low blood pressure can occur, which can result in weakness, fainting and in severe cases, death.
Treatment varies depending on the reaction type. The stinger of honey bees may remain in the skin and continue to release venom from the venom sack. If the stinger is found, it should be gently removed to prevent release of additional venom. Local reactions typically resolve within one week without treatment but ice can be applied to the site to relieve swelling and an antihistamine, such as Benadryl, can be given to relieve itching. Occasionally, local reactions can get infected and one should seek medical treatment if there is pus or drainage from the site or one experiences fever. Systemic reactions should be treated by a medical professional. Call 911 if you suspect a systemic reaction and take an antihistamine while you wait for help to arrive. Individuals who have previously had a severe reaction to an insect sting should carry epinephrine or an EpiPen with them, which is prescribed by a doctor. Once stung, they should immediately inject the medicine into their outer thigh and seek emergency medical attention.
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