post-title Allergy to Stinging Insects 2013-07-31 15:48:56 yes no Posted by

Allergy to Stinging Insects

Allergy to Stinging Insects (Hymenoptera Allergy) by Dr. Jennifer Bullock Allergic reactions to insect stings have been reported to occur in up to 3% of adults, and in up to 1% of children. Most allergic reactions to insect stings are caused by yellow jackets, wasps, hornets, honeybees, and fire ants. Yellow jacket stings are the […]

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Allergy to Stinging Insects (Hymenoptera Allergy) by Dr. Jennifer Bullock

Allergic reactions to insect stings have been reported to occur in up to 3% of adults, and in up to 1% of children. Most allergic reactions to insect stings are caused by yellow jackets, wasps, hornets, honeybees, and fire ants. Yellow jacket stings are the most frequent cause of allergic reactions to insect stings in North America, but hornets, wasps, and honeybee allergic reactions do occur, espeically if the insect’s nest is disturbed. Allergic reactions to fire ants are much more common in Southeastern states of the USA, where the fire ant is more widespread, due to the warmer climate. Allergy to stinging insects is developed only if you have been stung before, and you are more likely to develop the allergy if you are stung often.

There are two major types of reactions that may occur after an insect sting. A large local reaction consists of a very large area of swelling and redness connected to the area of the sting, and it may last for 5-10 days after the sting. For example, someone stung on the hand might experience swelling of the hand and arm. This type of reaction can also cause a red “streak” up and down the leg or arm, which is caused by the body’s inflammatory response to the insect’s venom. While these reactions can be painful and irritating, they are rarely life-threatening, and most people who have large local reactions do not develop more severe (systemic) reactions the next time they are stung. Patients who have had very large local reactions do need to be cautious if they are stung on the head or neck, as large areas of swelling around the mouth or neck can compress the airway. Large local reactions are best treated with steroids and ice. Physicians will often give people with this problem Epinephrine to have on hand, just in case they are stung near the mouth or on the neck, as the Epinephrine can help to control severe local swelling.

Systemic allergic reactions to an insect sting typically occur within minutes of the sting, and can cause hives, redness or itching of the skin, swelling that is not connected to the site of the sting, tightness or swelling of the throat, difficulty breathing, wheezing, dizziness, low blood pressure, loss of consciousness, vomiting or diarrhea. Fortunately, children who experience only hives after an insect sting have a relatively low risk of developing a more severe reaction with future insect stings, but this is not necessarily true for adults. People who have had a systemic allergic reaction to an insect sting should definitely carry injectible Epinephrine, and should seek the advice of an allergist for testing to determine which type of insect venom has caused the reaction. Treatment with venom immunotherapy (a series of allergy shots given to desensitize a person to the insect venom) is crucial to consider in adults who have had any type of systemic reaction, and is also crucial in children who have had any reaction involving more than just hives after a sting. Venom allergy shots are very effective at preventing a life-threatening or fatal reaction.

If you have had a systemic reaction or large local reaction to an insect sting, it is also important to exercise caution during the warmer months of the year. Most insects sting when they are threatened, so try not to disturb nests which may be found in shrubs and trees (hornets), in the ground (yellow jackets), and under the eaves of the house, window sills, and deck railings (wasps). Yellow jackets become very aggressive around food, at picnics, and around trash cans containing food. They also become aggressive if their nest is distubed by mowing. Yellow jackets become more aggressive in the beginning of the Fall, when their food sources become more limited. Many people are stung when an insect flies into their car, so if possible, try to keep car windows closed.

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