Lifestyle > Health
Stinging Insect Allergy Q&A
Recognizing the signs of a severe reaction is important for the summer months
by Lisa Sullivan
Stinging insects, such as
bees, wasps and hornets, are eager to emerge from the long Chicagoland winters.
They seem to enjoy our barbeques, sports and outdoor leisure spots as much as we
do. Unfortunately, these uninvited “guests” may bring unintended harms. It is
important to know that anyone at anytime can develop a life-threatening insect
allergy and that even non-allergic individuals can experience a life-threatening
reaction from multiple stings. Therefore, I find it useful for people to
recognize the signs of a severe reaction should one ever
occur.
My leg swelled a great deal when it was stung by a bee. Does it mean that I’m allergic?
Surprisingly, the answer is probably no, but it is best decided in consultation with board certified allergist. When insects sting, most people experience an immediate localized burning and swelling that can persist for days, due to the venom toxins at the site of injury. The amount of venom injected and the person’s immunity in the skin will determine how large the localized reaction becomes. As long as a local reaction remains limited to the skin and contiguous with itself, it is generally not life-threatening.
An exception would be if a local reaction occurs near the mouth or neck, where swelling may directly impinge on the airway. Local reactions neither increase nor predict your risk for systemic reactions, known as anaphylaxis. They do however increase your likelihood of having larger local reactions in the future.
What is “anaphylaxis”?
Anaphylaxis is a systemic, full-body, allergic immune response that can be life-threatening. Most people associate the word “anaphylaxis” with hives or trouble swallowing. This is only partially correct. Anaphylaxis can affect all body systems in various combinations and thus may fail to produce a telltale hive or swallowing clue.
It is better to think of anaphylaxis as a rapid downhill spiral of symptoms that can involve any body part or organ, generally within minutes to an hour after its trigger (e.g., insect sting, food allergy, etc.). For example, if a friend is stung and then suddenly becomes ill with vomiting, diarrhea and dizziness, one should suspect anaphylaxis and not the stomach flu. The same would be true if an individual started having problems with asthma shortly after a sting. Basically, if any symptom other than localized swelling occurs within the first hour of a sting, you should call your doctor or go to the emergency room.
When should I use an epinephrine auto-injector (a.k.a. EpiPen or TwinJect)?
If anaphylaxis is suspected, it is always best to administer an epinephrine injection immediately and then call 911. A high-risk individual with a venom allergy may choose to take epinephrine even before symptoms appear. Epinephrine works “like magic” to reverse the symptoms, but this may be short-lived, so carrying a spare and getting to the emergency room quickly are a must.
Also, if ever an acquaintance becomes a victim to anaphylaxis or passes out in front of you, don’t hesitate to locate their epinephrine auto-injector and use it. The risk of harm from using it when not needed is negligible compared to the risk of not using it when needed. If you forgot your injector and need it, don’t be shy to make an announcement. It is likely that someone around you has one.
What can I do about my stinging insect venom allergy?
1. All patients who suspect a venom allergy should be formally evaluated and tested by an allergist. If an allergy is confirmed, the standard is to receive three to five years of immunotherapy (allergy shots). Once maintenance immunotherapy is reached, at about three to six months, a patient can enjoy an estimated 97 percent protection against severe sting reactions.
2. Always carry your epinephrine injector and don’t be afraid to use it.
3. Avoid getting stung. Have a professional eliminate nests on the property. Avoid perfume, cologne and fragrant soaps. Wear a cap. Dull clothes without designs, preferably red or grey tend to be less interesting to insects. One theory is that because insects see into the UV range to locate flowers, they ignore colors that don’t show up under a black light. Yet for some reason, the color black bothers them. They are also not crazy about hair, some think, because it reminds them of bears, a natural predator. Slowly distance yourself from the insect. If bees sense danger, they produce a scent to attract other bees.
4. Lessen the chance of a severe reaction. Remove all stingers immediately with the swipe of a fingernail or credit card. How fast the stinger is removed is more important than how.
Contributed by Dr. Lisa Sullivan, of Highland Park, with a practice in Buffalo Grove specializing in allergy, asthma and immunology for all ages, lisasullivanmd.com.
My leg swelled a great deal when it was stung by a bee. Does it mean that I’m allergic?
Surprisingly, the answer is probably no, but it is best decided in consultation with board certified allergist. When insects sting, most people experience an immediate localized burning and swelling that can persist for days, due to the venom toxins at the site of injury. The amount of venom injected and the person’s immunity in the skin will determine how large the localized reaction becomes. As long as a local reaction remains limited to the skin and contiguous with itself, it is generally not life-threatening.
An exception would be if a local reaction occurs near the mouth or neck, where swelling may directly impinge on the airway. Local reactions neither increase nor predict your risk for systemic reactions, known as anaphylaxis. They do however increase your likelihood of having larger local reactions in the future.
What is “anaphylaxis”?
Anaphylaxis is a systemic, full-body, allergic immune response that can be life-threatening. Most people associate the word “anaphylaxis” with hives or trouble swallowing. This is only partially correct. Anaphylaxis can affect all body systems in various combinations and thus may fail to produce a telltale hive or swallowing clue.
It is better to think of anaphylaxis as a rapid downhill spiral of symptoms that can involve any body part or organ, generally within minutes to an hour after its trigger (e.g., insect sting, food allergy, etc.). For example, if a friend is stung and then suddenly becomes ill with vomiting, diarrhea and dizziness, one should suspect anaphylaxis and not the stomach flu. The same would be true if an individual started having problems with asthma shortly after a sting. Basically, if any symptom other than localized swelling occurs within the first hour of a sting, you should call your doctor or go to the emergency room.
When should I use an epinephrine auto-injector (a.k.a. EpiPen or TwinJect)?
If anaphylaxis is suspected, it is always best to administer an epinephrine injection immediately and then call 911. A high-risk individual with a venom allergy may choose to take epinephrine even before symptoms appear. Epinephrine works “like magic” to reverse the symptoms, but this may be short-lived, so carrying a spare and getting to the emergency room quickly are a must.
Also, if ever an acquaintance becomes a victim to anaphylaxis or passes out in front of you, don’t hesitate to locate their epinephrine auto-injector and use it. The risk of harm from using it when not needed is negligible compared to the risk of not using it when needed. If you forgot your injector and need it, don’t be shy to make an announcement. It is likely that someone around you has one.
What can I do about my stinging insect venom allergy?
1. All patients who suspect a venom allergy should be formally evaluated and tested by an allergist. If an allergy is confirmed, the standard is to receive three to five years of immunotherapy (allergy shots). Once maintenance immunotherapy is reached, at about three to six months, a patient can enjoy an estimated 97 percent protection against severe sting reactions.
2. Always carry your epinephrine injector and don’t be afraid to use it.
3. Avoid getting stung. Have a professional eliminate nests on the property. Avoid perfume, cologne and fragrant soaps. Wear a cap. Dull clothes without designs, preferably red or grey tend to be less interesting to insects. One theory is that because insects see into the UV range to locate flowers, they ignore colors that don’t show up under a black light. Yet for some reason, the color black bothers them. They are also not crazy about hair, some think, because it reminds them of bears, a natural predator. Slowly distance yourself from the insect. If bees sense danger, they produce a scent to attract other bees.
4. Lessen the chance of a severe reaction. Remove all stingers immediately with the swipe of a fingernail or credit card. How fast the stinger is removed is more important than how.
Contributed by Dr. Lisa Sullivan, of Highland Park, with a practice in Buffalo Grove specializing in allergy, asthma and immunology for all ages, lisasullivanmd.com.
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