For some, insect stings can be a serious problem
By: Dan Palmquist, M.D.
In Minnesota, our summer days and nights are filled with cabins on a lake, double-header ball games, camping in the woods, and lots and lots of bugs. For most people, insects are an unavoidable summer nuisance. But for a small percentage who experience severe allergic reactions to certain insect stings, bugs can be a serious, and even life-threatening, summer problem. Just about everyone has experienced the effects of an insect sting. Mosquitoes, gnats, flies bees, and wasps are familiar summer “stingers.” When these insects sting, they release venom, which contains substances called allergens, into your skin. A normal reaction to these toxins includes swelling, redness, pain, and itching at the site of the sting. Medical treatment is usually not needed for a normal reaction. An ice pack or cold compress along with a nonprescription pain reliever such as acetaminophen can help to reduce swelling and pain. Oral antihistamines, such as diphenhydramine (Benedryl) can reduce itching. Some people experience an increased sensitivity to the allergens in an insect sting. Their immune system overreacts to the allergens, treating them as harmful, foreign substances in the body. When this occurs, it is known as an allergic reaction. The stings of certain insects – bees, wasps, hornets, yellow jackets, and fire ants – cause most allergic reactions.
A mild reaction can be treated in much the same way as a normal reaction – with cold packs, an over-the-counter pain reliever, and antihistamine, if needed. If the sting site is on an arm or leg, elevating the limb can help reduce swelling. A more serious allergic reaction, called a systemic reaction, can spread throughout your whole body, and can cause symptoms such as itching, hives, wheezing, difficulty breathing, stomach cramps, swelling of the lips, tongue, throat, or other body parts, low blood pressure, confusion, shock, and unconsciousness. The combined symptoms of s severe reaction are known as anaphylaxis. The sooner symptoms occur after exposure to the sting, the more severe the anaphylactic reaction is likely to be. An anaphylactic reaction may occur with the first exposure to an allergen, with every exposure, or after several exposures. This type of reaction can be life-threatening, and is considered a medical emergency requiring immediate medical treatment. Treatment for anaphylaxis focuses on keeping the person airway open and relieving other breathing or heart problems that can occur. An injection of epinephrine, along with an antihistamine, are often used to treat the symptoms of anaphylaxis. People who have had a severe allergic reaction in the past are at high risk for having another if stung again. For this reason, they should carry an allergy kit with them at all times. The allergy kit typically includes emergency medical information, antihistamine tablets and two one-time-use epinephrine injections known as an Epi-Pens. Your doctor can prescribe the Epi-Pen and show you how to self-administer the injection is you are stung. Immunotherapy is a long-term treatment option for people who have a history of severe reactions to insect stings. Immunotherapy involves a series of allergy shots that can prevent or reduce the severity of symptoms during a systemic allergic reaction. Allergy shots work by introducing small amounts of insect venom into your body, making you less sensitive over time to the allergens. While allergy shots are safe for most people, there are risks and benefits to immunotherapy, and anyone considering it should discuss their individual situation with their doctor. Whether you experience a serious systemic reaction, or a mild normal reaction to insect stings, one thing is certain: no one enjoys being stung by a bee, wasp, or hornet. Luckily, there are certain things that you can do to ovoid stinging insects altogether. Wear light colored clothing – beige, white, or khaki. Bright colors or fabrics with floral prints may attract certain stinging insects. Wear shoes (not sandals), long sleeves and long pants when outside. When attending outdoor events that include food, keep away from the food serving areas and the trash containers. Avoid scented cosmetics, perfumes, hairspray, lotions, and aftershave. They can all attract insects. Keep car windows closed. Avoid areas where insects are likely to nest. If a stinging insect is nearby, avoid sudden or rapid movements. Move away slowly, unless you are being pursued. Summer's here, just waiting to be enjoyed – bugs and all. Even if you or someone you are with has a history of severe reactions to insect stings, you can take part in the outdoor fun of summer. Be prepared with an allergy kit at all times, take care to avoid stinging insects, and enjoy.
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Dr. Palmquist is a board certified family practice physician at Raiter Clinic. |