Bees, wasps, hornets and yellow jackets are found throughout the United States and are most active during late summer and early fall. The red or black fire ant, found mainly in the southern United States, is a serious health hazard year-round. Avoidance of insect stings is the first line of defense. Here are some proven strategies:
- Don’t walk barefoot in the grass, where stinging insects forage.
- Don’t drink from open soft drink cans; stinging insects are attracted to them and may crawl inside.
- Keep food covered when eating outdoors.
- Don’t use sweet-smelling perfume, hairspray or deodorant.
- Avoid wearing brightly colored clothing with flowery patterns.
- Wear long pants, long-sleeved shirts, socks, shoes and work gloves when working outdoors.
- Be cautious near bushes, eaves and attics, and avoid garbage containers and picnic areas.
- Have a professional exterminator remove known nests and inspect for other potential nesting areas.
For emergency treatment, an allergist can prescribe and give instructions on how to use an epinephrine auto-injector. A person who has had a systemic allergic reaction to an insect sting has an increased risk of having a similar or worse reaction if stung again and should always have two epinephrine auto-injectors close at hand. The risk of an allergic reaction can persist for a long time, even when the systemic allergic reaction was many years earlier.
Epinephrine is the only approved treatment for anaphylaxis. A delay in using epinephrine has been shown to increase the risk of death. For long-term protection, an allergist can treat the allergic person with allergy shots (immunotherapy), which build tolerance over time through gradually increasing doses of purified insect venom. Venom immunotherapy significantly reduces the risk of a systemic reaction to future stings. The length of venom immunotherapy is usually three to five years, but it can be continued indefinitely depending on the severity of past reactions and the risk to the patient of future stings.
Fire ant sting allergy treatment
Fire ant sting allergy is treated in a two-step approach:
- The first step is the emergency treatment of the symptoms of a serious reaction when they occur;
- The second step is preventive treatment of the underlying allergy with whole body extract immunotherapy.
Life-threatening allergic reactions can progress very rapidly and require immediate medical attention. Emergency treatment usually includes administration of certain drugs, such as epinephrine, antihistamines, and in some cases, corticosteroids, intravenous fluids, oxygen and other treatments. Once stabilized, these patients sometimes require close observation in the hospital overnight.
Injectable epinephrine is often prescribed as emergency rescue medication for treating an allergic reaction. People who have had previous allergic reactions and rely on epinephrine must remember to carry it with them at all times. Also, because one dose may not be enough to reverse the reaction, immediate medical attention following a fire ant sting is recommended.
What is a normal reaction to a fire ant sting, and how is it treated?
The severity of a fire ant sting reaction varies from person to person. One of the main differences between fire ants and other insects is that a usual sting event consists of multiple fire ants stinging. This is because when a fire ant mound is disturbed hundreds to thousands of fire ants respond. In addition, each ant can sting repeatedly. Each ant will bite and hold on with its mandibles (jaw) and sting several times. If not removed, this results in a little semi-circular pattern of stings. Since fire ants hold on with their mandibles, they often have to be pulled off individually and are not easily brushed off when they are stinging.
Almost all people stung by fire ants develop an itchy, localized hive or lump at the sting site, which usually subsides within 30 to 60 minutes. This is followed by a small blister within four hours. This usually appears to become filled with pus-like material by eight to 24 hours. However, what is seen is really dead tissue, and the blister has little chance of being infected unless it is opened. When healed, these lesions may leave scars.
Fire ant sting treatment is aimed at preventing secondary bacterial infection, which may occur if the pustule is scratched or broken. Clean the blisters with soap and water to prevent secondary infection. Do not break the blister. If a blister is accidently opened, careful attention to keeping the area clean with soap and water should still prevent infection. Topical corticosteroid ointments and oral antihistamines may relieve the itching associated with these reactions.
What is whole body extract immunotherapy?
The long-term treatment of fire ant sting allergy is called whole body extract immunotherapy, that contains the entire body of the ant, not just the venom, as is the case with other stinging insects. It is a highly effective program administered by an allergist-immunologist, which can prevent future allergic reactions to fire ant stings. At this time, we are not able to milk venom from fire ants.
Whole body extract immunotherapy involves administering gradually increasing doses of extract to decrease a patient’s sensitivity to the fire ant sting. This can reduce the risk of a future allergic reaction to that of the general population. In a matter of weeks to months, people who previously lived under the constant threat of severe reactions to fire ant stings can return to leading normal lives.
If you think you might be allergic to fire ant stings, see an allergist. Based on your past history and certain tests, the allergist will determine if you are a candidate for skin testing and immunotherapy.