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ACAAI > Patients & Public > Resources > Ask the Allergist
Reaction to Fire Ants

Q. For many years, I have been going from my Missouri home to central Florida for the winter months, where I play in golf leagues. During this time, I have been stung at least 5-6 times per winter by fire ants. Previously, the stings started with a red spot, to a bump, and if left alone, would fester to a blister, taking a couple weeks to heal. Last October, I was on my condo deck barefoot and received about 50 stings. When I went back into my condo, I took an antihistamine and noted my face, was getting red. I tried driving to another family member's home. One the way, I became faint and wrecked my car. By this time, I was very sweaty, vomited, and lost control of my bowels and bladder. I was taken by ambulance to a local ED where I received treatment and a prescription for an epinephrine auto-injector.

I question if the severe episode was an allergic reaction or my panic, as a couple of months later I was stung on the hand by a fire ant, picking up a golf club, monitored myself, continued to finish the round of golf -- no reaction, but the sting festered as always, and took a couple of weeks to heal. I'm getting ready to go back to Florida, and I will probably be stung again. What would you recommend I do to further evaluate this problem?

A. You are strongly urged to see an ABAI board-certified allergist in Missouri or Florida and be evaluated for hypersensitivity to fire ants. Here’s why: the event you suffered in October after the 50 stings was an anaphylactic (severe allergic) reaction. We know that about 50 people die every year from allergic reactions to insect stings, including fire ant stings. Sometimes the deaths are due to severe breathing problems and sometimes they can be due to passing out while doing something dangerous like driving, just like you were doing. We also know that after a severe allergic reaction, when people are stung again, they do not always have a severe reaction. In fact, the chance of this reaction happening again is about 50-60%. Therefore, it is not surprising that you did not react the next time you were stung. However, this is not reassuring, since that 50-60% chance of having an equally severe or worse reaction remains with each subsequent sting! If you see an allergist and are an appropriate candidate for desensitization (immunotherapy) to fire ants, your chance of having a future reaction can be reduced to 2-3%! So my advice to you is to see an allergist and get evaluated, and start fire ant immunotherapy if you are an appropriate candidate - so that you can enjoy your golf vacations in Florida again without worrying about every fire ant you see.