Allergic Reactions to Stings from Hornets, Wasps, Bees and YellowJackets: Patient Information

Types of insect sting reactions
Most people are not allergic to insect stings and should recognize the difference between an allergic reaction and a normal or large local reaction. This will prevent unnecessary worry and medical expense.

The severity of an insect sting reaction varies from person to person. A normal reaction will result in pain, swelling, and redness confined to the sting site. Simply disinfect the area and apply ice to reduce the swelling. A large local reaction will result in swelling that extends beyond the sting site. For example, a person stung on the forearm may have his/her entire arm swell to twice it's normal size. Although alarming in appearance, this condition is often treated the same as a normal reaction. However, because this condition may persist for 2-3 days, antihistamines and steroids are sometimes prescribed to lesson the discomfort. The most serious reaction to an insect sting is an allergic one. This condition requires immediate medical attention. Symptoms of an allergic reaction or "anaphylaxis" may include one or more of the following:

• Hives, itching, and swelling in areas other than the sting site.
• Tightness in the chest and difficulty in breathing.
• Hoarse voice or swelling of the tongue.
• Dizziness or a sharp drop in blood pressure.
• Unconsciousness or cardiac arrest.

This type of reaction can occur within minutes after the sting and may be life threatening or even fatal. People who have experienced an allergic reaction to an insect sting have a 60% chance of a similar or worse reaction if stung again.

Treating Allergic Reactions
An allergic reaction is treated with epinephrine, either self-injected or administered by a doctor. In some cases, intravenous fluids, oxygen, and other treatments are necessary as well. Once stabilized, these patients are sometimes required to stay overnight at the hospital under close observation. People who have had previous allergic reactions and rely on the protection of epinephrine must remember to carry it with them wherever they go. Also, because one dose may not be enough to reverse the reaction, immediate medical attention following an insect sting is recommended.

Avoidance
You can lessen your chances of an insect sting by taking certain precautionary measures. Yellow jackets will nest in the ground and in walls. Hornets and wasps will nest in bushes, trees and on buildings. Use extreme caution when working or playing in these areas and never walk barefoot in the lawn. Avoid insect attractants such as fragrances (perfumes, hair sprays, lotions, etc.) open garbage cans and exposed food at picnics. Also, try to reduce the amount of exposed skin when outdoors.

Preventing Allergic Reactions
Allergic reactions to insect stings can be prevented with venom immunotherapy, a treatment that is 97% effective in preventing future occurrences. It involves administering gradually increasing doses of venom that stimulate the patient's own immune system to become resistant to a future allergic reaction. In a matter of weeks, people who previously lived under the constant threat of severe reactions to insect stings can go about leading normal lives.

Finding Out More About Venom Immunotherapy
Consult an allergist. If you've had an allergic reaction, it's important to talk to an allergist, a doctor who is a specialist in the diagnosis and treatment of allergic disease. Based on your past history and certain tests, the allergist will determine if you are a candidate for immunotherapy treatment. Although stinging insect allergy is a serious problem, much of the risk and fear of a reoccurrence can be virtually eliminated with immunotherapy.

This information is provided by
ALK Laboratories, Inc.
Wallingford, CT
For more information, call 1-800-325-7354