INSECT STINGS
Mean Bugs: Who Gets Stung the Hardest?
Bees, wasps, hornets and yellow jackets could all ruin a summer vacation, or a backyard barbecue
Sumathi Reddy : WSJ : July 14, 2014
A painful bee sting is sure to kill the buzz of a summer vacation.
And when that's followed by huge swelling and a trip to the ER, it can ruin your return to work as well.
For most people, a bee sting, which injects venom into the victim, means some immediate pain and maybe a little swelling, redness and itchiness for a few hours. Other people are less fortunate. An allergic response right around the sting area, called a local reaction, can cause those symptoms to last for days.
Worse still, what is known as a systemic allergic reaction can ripple outward, causing hives and swelling all over the body and possibly anaphylactic shock, which can be fatal.
As much as 4% of the population is sensitive to insect stings and it is estimated that up to 200 people in the U.S. die from stings every year. Allergic reactions aren't predictable: People may not react the first few times they are stung and then break out in hives the next time. Having a reaction doesn't necessarily mean you will have one again, although it increases the chance you will.
Certain times of year are worse than others. Yellow jackets are most likely to sting in the late summer and fall. That's when their natural food source—other insects—is less abundant and the yellow jackets are more prone to pester outdoor picnics and scavenge around trash cans.
Other major culprits include wasps, hornets and fire ants. These all belong to the order of insects called Hymenoptera and they can vary in temperament. Yellow jackets tend to be the most aggressive, delivering the most stings. Honey bees, by contrast, are the least likely to attack, except when they feel threatened.
"They are a problem more during the summer than the winter because that's when they're foraging and when they're nesting and reproducing," said Richard F. Lockey, health director in the division of allergy and immunology at the University of South Florida College of Medicine in Tampa.
It isn't clear why some people get stung more than others except that their behavior might be more likely to provoke the insects, experts say. People also have different degrees of sensitivity, which might account for varying responses to stings.
Most local allergic reactions, even when they bring on swelling, can be treated with ice, an antihistamine and a topical steroid. Medical treatment usually isn't necessary unless there are signs of a secondary skin infection, such as a fever, or you are incapacitated due to swelling.
Such was the case for me after a post-canoeing sting this summer left me with an insanely itching elephant foot that wouldn't fit into a flip-flop. After hobbling into an urgent-care clinic, I was prescribed oral steroids to bring down the swelling and antibiotics as a precaution.
Large, location reactions, if untreated, can take several days to reach peak swelling and may take seven to 10 days to go away, said Theodore Freeman, an allergist-immunologist with the San Antonio Asthma & Allergy Clinic in Texas.
Systemic allergic reactions, which spread to other parts of the body, are the real worry.
"What we get concerned about is when people get stung and they get anaphylaxis right away," said Dr. Freeman, who sits on the American Academy of Allergy, Asthma & Immunology's anaphylaxis committee.
Such cases usually start with hives and swelling all over the body. They then can spread to other organ systems, causing respiratory problems, low blood pressure, gastrointestinal problems and cardiovascular irregularities. They can lead to loss of consciousness and death.
In cases of a systemic reaction, doctors recommend immediate medical attention so epinephrine can be administered to stop the reaction from progressing. If you give yourself epinephrine, you should still seek medical care since the drug can wear off in 30 to 45 minutes. Doctors suggest patients get tested to see what particular venoms they are allergic to and then get a series of allergy-venom shots to help protect from future reactions.
John Morse, a beekeeper near Tampa, Fla., decided to get allergy shots after he suffered a severe reaction from multiple bee stings all over his legs. It wasn't the first time he had been stung, but he hadn't had serious issues before.
"I didn't realize the reactions to these stings was progressively getting worse and it all kind of culminated," said the 52-year-old, who tends to 10 bee hives as a hobby and works in information technology for a moving-and-storage company.
The incident happened in 2012 when he was moving a hive, which agitated the bees. His throat started closing and his face swelled. He ended up in the emergency room, where he was given epinephrine.
When a doctor told him he was going to have to give up beekeeping, he went to see Dr. Lockey and began getting allergy shots for honey bees and yellow jackets. Mr. Morse still keeps bees and hasn't had another reaction. He gets allergy shots every six weeks and he's more careful about protecting himself with a bee veil, long pants and leather gloves.
After a honey bee sting, the stinger should be removed because the venom sack can continue pumping the venom into your body. You don't want to pinch it because that will push more venom out. Instead, flick it off, using, say, the edge of a credit card. Yellow jackets, hornets and other types of wasps don't leave the stinger behind, which means they can sting multiple times.
Insect stings have been increasing in some parts of the country. Jeffrey Demain, director of the Allergy, Asthma and Immunology Center of Alaska, said a study he co-authored in 2011 in the journal Proceedings of Allergy and Clinical Immunology found a 48% increase in people in his state seeking care for sting events, especially from yellow jackets. He believes this may be due to recent years' milder winters, which can help more colonies survive.
The most dangerous location for a sting is on the mouth or tongue—from a yellow jacket, for instance, that has climbed into a bottle of a sugary drink. To avoid yellow jackets, stay away from open garbage containers and cover food at picnics.
Insect repellent is designed to ward off insects like mosquitoes, which are biters, not stingers. Repellents won't keep bees and wasps at bay. Dr. Freeman said getting rid of them requires practical measures like looking for nests around your house and yard and spraying them. Wear shoes and gloves for gardening and yard work.
Some limited evidence suggests wearing perfume, cologne or deodorant might attract the stinging creatures. So going au naturel might be a safe bet.
Bees, wasps, hornets and yellow jackets could all ruin a summer vacation, or a backyard barbecue
Sumathi Reddy : WSJ : July 14, 2014
A painful bee sting is sure to kill the buzz of a summer vacation.
And when that's followed by huge swelling and a trip to the ER, it can ruin your return to work as well.
For most people, a bee sting, which injects venom into the victim, means some immediate pain and maybe a little swelling, redness and itchiness for a few hours. Other people are less fortunate. An allergic response right around the sting area, called a local reaction, can cause those symptoms to last for days.
Worse still, what is known as a systemic allergic reaction can ripple outward, causing hives and swelling all over the body and possibly anaphylactic shock, which can be fatal.
As much as 4% of the population is sensitive to insect stings and it is estimated that up to 200 people in the U.S. die from stings every year. Allergic reactions aren't predictable: People may not react the first few times they are stung and then break out in hives the next time. Having a reaction doesn't necessarily mean you will have one again, although it increases the chance you will.
Certain times of year are worse than others. Yellow jackets are most likely to sting in the late summer and fall. That's when their natural food source—other insects—is less abundant and the yellow jackets are more prone to pester outdoor picnics and scavenge around trash cans.
Other major culprits include wasps, hornets and fire ants. These all belong to the order of insects called Hymenoptera and they can vary in temperament. Yellow jackets tend to be the most aggressive, delivering the most stings. Honey bees, by contrast, are the least likely to attack, except when they feel threatened.
"They are a problem more during the summer than the winter because that's when they're foraging and when they're nesting and reproducing," said Richard F. Lockey, health director in the division of allergy and immunology at the University of South Florida College of Medicine in Tampa.
It isn't clear why some people get stung more than others except that their behavior might be more likely to provoke the insects, experts say. People also have different degrees of sensitivity, which might account for varying responses to stings.
Most local allergic reactions, even when they bring on swelling, can be treated with ice, an antihistamine and a topical steroid. Medical treatment usually isn't necessary unless there are signs of a secondary skin infection, such as a fever, or you are incapacitated due to swelling.
Such was the case for me after a post-canoeing sting this summer left me with an insanely itching elephant foot that wouldn't fit into a flip-flop. After hobbling into an urgent-care clinic, I was prescribed oral steroids to bring down the swelling and antibiotics as a precaution.
Large, location reactions, if untreated, can take several days to reach peak swelling and may take seven to 10 days to go away, said Theodore Freeman, an allergist-immunologist with the San Antonio Asthma & Allergy Clinic in Texas.
Systemic allergic reactions, which spread to other parts of the body, are the real worry.
"What we get concerned about is when people get stung and they get anaphylaxis right away," said Dr. Freeman, who sits on the American Academy of Allergy, Asthma & Immunology's anaphylaxis committee.
Such cases usually start with hives and swelling all over the body. They then can spread to other organ systems, causing respiratory problems, low blood pressure, gastrointestinal problems and cardiovascular irregularities. They can lead to loss of consciousness and death.
In cases of a systemic reaction, doctors recommend immediate medical attention so epinephrine can be administered to stop the reaction from progressing. If you give yourself epinephrine, you should still seek medical care since the drug can wear off in 30 to 45 minutes. Doctors suggest patients get tested to see what particular venoms they are allergic to and then get a series of allergy-venom shots to help protect from future reactions.
John Morse, a beekeeper near Tampa, Fla., decided to get allergy shots after he suffered a severe reaction from multiple bee stings all over his legs. It wasn't the first time he had been stung, but he hadn't had serious issues before.
"I didn't realize the reactions to these stings was progressively getting worse and it all kind of culminated," said the 52-year-old, who tends to 10 bee hives as a hobby and works in information technology for a moving-and-storage company.
The incident happened in 2012 when he was moving a hive, which agitated the bees. His throat started closing and his face swelled. He ended up in the emergency room, where he was given epinephrine.
When a doctor told him he was going to have to give up beekeeping, he went to see Dr. Lockey and began getting allergy shots for honey bees and yellow jackets. Mr. Morse still keeps bees and hasn't had another reaction. He gets allergy shots every six weeks and he's more careful about protecting himself with a bee veil, long pants and leather gloves.
After a honey bee sting, the stinger should be removed because the venom sack can continue pumping the venom into your body. You don't want to pinch it because that will push more venom out. Instead, flick it off, using, say, the edge of a credit card. Yellow jackets, hornets and other types of wasps don't leave the stinger behind, which means they can sting multiple times.
Insect stings have been increasing in some parts of the country. Jeffrey Demain, director of the Allergy, Asthma and Immunology Center of Alaska, said a study he co-authored in 2011 in the journal Proceedings of Allergy and Clinical Immunology found a 48% increase in people in his state seeking care for sting events, especially from yellow jackets. He believes this may be due to recent years' milder winters, which can help more colonies survive.
The most dangerous location for a sting is on the mouth or tongue—from a yellow jacket, for instance, that has climbed into a bottle of a sugary drink. To avoid yellow jackets, stay away from open garbage containers and cover food at picnics.
Insect repellent is designed to ward off insects like mosquitoes, which are biters, not stingers. Repellents won't keep bees and wasps at bay. Dr. Freeman said getting rid of them requires practical measures like looking for nests around your house and yard and spraying them. Wear shoes and gloves for gardening and yard work.
Some limited evidence suggests wearing perfume, cologne or deodorant might attract the stinging creatures. So going au naturel might be a safe bet.
