Take the Sting Out of Summer

National Jewish experts answer questions about insect-sting allergies

Being buzzed by a bee can be more than an annoyance. Some people can suffer serious or even life-threatening allergic reactions if those winged pests sting. Dan Atkins, MD, a pediatric allergist, and Ann Mullen, R.N., a patient education expert, explain insect-sting allergies and what to do about them

Question: Are insect-sting allergies unusual?

Answer: No. More than 1 million Americans report allergic reactions to insect stings - and roughly 50 die each year after being stung.

Question: Which insects can cause allergic reactions?

Answer: Yellow jackets, yellow hornets, white-faced hornets, wasps and honeybees are the most common culprits.

Question: What happens when one of these insects stings a sensitive person?

Answer: Reactions fall into two categories: immediate and delayed. Immediate reactions happen within four hours of a sting. They include localized pain, swelling and skin redness, lasting for several hours, at the sting site. Some people have an immediate "large local reaction" in which a larger area around the sting becomes swollen. They also suffer low-grade fever, mild nausea, aches and tiredness.

The most dreaded type of immediate reaction is called anaphylaxis. The person turns red and has itching, hives, swelling, sneezing, runny nose, swelling of the throat, breathing difficulties, nausea, abdominal cramping, vomiting and diarrhea. Sometimes, anaphylaxis can be so severe that it can lead to an irregular heartbeat, shock and even death.

Delayed reactions occur more than four hours after a sting - in a few cases, even a week later. People report hives, fever, joint pain and fatigue. These people may be at risk for anaphylaxis if they are stung again later. 

Question: How should I treat an insect sting?

Answer: If you have no history of allergic reactions, take aspirin for pain, and use ice to reduce swelling. If you have experienced reactions before, take an oral antihistamine (preferably one that doesn't cause drowsiness). If you have a history of severe or anaphylactic reactions, you should wear a bracelet that identifies your sensitivity, learn to give yourself injections of epinephrine, and keep epinephrine and antihistamines on hand. Call 911 after you take the medications.

If you have experienced a delayed reaction to a sting, consider immunotherapy - shots for allergies to insect venom. These can be very effective in preventing future reactions. See an allergist to learn more.

Question: Is there any way I can protect myself against insect stings while I'm outdoors?

Answer: Cover up! Wear long pants and long sleeves while hiking or mowing the lawn, and gloves for gardening. Trade your sandals for shoes.

Question: Is any color of clothing better than another?

Answer: Wear white or light-colored clothing; dark clothing or clothing with flowery designs are more likely to attract insects.

Question: I like to exercise outdoors. How can I avoid stings?

Answer: Scents can attract insects, so use an unscented deodorant and avoid strong perfume, cologne, hair products or lotions. Rinse off perspiration after vigorous exercise. Use insect repellents. If you are planning to picnic, be sure to cover food and drinks because they will draw insects. Don't forget to cover the garbage as well.

For more information about these and other topics, call LUNG LINE, 1-800-222-LUNG (5864) or send an e-mail. Always talk to your personal physician before making a change to your medical treatment.