It has been estimated that potentially life-threatening reactions to insect venom occur in 0.4% to 0.8% of children and up to 3% of adults. Allergic reactions can occur even after many normal reactions previously. It is believed that up to 40 deaths occur secondary to sting reactions each year in the US.
Stinging insects in the Owensboro area
In the US, the majority of sting reactions are caused by wasps, yellow jackets, hornets and bees. The red and black imported fire ant can be found in many areas of the southern United States, but is not found in Kentucky at this time.
Symptoms of insect sting reactions
- Pain at the site
- Swelling locally and general
- Anaphylaxis(less common) a potentially life-threatening reaction with respiratory or breathing problems, cardiovascular symptoms like hypotension or shock.
Types of insect sting reactions
There are three types of reactions that can occur:
- Normal local reaction which results in local pain, swelling, and redness at the sting site
- Large local reaction is typically swelling that extends well beyond the sting site. Example would be a sting on the arm causing the whole arm to swell. This reaction usually peaks over 2-3 days after the sting and can last for a week.
- Systemic allergic reaction is the most serious type, and is often referred to as Anaphylaxis. Symptoms can range from mild to severe and can include hives, itching, flushing, swelling distant to the sting, dizziness, hypotension, hoarse voice, swelling of the tongue or difficulty swallowing, abdominal cramping, vomiting, nausea, diarrhea, sense of impending doom, metallic taste, loss of consciousness, shock and even death. With subsequent stings, patients with a history of systemic allergic reaction to venom stings are at a considerable increased risk for reactions that are equal to or worse than previous reactions.
Diagnosis of stinging insect allergy
Evaluation for possible stinging insect allergy includes a thorough history, exam and allergy testing. Diagnostic testing can be done with skin testing or through blood tests looking for IgE antibodies to insect venom. Skin testing is the most accurate method to determine whether or not a patient has insect sting allergy.
Management and treatment of insect allergies
- Avoidance of insect stings is the first part of management. Some advice to help:
- Don’t walk barefoot in the grass
- Don’t drink from open soft drink cans/bottles
- Keep food covered when eating outdoors
- Don’t use strong perfumes, hairsprays 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 cans, and picnic areas
- Have a pest control professional remove nests
- Keep auto injector epinephrine device like an epipen with you at all times.
- Insect venom immunotherapy is a potential treatment option as well. Venom allergy shots can considerably reduce the likelihood of anaphylaxis from future stings. Allergy shots to insect venom are administered for 3-5 years in most cases. However, in patients with an history of very severe reactions, shots may be continued indefinitely.