The Winged and Wingless Allergy Demons

By Craig Moffat MD

​Every year around this time we see an increased number of patients who have suffered sting reactions from venomous flying insects.​

Bees
​While vicitims seldom know accurately what actually stung them, we know for sure in our northern climes it was not a fire ant bite. Generally, they are honeybees, or their cousins from the vespid family, yellow jacket, yellow hornet white-faced hornet or paper wasps. August to September are our peak sting months. 

Most people have only local reactions and treat them successfully with ice and antihistamines, but other more serious reactions may occur. These include systemic reactions, with hives, flushing, swellings, hoarseness, airway obstruction, wheezing, and even shock, collapse, and death. This degree of reaction fortunately occurs only in up to 3% of people who are stung, but tend to be more prevalent and more severe in adults. Another reaction is called a “large local reaction” where one experiences exaggerated redness and swelling gradually enlarging over 1-2 days, peaks at 48 hours and resolving over 5-10 days. Reactions here may be large reaching 6” in diameter and may require prednisone. While these are worrisome, only 5-10% of these reactions will progress to a more serious reaction the next sting.

For systemic reactions, our most effective treatment is venom immunotherapy (VIT). This is a 4-6 year treatment of injections of venom in increasing amounts that leads to excellent protection (up to 94%) against future systemic reactions. In order to receive this treatment, one must have a reliable history of a systemic reaction AND a positive venom skin test or blood test. Interestingly, for reasons that are not understood, honeybee stings appear to cause a higher rate of recurrent systemic reactions compared to vespids, and honeybee VIT is slightly less effective in preventing future reactions (77% vs 91%) and protection seems to last not as long.

For sting reactions, seek emergency medical help if you experience any systemic symptoms, and you may want to talk to your doctor if you experience large local reactions. Contact Sandy Allergy Clinic for more information or schedule time for more information or evaluations.