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Summer in Ohio means long sunny days, beautiful greenery, and—for some people—deadly insect stings. While usually just bothersome, stings from insects in the Hymenoptera order, which includes bees, wasps, hornets, and fire ants can cause allergic reactions in about 3 percent of people by triggering the immune system to produce immunoglobulin E, an antibody that helps fight off harmful substances in the body.
The first time, or even the first few times, you’re stung, the reaction may be mild. Generally, a red welt, slight swelling and itching follow the sharp, localized pain of a sting.
About 10 percent of people have what’s called a large local reaction, which can include more extreme swelling that gets larger during the several days after the sting and more pronounced redness. If you’ve had a large local reaction, talk with your doctor about the chances that you may have a venom allergy.
In about 3 percent of people—twice as many males as females—a sting by a bee or other Hymenoptera insect can lead to an instantaneous and severe allergic reaction called anaphylaxis.
Anaphylaxis, which happens very quickly after exposure to certain insect stings, can be life-threatening if not treated. While many people associate anaphylactic shock with closure of the airways due to swelling, according to the National Institutes of Health, it actually affects tissues in all parts of the body and can cause:
- Abnormal (high-pitched) breathing sounds
- Chest discomfort or tightness
- Difficulty breathing
- Difficulty swallowing
- Dizziness or light-headedness
- Hives, itchiness
- Skin redness
- Swelling of the face, eyes, or tongue
If you’ve experienced anaphylaxis after an insect sting, you have a 30 to 60 percent chance of it happening again the next time you’re stung.
The following Hymenoptera insects account for most venom allergy reactions:
- Honeybees from the Apidae family
- Yellow jackets, hornets, and wasps from the Vespidae family
- Fire ants from the Formicidae family
Your history of reaction to insect stings is important in diagnosing an allergy. If you’ve had a large local reaction, be sure to mention it to your physician. A skin prick test that introduces a small concentration of venom can also be used to help more conclusively diagnose an allergy.
For large local reactions, ice, antihistamines, and topical corticosteroids can help reduce swelling , pain, and itching.
If you are concerned about a severe reaction, such as anaphylaxis, your doctor may recommend that you carry an EpiPen, which allows you to receive an immediate dose of epinephrine to relax the muscles around your airways. Any time you experience symptoms, seek immediate medical care–even if you’ve used an Epi-pen. Emergency treatment may include additional epinephrine, antihistamines to address hives and swelling, bronchodilators to treat wheezing, or corticosteroids.
Venom immunotherapy (allergy shots), which introduces small doses of venom into your system over time, can help desensitize your immune system. An ongoing maintenance dose is required 5 years to indefinitely.
In addition to carrying an EpiPen, it’s important to minimize your exposure to the offending insect. Learn to identify stinging insects and stay away from nests or have them destroyed by an exterminator if you find them in your yard or near your house. The American Academy of Allergy, Asthma, and Immunology also recommends:
- Avoid wearing perfume or bright-colored clothing when you’re outdoors.
- Be aware around food and drinks outdoors, particularly sugary items.
- Avoid drinking from straws, cans, or bottles where an insect could be hidden.
- Wear closed-toe shoes and don’t go barefoot.
You may also choose to wear a medical alert bracelet or carry a card in your wallet that identifies your allergies in case of emergency.
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