Insect Allergy
.png)
Insect allergy is a very serious and life-threatening condition. It is estimated that approximately fifty people die from insect venom allergy each year in America.
There are 7 well-known insects that cause most of the reactions. Yellow jacket and honey bee are the most common allergy causing insects.The first 5 are common in the Midwest:
-
Honey Bee (HB)
-
Yellow Jacket (YJ)
-
Yellow Faced Hornet (WFH)
-
White Faced Hornet (YFH)
-
Paper Wasp (PW)
-
Asian Beetle (AB)
-
Fire Ant (FA)
In the sourthern United States, fire ant allergy is common. Recently an allergy to the Asian Beetle has been observed. This is becoming a problem on the East Coast and is spreading.
Symptoms
There are two kinds of reactions from insect stings:
-
Local: pain, redness, and swelling at the site of the sting. This usually resolves in 2-3 days.
-
Systemic or General: common symptoms are itchy skin, hives, and lip swelling that may sometimes progress to tongue or throat swelling with difficulty swallowing or breathing, and in the most severe cases, collapse and death (anaphylaxis).
The stinging insect allergy diagnosis is made with a detailed history, focused examination, and skin or blood testing for insect venom. Sometimes the stinging insect is killed by the patient and is brought in for identification purposes.
The Honey Bee has rounded ‘fuzzy’ body with dark brown coloring and yellow markings. HB usually leaves behind a barbed stinger on the skin and the bee dies as a result. Honey bees are non-aggressive and sting only when aggravated or provoked. However, Africanized HB found only in the southern United States are more aggressive and are called ‘killer bees’. HB lives in colonies or honeycombs in hollow trees or cavities of buildings.
Yellow Jackets are black with yellow markings. Their nests, made of paper-mache material, are usually located underground but sometimes found in walls or cracks in masonry.
Hornets are black or brown with white, orange, or yellow markings and are usually larger than YJ. Their nests are gray or brown, football shaped, usually found high above the ground in tree or shrubbery branches.
Paper Wasps are slender with black elongated bodies. Their nests are also made of paper like material in the form of combs, which open downwards. The nests are often located under eaves, behind shutters, in shrubs, or in wood piles.
Fire ants are reddish brown or black stinging insects related to honey bee and wasps. They build nests of dust. They can attack without warning. The ant grips the skin with its jaws and the then stings in a circular pattern. The ant venom causes an immediate burning sensation.
Treatment
If stung by a Honey Bee that leaves behind a stinger with an attached venom sac in the skin, remove stinger within 30 seconds by FLICKING IT with finger nail or knife tip. By removing the stinger right away you will prevent further venom from being pumped into the skin. DO NOT SQUEEZE the stinger as that will push more venom into the skin.
Avoidance of stinging insects is very important.
-
When outdoors do not wear bright colored clothes (e.g., clothes with floral pattern) or use perfume, which attracts insects. In other words do not smell or look like a flower to an insect.
-
Do not walk bare feet on grass, as yellow jackets make their nests in the ground.
-
Avoid lawns with clover or bright flowers.
-
Do not mow the lawn or do garden work during insect season (i.e., the warm months in the Midwest).
-
Be very careful in areas where there is food such as picnic areas or garbage areas as insects are attracted by food.
-
Do not drink from a soda can that has been left open for sometime. The insects are attracted by sugary foods and frequently fall in the can and sting on the tongue.
-
When approached by an insect stay still, be calm, and slowly walk away.
-
Drive with car windows up and air conditioning on. If an insect gets into the car, it could create a panic (especially in person allergic to insects) that might lead to an accident.
-
Look around the house for insect nests and have them removed professionally. Do not remove them yourself.
Patients must always carry an antihistamine medication such as Benadryl® or Claritin® and an epinepherine injection for emergency use in case of a reaction.
The antihistamine can be used for mild symptoms such as skin itching or hives while the epinepherine injection is indicated for more severe reactions such as difficulty swallowing or breathing. These medications are a first aid only and are not a complete treatment. After taking the medication and/or using the Epipen® use you MUST go the nearest medical facility for further care.
Immunotherapy (allergy shots) are highly effective in preventing allergic reactions from subsequent stings from the same insect.
Allergy shots provide 97-98% protection from a serious reaction from a sting from the same insect that caused the initial reaction . That means that once the allergy shots have built up a level of tolerance in the patient’s immune system, the chances of having a reaction from the sting of the same insect are 2-3 % and the reaction is likely to be much milder and not life-threatening.
