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The Itching Games, Part 1: "Bee-ware"

Posted on Tuesday, August 05, 2014, by Ashley Snyder

By Dr. Kathryne Buege

You have arrived at a summer picnic and, unbeknownst to you, your name has been picked by the Phylum Arthropoda to participate in their annual "Itching Games."  Here are a few survival tips to navigate their playing field.

What is Phylum Arthropoda?

It is the largest division of the animal kingdom. Bees, wasps, mosquitoes, fire ants, black widow and brown recluse spiders, ticks and scorpions, to name a few. This post is dedicated to the bee and insect stings that inevitably cross our paths this time of year.

Toxic reactions to multiple stings by Hymenoptera (wasps, bees and ants) and severe systemic allergic reactions to one or more stings or bites of other insects such as deer flies, black flies, horseflies, and kissing bugs can all present emergency, life-threatening situations. "Bee" aware of what to do when stung by an insect or bee and take appropriate action.

What you need to know about Hymenoptera:

  • The most important venomous insects known to humans
  • This order of species includes honeybees, bumblebees, yellow jackets, hornets, wasps and ants.
  • Honeybees and bumblebees are usually docile and only sting when provoked.
    • Males have no stinger! Yes, ladies - the females pack the punch, but are only able to sting one time and then die.
  • Wasp, hornet and yellow jacket stings cause most of the reported allergic reactions.
    • They nest in the ground, in walls and have volatile tempers.
    • Like honeybees and bumblebees, the females have the stinger, but have the ability to withdraw their stinger, allowing for multiple stings. OUCH!
  • Sting signs and symptoms:
    • Pain, slight erythema (skin redness), edema (swelling) and itching at the sting site
    • In some cases, more serious reactions may develop (anaphylactic reaction).

What to do if you are stung:

  • Remove the stinger and wash the affected area with soap and water. Older conventional methods recommend scraping the sting site with a flat surface, like a credit card.
  • Apply cold compresses.
  • Elevate the affected limb.
  • Control any itching with anti-histamines, such as Benadryl (sedating), Zyrtec (sedating for some), or Claritin and Allegra (non-sedating).
  • NSAIDS (non-steroidal anti-inflammatories) for pain relief
  • H-2 blockers (Zantac) for any gastrointestinal symptoms

Signs & symptoms of anaphylaxis:

  • The majority of reactions occur within 15 minutes, and nearly all occur within 6 hours of the sting or bite.
  • There is no correlation between the number of stings and the systemic reaction.  Typically the shorter interval between the sting itself and the onset of symptoms, the more severe the reaction.
  • Watch for facial flushing, tongue swelling, generalized urticaria (hives), dry cough, throat constriction, vomiting, diarrhea and bluish discoloration in the extremities.
  • Seek immediate medical attention/call 911.
  • If available, use an EpiPen, injected into the muscle, massaging the injection site to hasten absorption.
  • Patients should be monitored/observed for several hours in an acute care setting.

Uncomplicated local reactions typically consist of redness and painful swelling at the sting site, and resolved within a few hours. Occasionally, swelling may last one to two days.

Large, local reactions may have exaggerated redness and swelling that does not resolve until 5 to 10 days later. Most stings do not become infected, although this can occur. An infected sting must be differentiated from a large local reaction, so contacting your medical care facility or MASH Urgent Care for evaluation is a great idea if you experience prolonged or unusual symptoms.

Remember, talk to your health care provider about what treatment regimen is best for you, and "may the odds be ever in your favor!"