Conservation Corner: March 25, 2002

Allergic Reactions To Insect Stings
by James L. Cummins

Allergic reactions to insect stings are a common and often serious medical problem. Insects that sting are divided into two major subgroups: the group consisting of the yellow jacket, hornet and wasp; and the one made up of the more docile honeybee and bumblebee. The fire ant is a non-winged member of the first group and is responsible for an increasing number of allergic reactions.

According to Dr. William M. McKell, a physician at Singing River Hospital in Ocean Springs, "Reactions to stings are divided into two major categories, local and systemic. The usual and expected reaction is one of localized pain, swelling and redness at the site."

"The first step in management is to remove any retained stinger. Bees have a multi-barbed stinger which, along with the venom gland, remains attached to the victim. This needs to be scraped away from the skin with a sharp object such as a fingernail or knife blade (do not grasp the stinger for this may inject additional venom). Essentially no treatment is required for this self-limited reaction other than possibly cold compresses and over-the-counter pain medication. Some advocate the application of moist tobacco or meat tenderizer (papain), and they may well be of benefit, however, I have never seen data supporting or refuting their use."

A large local reaction, such as swelling of the entire arm secondary to a sting on the hand, consists of more discomfort and prolonged swelling. These may well last a week. According to McKell, management here usually consists of over the counter pain medication and antihistamines; if the swelling is extensive and disabling, oral cortisone-type drugs may be of benefit. McKell
states that it is unknown why this occurs, but in those in whom it has
developed are more likely to have reactions in the future.

"A severe and sometimes fatal systemic reaction is called anaphylaxis. It will usually begin within 20-30 minutes of the sting and consist of generalized hives and swelling, difficulty breathing, and/or circulatory collapse and shock. This is a true medical emergency
resulting in 40-150 deaths per year in the United States, requiring
immediate professional attention," states McKell.

The fire ant will bite anything that invades his bed, hold on with his jaws, and rotate his body, inflicting multiple stings, typically in a circular pattern. "These appear infected, but are not. I include this only to discourage the routine use of antibiotics for such a sting," continued McKell.

Individuals who have had a systemic reaction should consider evaluation by an allergist. Adults who have experienced this have a 30-60% risk of having another systemic reaction if stung again.

James L. Cummins is Executive Director of the Mississippi Fish and Wildlife Foundation in Stoneville, Mississippi. Known as "Wildlife Mississippi," the Foundation is a non-profit, conservation organization founded to conserve, restore and enhance fish, wildlife and plant resources throughout Mississippi.