bee on a flower
Allergies

Insect-Sting Allergy: Preventing Bad Reactions


Allergic reactions to insect slings, which afflict fewer than 5 percent of those who are stung, can be so severe that death may occur within a few minutes after a sting. Even if not fatal, sting allergy symptoms can be very frightening-dizziness, itchy welts or massive swelling of the body, inability to breathe, swallow or speak, fainting from low blood pressure, and shock.

Fear Can Limit Activities

Although most people who experience such reactions live to tell the tale, survivors dread the coming of spring and the increased risk of insect stings. Bees, wasps, hornets and yellow jackets, which are otherwise environmentally beneficial, may all be the unwitting instigators of terrifying allergic reactions. For every person who dies from insect-sting allergy there are hundreds who feel they came too close for comfort, and who subsequently curtail their lifestyles, avoiding any outdoor activities-such as golf, gardening, camping or picnics. Most who avoid outdoor activities are not aware of a treatment called venom immunotherapy that allows them to become immune to insect­sting reactions.

Seeing An Allergist

The first step for someone who has had a severe reaction to an insect sting is to see an allergist. This expert can determine whether it is necessary to proceed with the simple diagnostic tests to pin down the cause of the reaction. If the patient’s story suggests more than a localized reaction, the allergist will do skin or blood testing to determine which specific insects might cause problems in the future.

Venom Immunotherapy

Anyone with a positive venom skin or blood test and at least one previous generalized sting reaction (one not limited to the area of the sting) has six chances out of 10 to react badly when stung again. Because of this, experts feel that such patients deserve venom immunotherapy, which is 97 percent effective in preventing future generalized reactions. Venom immunotherapy is the process of administering traces of insect venom until the patient develops immunity to sting reactions. Protection can be achieved in a matter of weeks and can be maintained with periodic venom boosters. Until the venom immunotherapy takes effect, allergists advise their patients to take common sense precautions against being stung: don’t go barefoot, don’t hang around trash cans or picnic sites, and carry an emergency self-treatment kit that includes injectable epinephrine.

Emergency Epinephrine Kits

Many patients fail to have their epinephrine kits in the right place at the right time, and some reactions are so severe that epinephrine alone is not enough detoxic. Furthermore, some persons with heart or blood pressure problems shouldn’t risk the possible side effects that epinephrine can cause-increased blood pressure and rapid or erratic pulse. Because of this, and because venom immunotherapy is so effective, specialists recommend it in most “bee”­allergic adults and some children. However, many children do not need venom immunotherapy because the prospect for spontaneous disappearance of “bee” allergy is significantly greater in children than in adults. Your allergist can help you decide what treatment, if any, is necessary in your case.

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