What You Need to Know About Stinging Insect Allergy

Skyland, North Carolina, UNITED STATES

ASHEVILLE, N.C., June 21, 2017 (GLOBE NEWSWIRE) -- Stinging insect allergy affects approximately 3% of adults and 0.4-0.8% of children in the United States, with 40 - 100 people in the United States dying each year from a sting reaction. This type of allergy may develop at any age, is not inherited, and can occur whether or not one has other types of allergies. People with a severe allergic reaction to an insect sting have usually tolerated a prior sting; it is rare to have a life-threatening reaction the first time a person is stung. The insects responsible for the most serious allergic reactions are honey bees, wasps, hornets, yellow jackets, and fire ants. Bumblebees rarely sting.

Reactions to insect stings fall into two categories: anaphylaxis and large local reactions.

Anaphylaxis is defined as a sudden onset life-threatening allergic reaction. Onset of symptoms can be immediately to within 2 hours after a sting. Symptoms may include hives, swelling, difficulty breathing, wheezing, coughing, a feeling of throat closing or throat tightness, nausea, vomiting, low blood pressure, lightheadedness, shock, or loss of consciousness. In other words, any symptoms distant to the site of a sting may be life-threatening. However, if a person is stung and only has swelling at the site of the sting with no other symptoms, this is called a large local reaction.

People who have a large local reaction to a sting are not at increased risk of a life-threatening reaction to future stings; they do not necessarily need evaluation or treatment by an allergist. However, once a person has had a severe reaction to a sting (anaphylaxis), there is a 50-65% chance of having a similar or more severe reaction if stung in the future. Anyone who has experienced symptoms consistent with anaphylaxis after an insect sting (or symptoms distant to the sting site) should be referred to an allergist. They will need an evaluation and consideration for venom-specific immunotherapy in order to minimize the likelihood of future reactions. The exception is children under 16 years of age who only develop hives but no other symptoms after a sting. They are not at increased risk of anaphylaxis with future stings, and do not need an allergy evaluation or consideration for treatment with venom-specific immunotherapy.

The allergist will take a detailed history to confirm the nature of the sting reaction. The insect culprit will be identified if possible. Insect allergy is then diagnosed with venom allergen skin prick and intradermal testing. Occasionally, blood testing for venom allergy may be performed to complement skin testing. Because there is cross-reactivity between some venoms and it is not always possible to identify the insect responsible for the reaction, testing for all relevant venoms is usually performed. Venom skin testing accurately identifies >90% of stinging insect venom sensitivities.

Treatment and Practical Tips

Treatment of stinging insect venom allergy consists of venom-specific immunotherapy, the recommendation to carry injectable epinephrine, and observing general avoidance measures to reduce the risk of being stung in the future. The allergist may also provide a written anaphylaxis action plan and recommend obtaining a medical-alert bracelet which states that the wearer has stinging insect venom allergy.

Venom-specific immunotherapy reduces the risk of an allergic reaction to a future sting from 50-65% to fewer than 5%. It exposes the patient’s immune system to gradually increasing doses of the venom(s) to which they are allergic. This produces tolerance to the venom(s) that protects them against anaphylaxis if stung again. Venom-specific immunotherapy is typically given for 3-5 years. It is 98% effective in preventing future systemic reactions and is the standard of care for treating venom-allergic patients. Venom immunotherapy can be a life-saving therapy.

Epinephrine is the cornerstone of treatment for all forms of anaphylaxis. All patients with a history of stinging insect venom anaphylaxis should carry epinephrine at all times and be properly instructed in its use. Epinephrine should be administered immediately at the onset of any life-threatening symptoms consistent with anaphylaxis and should be followed by transport to the nearest emergency room for additional care. Because epinephrine is short-acting (15-20 minutes), symptoms of anaphylaxis may recur after the epinephrine wears off. The use of this medicine is therefore considered a temporizing measure, not a substitute for seeking medical care. An antihistamine such as Benadryl should also be used, but only after epinephrine has been given.

General avoidance measures to reduce the future risk of a sting include the following:

  1. Avoid wearing perfumes and scented lotions, which may attract insects.
  2. Wear shoes (closed-toed) outdoors at all times.
  3. If eating outdoors, keep food covered until eaten, and leave the clean-up to others.
  4. Exercise caution when eating sweet foods and drinks (sodas, juices) outdoors.
  5. Avoid or exercise caution around pools, picnic tables, and trash cans.

  6. If possible, leave yard-work, gardening, and landscaping to others; otherwise proceed with extreme caution.

  7. Have periodic inspection of your home and property by a professional pest company or non-allergic relative or friend to exterminate nests.

Contact Information:
Amanda Reed, Marketing and Corporate Communications Manager
Allergy Partners, P.A.
828-277-1300 phone
828-277-2499 fax

PR: NOVA MedMarket