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DESCRIPTIONThere are a only a few stinging insects in the United States that can cause an allergic reaction:
- Honeybees.
- Hornets.
- Yellow jackets.
- Bumblebees.
- Wasps.
- Spiders.
- Ants.
Insects of the group known as hymenoptera, which includes bees, wasps, hornets, and ants, cause an allergic reaction in 5 out of 1,000 people. These insects occur throughout the U.S. except for fire ants which are found only in the Southeastern states. This reaction is known as an insect venom allergy, and it can be dangerous, even life threatening. The yellow jacket and honeybee care the cause of most allergic reactions to insects. Over 2 million Americans are allergic to stinging insects. More than 500,000 people enter hospital emergency rooms every year suffering from insect stings and 40-150 people die as a result of an allergic reaction to these stings.
Identifying Stinging Insects
To avoid stinging insects, it is important to learn what they look like and where they live. Most sting reactions are caused by five types of insects: yellow jackets, honeybees, paper wasps, hornets and fire ants.
Yellow jackets are black with yellow markings, and are found in various climates. Their nests, which are made of a paper-maché material, are usually located underground, but can sometimes be found in the walls of frame buildings, cracks in masonry or woodpiles.
Honeybees have a rounded, "fuzzy" body with dark brown coloring and yellow markings. Upon stinging, the honeybee usually leaves its barbed stinger in its victim; the bee dies as a result. Honeybees are nonaggressive and will only sting when provoked. However, Africanized honeybees, or so-called "killer bees" found in the southwestern United States and South and Central America, are more aggressive and may sting in swarms. Domesticated honeybees live in man-made hives, while wild honeybees live in colonies or "honeycombs" in hollow trees or cavities of buildings. Africanized honeybees may nest in holes in house frames, between fence posts, in old tires or holes in the ground, or other partially protected sites.
Paper wasps' slender, elongated bodies are black, brown, or red with yellow markings. Their nests are also made of a paper-like material that forms a circular comb of cells which opens downward. The nests are often located under eaves, behind shutters, or in shrubs or woodpiles. 
Hornets are black or brown with white, orange or yellow markings and are usually larger than yellow jackets. Their nests are gray or brown, football-shaped, and made of a paper material similar to that of yellow jackets' nests. Hornets' nests are usually found high above ground on branches of trees, in shrubbery, on gables or in tree hollows.
Fire ant is the name of several species of ants that inflict painful, burning stings. Five species of fire ants are found in the Southeastern United States. Fire ants are reddish brown to black stinging insects related to bees and wasps. One of these, the red imported fire ant, is a major pest. They measure about 1/4 inch (6 millimeters) long. This species is native to South America. It probably entered the United States by accident aboard freight shipped through Mobile, Alabama during the 1930's. It has since spread rapidly and now inhabits an area that stretches from North Carolina to central Texas. In the 1980's, scientists developed special insecticides that contain soybean oil, which attracts the fire ants. The use of insecticides as fire ant baits help control the population of fire ants. Fire ants build nests of dirt in the ground that may be quite tall (18 inches to 2 feet tall) in the right kinds of soil. The mounds are so hard that they damage farm machinery. Hundreds of thousands of fire ants may inhabit one mound, and some areas have more than 200 mounds per acre. If a person or animal disturbs a mound, the ants swarm out to attack the intruder. Fire ants may attack with little warning: after firmly grasping the victim's skin with its jaws, the fire ant arches its back as it inserts its rear stinger into the skin. It then pivots at the head and may inflict multiple stings in a circular pattern. Fire ant venom often causes an immediate burning sensation. The ant's sting leaves a small, pus-filled, itchy bump that is easily infected. Some people experience severe - in rare cases, fatal - reactions to fire ant venom. The four other species of fire ants in the Southeaster United States do not pose major agricultural or health problems. Three of these species are native to this region. The fourth - the black imported fire ant - is a South American species that probably entered the United States in 1918.Scientific classification. Fire ants belong to the order Hymenoptera. The scientific name for the red imported fire ant is classified as Solenopsis invicta. 
Helpful Links About Stinging Insects
University of Kentucky: Controlling Wasps, Hornets, and Yellowjackets
Corky's Pest Control: Stinging Insects: Bees, Wasps, Hornets
University of Kentucky: Yard Wasps
University of Kentucky: Cicada Killer Wasps
Corky's Pest Control: Paper Wasps
Corky's Pest Control: Mud Dauber Wasps
University of Kentucky: Controlling Nuisance Honey Bees
Corky's Pest Control: Africanized Honey Bees (Killer Bees)
Corky's Pest Control: Carpenter Bees
North Carolina Cooperative: European Hornets
University of Kentucky: European Hornet in Kentucky
Corky's Pest Control: Yellow Jackets
AntColony.org: Fire Ants
University of Texas: Imported Fire Ant - FAQ
Texas Imported Fire Ant Research & Management Project
University of Minnesota: Lockley: Imported Fire Ants
Imported Fire Ants on Lawns and Turf
CAUSES
Prevalence of Insect Sting Anaphylaxis: As many as two million people in the United States are allergic to the venom of stinging insects. Many of these individuals are at risk for life-threatening anaphylactic reactions, resulting in curtailment of outdoor activities. Mortality attributed to these stings is estimated at 50 deaths per year.
The offending insects belong to the order Hymenoptera, which includes the Apids, or bees, and the Vespids, which are the wasps, yellow jackets, and hornets. Also, in the southern United States is the fire ant. Venoms from these insects contain several vasoactive substances, are hemolytic and neurotoxic, and are highly potent sensitizing agents.
Anaphylactic Reaction: An individual stung by a bee or vespid may exhibit responses ranging from a local reaction with pain, swelling and redness confined to the sting site; to an allergic anaphylactic reaction. The systemic response can involve one or more organ systems with hives and itching, weakness, dizziness, hypotension, difficulty breathing including sneezing and/or stridor, nausea and vomiting, abdominal cramps, or unconsciousness.
60% Risk of Anaphylaxis Upon Re-sting: In people allergic to insect stings, their immune system overreacts to the venom injected by a stinging insect. After the first sting, the allergic person's body produces an allergic substance called Immunoglobulin E (IgE) antibody, which reacts with the insect venom. If the person is stung again by an insect of the same or similar species, the insect venom interacts with the IgE antibody produced in response to the earlier sting. This triggers the release of histamine and other chemicals that cause allergic reactions.
The allergic reaction is usually the result of previous stings, with the immunologic basis being an IgE response. The majority of these patients have specific anti-venom IgE antibodies that react with one or more insect venoms. IgE attaches to circulating basophils and to mast cells present in the skin, respiratory mucosa, and other tissues. When a specific venom antigen interacts with it's specific antibody, the basophils or mast cells release histamine and other mediators which set off a chain of events culminating in the allergic symptoms.
Patients who have experienced a systemic allergic reaction from a Hymenoptera sting have a greater than 60% chance of a similar response if re-stung.
SYMPTOMS
Most people are not allergic to insect stings and should recognize the difference between an allergic reaction and a normal or large local reaction. This will prevent unnecessary worry and medical expense.
The severity of an insect sting reaction varies from person to person. A normal reaction will result in pain, swelling, and redness confined to the sting site. Simply disinfect the area and apply ice to reduce the swelling. A large local reaction will result in swelling that extends beyond the sting site. For example, a person stung on the forearm may have his/her entire arm swell to twice it's normal size. Although alarming in appearance, this condition is often treated the same as a normal reaction. However, because this condition may persist for 2-3 days, antihistamines and steroids are sometimes prescribed to lesson the discomfort. The most serious reaction to an insect sting is an allergic one. This condition requires immediate medical attention.
An allergic reaction or "anaphylaxis" to an insect sting can occur immediately, within minutes, or even hours after the sting (although never more than 24 hrs.).
- Hives.
- Itchiness.
- Swelling in the joints or other areas other than the sting site.
- Vascular swelling.
- Difficulty breathing, tightness in the chest, respiratory distress.
- Dizziness or a sharp drop in blood pressure.
- Shock (circulatory collapse).
- Nausea.
- Cramps or diarrhea.
- Unconsciousness.
- Cardiac arrest.
- Death within minutes.
Signs that a dangerous reaction is developing include:
- Confusion.
- Difficulty swallowing.
- Hoarseness or swelling of the tongue.
- Labored breathing.
- Severe swelling.
- Weakness.
- A feeling of impending disaster.
- A more severe reaction results in closing of the airway and/or shock, producing unconsciousness.
Some biting insects, such as mosquitos, can cause allergic skin reactions that appear as scaly and itchy eczema.
RISK FACTORS
People who have experienced a systemic allergic reaction to an insect sting have a 60% chance of a similar (or worse) reaction if stung again.
Stinging insects are most active during the summer and early fall when nest populations can exceed 60,000 insects.
These insects are most dangerous in the vicinity of their nests. A passer-by is viewed as a threat to the safety of their home and is often chased out of the area by a sting(s).
Yellow jackets, hornets, and wasps can sting repeatedly. Honeybees have barbed stingers which are left behind in their victims' skin. These stingers are best removed by a scraping action rather than a pulling motion which actually squeezes more venom into the skin.
Stinging insects are especially attracted to sweet fragrances (perfumes, colognes, and hair sprays), picnic food, open soda and beer containers, and garbage areas. Avoiding these attractants will lessen a person's chance of being stung.
PREVENTION
Knowing how to avoid stings from bees, wasps, hornets, and yellow jackets leads to a more enjoyable summer for everyone. The following precautions are suggested:
- Avoid walking barefoot in the grass (honeybees and bumblebees forage on white clover, a weed that grows in lawns throughout the United States).
- Insect repellants DO NOT work against stinging insects.
- Never swat or flail at a flying insect. If need be, gently brush it aside or patiently wait for it to leave.
- DO NOT drink from open beverage cans. Stinging insects will crawl inside a can attracted by the sweet beverage.
- When eating outdoors, try to keep food covered at all times. Stinging insects are fond of the same foods you are.
- Garbage cans stored outside should be covered with tight- fitting lids.
- Avoid wearing sweet-smelling perfumes, hairsprays, colognes, and deodorants.
- Avoid wearing bright colored clothing with flowery patterns. Bees may mistake you for a flower.
- If you have had an allergic reaction to an insect sting, it is important that you see an allergist. You have a 60% chance of having a similar, or worse reaction if stung again. There is a treatment, venom immunotherapy, which is 97% effective in preventing future allergic reactions to insect stings.
TREATMENT DIAGNOSIS & TESTS
Exams and Tests
People who have had a systemic reaction to a Hymenoptera insect sting should be evaluated by an allergy specialist for venom immunotherapy (VIT). 70-90% of these patients will have a verified sensitivity as measured by skin or in-vitro testing.
CONVENTIONAL MEDICAL TREATMENT
The 3 "A's" of Allergy Management:
- Allergist: Consult an allergist regarding evaluation for preventive treatment.
- Adrenaline: Carry injectable epinephrine.
- Avoidance: Practice insect avoidance.
Venom Immunotherapy 97% Effective: Purified venoms have been available since the late 1970's. They replaced whole body extracts which lacked reliable antigenicity and had been shown to be ineffective. In double-blind, placebo controlled clinical studies, venom immunotherapy has been shown to be 97% effective in eliminating a reoccurrence of a systemic reaction to an insect re-sting. Numerous other studies evaluating the frequency of anaphylaxis after re-sting in immunotherapy treated patients and in untreated patients confirm these results.
Immunotherapy Regimen by an Allergist: Patients who have had a systemic reaction to a Hymenoptera insect sting should be evaluated by an allergy specialist for venom immunotherapy (VIT). 70-90% of these patients will have a verified sensitivity as measured by skin or in-vitro testing. When indicated, an immunotherapy regimen typically involves a gradual weekly then bi-weekly increase in venom dose over 6-20 weeks, until a maintenance dose is reached. Once this level of protection has been achieved, it is maintained with periodic booster doses administered at 4 to 8 week intervals for a period of 3 to 5 years. While antibody levels achieved by VIT vary from patient to patient, the ideal response involves a rise in IgG, the blocking antibody, and an offsetting decrease in IgE.
Allergic reactions to insect stings can be prevented with venom immunotherapy, a treatment that is 97% effective in preventing future occurrences. It involves administering gradually increasing doses of venom that stimulate the patient's own immune system to become resistant to a future allergic reaction. In a matter of weeks, people who previously lived under the constant threat of severe reactions to insect stings can go about leading normal lives.
Venom Immunotherapy - Compliance and Safety: In a study with over 1400 patients receiving VIT, 92% achieved maintenance dosage and 84% of these completed therapy. The risk of an anaphylactic event from VIT is minimal (0.17% per year), and no reported deaths.
Epinephrine Sting Kits: Epinephrine patient self-administration kits are useful and particularly important during the period before VIT maintenance dosage has been achieved. However, epinephrine kits should not be seen as a substitute for an allergy evaluation and VIT. Epinephrine alone is not always enough to reverse serious anaphylactic sting reactions and may cause serious side effects in some patients with heart conditions or patients on certain medications. Also over time, many patients tend to forget to carry the epinephrine with them.
An allergic reaction is treated with epinephrine, either self-injected or administered by a health care provider. In some cases, intravenous fluids, oxygen, and other treatments are necessary as well. Once stabilized, these patients are sometimes required to stay overnight at the hospital under close observation. People who have had previous allergic reactions and rely on the protection of epinephrine must remember to carry it with them wherever they go. Also, because one dose may not be enough to reverse the reaction, immediate medical attention following an insect sting is recommended.
Patient Management: The complete management of the insect sting anaphylaxis patient goes beyond the emergency department or the physician's office. It should include providing the patient with information on avoidance behavior to lower the risk of a re-sting, prescribing a form of injectable epinephrine for patient self-administration, and referral to an allergy specialist for evaluation for venom immunotherapy.
Medications
An allergic reaction is treated with epinephrine (adrenaline). Several self-injectable devices are available by prescription including Epi-Pen, ANA-Kit, and others. These devices are filled with the epinephrine to be injected in to the subcutaneous tissue or muscle, preferably into the front of the thigh. These self-injected devices usually contain only one dose and, on occasion, more than one dose is needed. Venom extractors are commercially available, but they have not been demonstrated to have any benefit.
If a serious sting occurs medical attention can be necessary, even if epinephrine is used and all seems stable! The allergic reaction can subsequently progress and become more serious after epinephrine has worn off. Sometimes epinephrine is not enough and intravenous fluids or other treatment is needed. If you are known to be seriously allergic to insects you must remember to carry the epinephrine at all times especially when out of reach of medical care (such as in the woods or even on an airplane). If epinephrine is not available when you are stung, contact a doctor as soon as possible. In addition to epinephrine, an oral dose of antihistamine (like Benadryl) can reduce the symptoms of an allergic reaction. Antihistamines take effect in about one hour. Ultimately, however, it is crucial to first avoid the sting, so such treatment isn't necessary!
HOME TREATMENT
You can lessen your chances of an insect sting by taking certain precautionary measures. Yellow jackets will nest in the ground and in walls. Hornets and wasps will nest in bushes, trees and on buildings. Use extreme caution when working or playing in these areas and never walk barefoot in the lawn. Avoid insect attractants such as fragrances (perfumes, hair sprays, lotions, etc.) open garbage cans and exposed food at picnics. Also, try to reduce the amount of exposed skin when outdoors.
HOLISTIC & NUTRITIONAL RECOMMENDATIONS
CONSIDERATIONS
Sometimes brewer's yeast or garlic rubbed on the skin deters insects. Eating garlic may help also.
Antihistamines given by injection or by mouth following a sting can reduce later-appearing symptoms.
A venom extractor called the Lil Sucker is available from International Reforestation Suppliers. It is small enough to fit inside a pocket or purse. If you get stung, it produces a vacuum that sucks the venom out within two minutes. The end of the extractor can also be used to remove a honeybee stinger. For more information about this product, call 800-321-1037. Other venom extractors are available through this suppliers:
RECOMMENDATIONS
To avoid insect stings, wear plain, light-colored clothing when spending time outdoors - avoid wearing anything that is flowered or dark. Do not wear perfume, suntan lotion, hairspray, or shiny jewelry. Avoid wearing sandals or loose fitting clothes.
If you have ever had an allergic reaction to an insect sting, you should have access to an epinephrine (adrenaline) kit at all times. Have your health care provider prescribe an emergency treatment kit and instruct you in its proper use. Epinephrine raises the blood pressure and speeds the heart rate, counteracting the allergic response. It is best administered via a preloaded syringe found in injection kits.
If you are bothered by a yellow jacket, do not squash it; doing so releases a chemical that attracts other yellow jackets and wasps. It is best to leave these insects alone, or to find and destroy the nest after dark, when they are less active.
If you do get stung, immediately and carefully remove any stinger left in the skin. It is best not to pull the stinger out. Instead, gently and carefully scrape or tease it out with a sterilized knife. If no knife is available, you can use a fingernail or even the edge of a credit card instead. After a sting, be alert for signs that a reaction is developing. Reactions can occur in minutes or hours, and they can progress very quickly. If you have any doubts about your condition, seek treatment at once.
As soon as possible after a bite or sting, soften charcoal tablets or capsules (these can be obtained from health food stores) in warm water and make a paste. Apply this paste to the site and cover it with a clean, wet piece of gauze or cotton. It is a good idea to take a few charcoal tablets with you whenever you will be spending time outdoors.
HERBS
Herbal flea-repellant pet collars contain oils of cedar, citronella, eucalyptus, pennyroyal, rosemary, and rue. These herbs may be effective insect repellants for humans as well. Caution: Do not use pennyroyal or rue during pregnancy. Avoid excessive and/or prolonged use.
Tea tree oil can be rubbed on exposed areas of the skin to deter insects. It can also be applied to bites. If pure tea tree oil is too strong, dilute it with canola oil or another low-fragrance vegetable oil until a tolerable strength is achieved.
NUTRITIONAL SUPPLEMENTS
NUTRIENTS Supplement Suggested Dosage Comments Essential Quercetin (Activated Quercetin from Source Naturals) As directed on label. A unique bioflavonoid that reduces allergic reactions. Vitamin C 5,000-20,000 mg daily, in divided doses. See Ascorbic Acid Flush. Acts as an anti-inflammatory and helps fight the toxicity of insect venom. For a child, use buffered vitamin C or calcium ascorbate. Helpful Aller Bee-Gone from CC Pollen As directed on label. A combination of herbs, enzymes, and nutrients designed to fight acute allergic symptoms.
Mountain Rose Herbs, Bulk Herbs A-B
Mountain Rose Herbs, Bulk Herbs C-D
Mountain Rose Herbs, Bulk Herbs E-J
Mountain Rose Herbs, Bulk Herbs K-O
Mountain Rose Herbs, Bulk Herbs P-R
Mountain Rose Herbs, Bulk Herbs S-Z
Click Here To Visit Herbal Remedies Product Page
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF... Consult an allergist. If you've had an allergic reaction, it's important to talk to an allergist, a doctor who is a specialist in the diagnosis and treatment of allergic disease. Based on your past history and certain tests, the allergist will determine if you are a candidate for immunotherapy treatment. Although stinging insect allergy is a serious problem, much of the risk and fear of a reoccurrence can be virtually eliminated with immunotherapy.
In the event of a insect sting with an allergic reaction, use your epinephrine treatment kit and contact emergency medical care immediately or as soon as possible for medical evaluation. A severe allergic reaction can be life threatening in a matter of minutes to hours.
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch
Helpful Links
MoonDragon's Health Information: Allergies
