Allergy to Bee and Wasp stings

Bees and wasps cause painful stings because they inject venom using a small dart-like needle in their tails. The bee leaves its dart behind, stuck in your skin, and the bee subsequently dies. The wasp does not lose its dart, and does not die after the sting, and furthermore it can sting repeatedly.

BEES AND WASPS IN AUSTRALIA

Honey bees were introduced into Australia. Many are “domestic” in the sense that they are used for honey manufacture or pollination in orchards. The other group are “feral” or wild honey bees. Australia does have native bush bees that do not sting, but there are also many wild honey bees in the bush. The European wasp arrived in Australia about 30 years ago, and is just now becoming a major pest. Many urban gardens have wasps in plague proportions. Unlike bees, wasps are quite aggressive when disturbed. There is a paper wasp that is native to Australia and tends to live in the bush. It can sting and cause allergies. Hornets and bumblebees are prevalent in many parts of the world, but not in Australia.

NORMAL LOCAL REACTION TO A STING It hurts when you are stung. The skin becomes sore and swollen, usually not more than 5 cm (2 inches) in diameter, and there may be a mark for a few days.

LARGE LOCAL REACTION TO A STING This is the mildest form of allergy. There is swelling which usually extends between 2 joints and lasts for more than 24 hours. If such again, a person who has had a large local reaction has a 60% chance of getting the same sort of allergy. But the chances of getting a more serious allergy are less than 5%. Further tests or allergy injections (desensitisation) are not required. If stung in the future, one or perhaps two doses of cortisone (oral steroid such as prednisolone) medication by mouth is usually sufficient to abort the reaction. Speak to your doctor about this treatment.

HIVES OR WIDESPREAD ITCHY RASH AFTER A STING Take a double dose of oral antihistamines stat and seek medical attention. This type of reaction deserves full assessment. Please arrange this with your doctor who will refer you on for specialist care. Even with this type of allergy, most people will not require allergy injections (desensitisation), but some will. However, they will need to carry antihistamines and possible Epipen or Anapen (see below).

SEVERE BREATHING PROBLEMS OR SEVERE SWELLING OR COLLAPSE AFTER A STING Call an ambulance, take a double dose of antihistamines stat. You will end up in an Emergency Department. The hospital should provide you with an EpiPen or Anapen prior to discharge. After recovery, full assessment is required. Most people with this type of allergy will be advised to undergo a course of allergy injections (desensitisation) to the venom. Such a course of treatment, although continuing over some years, is extremely effective in providing protection. Most people with this allergy will need to carry adrenaline (called epinephrine in the USA) to self-administer if necessary. The brand names of this product in Australia are EPIPEN and ANAPEN. They are available on the PBS in Australia for anaphylaxis. This means the cost is about $3 for pensioners and about $30 for non-pensioners.  Adequate training in this type of treatment is required. The chances of getting a similar reaction with a future sting are about 60% unless desensitisation is carried out. Allergy injections are available for severe allergy to honey bee, European wasp, and paper wasp stings. The actual treatment extract is subsidised by the Australian government and is therefore available through the Pharmaceutical Benefits Scheme and hence is very cheap (about $30/6 months for a non-pensioner.
Full assessment after this sort of reaction is best done by an Allergy Clinic in a public hospital, or a private allergist/clinical immunologist.

FIRST AID FOR A STING If a stinger or dart is still stuck in the skin, it should be QUICKLY removed. The dart will keep on pumping venom, and a SPEEDY REMOVAL is the best thing to do. Next, apply cold to the site. Further treatment will depend on severity of reactions as discussed above.

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