FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

BEE STINGS KILL MORE IN U.S. THAN SNAKEBITES

Question: A friend of mine always takes a "bee sting" kit with her every time she goes outdoors. She says that she's very sensitive to bee stings, but isn't she being a little silly lugging this kit around all the time?

Answer: I'd say your friend is just being cautious and is practicing good "preventative medicine." She isn't silly. In the United States a person is dramatically more likely to die from an insect sting than as a result of a snake bite. Each year between 100 and 150 people die from stings of wasps, hornets, spiders and fire ants. I could only find proof of two snake bite deaths in the United States last year. For some people, and I assume your friend is one of them, bee stings can be truly life threatening.

The vast majority of insect sting deaths are caused by allergic reactions, and up to 4 percent of the population is allergic to insect venom. So, your friend is a member of a relatively large group. Because these life-threatening reactions may occur within minutes of a single sting, sensitive individuals should take a bee sting kit with them when there is a risk of being stung.

A typical kit contains epinephrine to be given immediately after the bee stings its victim. An allergic person will quickly start to wheeze and become short of breath in reaction to the sting, and this is followed by a dramatic drop in blood pressure that's called "anaphylactic" shock. Giving one's self a shot while in the process of collapsing from shock can be difficult. There is a device, and EpiPen, that makes the process of giving the shot about as simple as taking a fountain pen out of your pocket. It is the "bee sting kit" I prescribe for my patients.

Most of us who spend much time outside have been stung before. Swelling itching and discomfort at the location of the sting is normal this is not an allergic reaction, but rather a direct reaction to the toxic chemicals in bee venom. The discomfort and swelling of a sting usually subsides within a few days without any treatment. Those experiencing multiple bee stings can have significant pain swelling and symptoms of a general illness as a consequence of the amount of bee venom they received. Again, this is not an allergic reaction, although death is a rare but possible consequence of untreated multiple (as few as 20 but usually over 100) stings.

Stings that produce massive swelling, and particularly swelling in parts of the body distant from the sting, are at increased risk of developing an anaphylactic allergic reaction to the next bee sting they get. These people should consider taking a bee sting kit with them when they go outside in the summer just as should those like your friend who have already had an anaphylactic reaction.

Question: What should I do to reduce the risk of being stung?

Answer: It is helpful to avoid wearing flashy clothing and shiny jewelry which attracts bees and other flying insects. Don't wear clothing made of wool or leather because these materials seem to attract the little pests. Also, don't use perfumes and scented soaps and lotions when you are going outdoors.

One very obvious precaution is to avoid going barefoot or wearing open-toed shoes when walking in grass or in the woods. Also, choose the places you go carefully. Bees are always prevalent where there are flowers and at frequently used picnic sites. Wasps are usually found near outdoor buildings and infrequently used picnic tables. Approach these with caution.

Bees seem to magically come circling around when I get out the picnic meal, and they probably come to your picnics, too. Swatting at these insects or trying to "shoo" them away often results in avoidable stings. Be calm around bees even if they land on you. They will soon discover that there is nothing to their liking on your arm and fly away leaving you unharmed. Swatting at them puts them into a defensive "attack" mode instead of a "food seeking" one.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.