FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

PROMPT USE OF KIT COULD SAVE FRIEND'S LIFE IF STUNG AGAIN BY BEE

Question: I got stung by a bee on my wrist. I had some swelling at the site of the sting, but it got better in a few days. A friend of mine, though, carries a little kit with him at all times so that he can give himself an injection if he's stung. He had to be rushed to the hospital a few years ago when he was stung.

Answer: Summer and early fall are prime season for insect stings, including bees, wasps and hornets. Your body's response can range from almost nothing at all to severe, life-threatening reactions like your friend had. Doctors call these anaphylaxis.

Prevention is by far the best therapy, and there are several measures you can take to avoid insect stings. Stinging insects are attracted to specific odors and fragrances. Food and garbage containers are alluring to yellowjackets, which will attack without provocation. Perfume, cologne, and open soda containers are appealing to hornets and wasps. Many of these "stingers" can also be attracted by fragrances in hair spray and hair gels. Also, brightly colored clothing, especially with a floral print, can be a magnet for stinging insects.

About 5 percent of the population is allergic to the sting of bees, ants and wasps. These membrane-winged insects are collectively called "hymenoptera." This name is derived from the Greek words "hymen" meaning membrane and "ptera" meaning wings. Fewer than 1 percent of people are so allergic to hymenoptera stings that they will have the severe anaphylactic reaction I referred to earlier.

A "normal" reaction to an insect sting is some redness, pain and swelling at the site of the sting. At times, the affected area may be fairly extensive. You may also experience fever, swollen glands and joint pain later on. The joint pain and fever sometimes doesn't develop until seven to 14 days after the sting, but this is rare.

The potentially life-threatening anaphylactic reaction, on the other hand, is usually evident within seconds to no more than twenty minutes of the sting. Signs of this severe reaction can include hives, itching or swelling in areas other than the sting site, throat constriction, difficulty breathing, tongue swelling, nausea, vomiting and fainting.

If someone you are with has this kind of reaction to an insect sting, call an ambulance and get him or her to the hospital at once. People who know that they are severely allergic should carry a medication like epinephrine with them at all times and wear a medical alert tag. There are allergy kits -- a common one is called Epipen -- that your doctor can prescribe. This is very likely the type of kit your friend has. Prompt use of the kit can save his life if he's ever stung again.

For people like you, however, who just have a mild body response to an insect-sting, applying ice to the area can help minimize the spread of the reaction. You might also want to try over-the-counter antihistamines, like Benadryl, to help reduce swelling. Applying a baking soda paste or meat tenderizer to the site can help relieve the pain from the sting. Fortunately, the vast majority of people have the same experience you had -- a localized sting reaction that resolves without consequence in a few days. But remember, prevention is always better than treatment.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.