Buzz Off! Rutgers Doc Offers Tips on Bug Bites and Stings

Stinging insects are as much a part of summer as pool parties and picnics. But beware, stings from insects, including honey bees, wasps, hornets, yellow jackets and fire ants, send more than half a million people each year to hospitals and cause at least 50 deaths, according to the American College of Allergy, Asthma and Immunology (ACAAI).

To stay safe, be aware of the signs of an allergic reaction and take steps to prevent stings. Leonard Bielory, M.D., an allergy specialist with the Rutgers Center of Environmental Prediction at the School of Environmental and Biological Sciences and attending physician at Robert Wood Johnson University Hospital specializes in diagnosing and treating allergies and asthma. Bielory offers the following tips to help you recognize an allergic reaction to a sting and treat it.

Normal reaction vs. allergic reaction

A normal reaction to an insect sting will include pain, swelling and redness at the sting site, but an allergic reaction to an insect sting requires immediate medical attention. Symptoms include:

• Hives, itching and swelling in areas other than the sting site
• Tightness in the chest and difficulty breathing
• Swelling of the tongue, throat, nose and lips
• Dizziness and fainting or loss of consciousness, which can lead to shock and heart failure

“If you have an allergic reaction to an insect sting you are at high risk for a similar or more severe reaction if stung again,” said Bielory. “So even if the first time you just had mild symptoms, like a rash, next time you could experience more severe or life-threatening symptoms. It’s important to talk with an allergist and get treatment.”

Stay safe: Avoid stings

The best strategy for avoiding a reaction is to steer clear of stings in the first place:

• Be cautious when eating outdoors and consider keeping food covered.
• If you can, avoid drinking beverages outside. Stinging insects are attracted to beverages and may crawl inside drink cans or other containers.
• Cover garbage cans with tight lids.
• Avoid sweet-smelling perfumes, hair sprays, colognes and deodorants.
• Avoid wearing bright-colored clothing.
• Don’t walk barefoot in the grass.
• Watch for signs of stinging insects when gardening, mowing the yard, or doing outside house maintenance. Hornets, for example, can build huge, nests in shrubs.
• In the South, be cautious around fire ant hills and don’t disturb them.

Immediate and long-term treatment

An allergist can help you determine what kind of insect you are allergic to and take steps to make sure you stay safe if you are stung again. An allergist may recommend two kinds of treatment:

• If an allergic reaction develops at the time of a sting, an epinephrine injection is the most immediate way to treat it. An allergist can prescribe an epinephrine auto-injector and teach you and your family members how to use it.
• In addition to carrying epinephrine, an allergist also can discuss whether you're a candidate for venom immunotherapy. These are allergy shots that treat insect sting allergy and may prevent future allergic reactions. Studies show these shots are 97 percent effective in preventing potentially life-threatening reactions to insect stings.

If your child is allergic to insect stings, be sure to alert teachers, coaches and camp counselors and teach them how to use epinephrine. Also talk to your child about how to avoid situations where stinging insects may be encountered.