The EAACI Insect Venom Hypersensitivity Group in now offering through the EAACI website the Insect Allergy Brochures with topics on Insect Allergies. The brochures are already circulating in Spain with remarkable success.

In the brochures, addressed to new scientists as well as patients, one can find general information on insect allergies, recomendations of avoidance to insect allergies, immediate and preventive treatment etc.

Bee Sting Allergy

Apis genus belongs to the Apidae Family, Apis mellifera (honey bee) species. Hb may cause an allergic reaction to the venom they inoculate when stung.

Danish:           Honningbi
Dutch: Bij
English: Honey bee
French: Abeille
German: Biene
Greek: ÌÝëéóóá  
Italian: Ape
Spanish: Abeja

Description: Workers length from 5-15 mm. The body is fairly hairy and of brown colour with black and golden areas in the abdomen, and four transparent wings.

Habitat: Beehives are located around the country and groves with tempting nectar: fruit trees, or flowers (pollen from compositae flowers, citrus fruits, etc.).

First bees were discovered in fossil deposits from Eocene period. Probably, their social behaviour might have been actually the same for 30 million years. Nowadays, modern beekeeping ensures their subsistence, which also provides bee by-products: honey, propolis, royal jelly, etc. Which are nourishing and definitely healthy.

Workers, which defend the beehive with their stings, develop a complex sting apparatus with a muscular venom sac from the last abdominal segments. After stinging, the barbed sting remains stuck under the skin, and the venom is squeezed out of the sac by rhythmical contractions into the wound. The abdomen tears and the bee dies.

After any bee sting, withdraw the sting immediately scratching it softly with your nail, a card or a knife. Do not use tweezers and not press: it may help to inject more poison.

A bee sting is painful. But pain intensity depends on the stung part of the body and the sensitivity of its victim. If there is an extreme sensitivity to stings, an anaphylactic shock may appear. Resulting even fatal, if it is not treated urgently.

What is venom? It is a complex of proteins with toxic and enzymatic activities.

How is the allergic reaction produced?
Allergic subjects develop IgE antibodies (immunity) against bee venom. Later stings involve new risks, because an allergic reaction may appear with variable severity.

What are the symptoms?
There are three types of allergic reactions to stings:

• Reactions around the sting or large local reactions: Local inflammation (more than 10 cm diameter) and pain, which generally persists more than 24 hours. (Immunotherapy is not usually indicated). The only requirements of local reactions usually are: cleansing the wound (with soap and water) and some cold application. In more serious cases, antihistamines and/or corticosteroids may be indicated.

• General or systemic reactions (2.3% prevalence in rural areas): Hives, angioedema, suffocation, drop in blood-pressure, weakness or even an anaphylactic reaction and shock, which are the more threatening clinical reaction (1-5 casualties/10 million people/year).

• Delayed or unusual reactions: Much less frequent and do not demand Immunotherapy.

When and how do they take place? Most of stings take place in summer (wasp population is bigger and people expose themselves more). However, wasp stings are not unusual in other seasons.  Beekeepers and their relatives are exposed the most part of the year.

Recommendations for allergic patients to Hymenoptera venom

Most of times, insects sting when they feel in danger.

Prevent:
• From approaching their nests (hives)
• From waving arms about when they are close.
• Any relative from touching beehives.

They become more aggressive with hot weather, perfumes and strong smells. Also when they defend food or sweet drinks (especially soft drinks).

Watch out when:
• Eating in the open air.
• Handling bin containers.
• Doing gardening.
• Walking on sandals or bare feet.
• Using any cologne, perfume or  an air freshener.
• Wearing loose, bright colour clothes.
• Hanging out clothes outside (if you did so, it would be advisable shake them off).

Before starting start driving your vehicle, make sure there are no insects in and close all windows.

In case of a bee sting:

• It would be advisable to leave the place, even if you are not allergic. Alarm pheromones are given off during the attack could lead to new stings.
• Withdraw the stinger immediately scratching it softly with your nail, a card or a knife. Do not use tweezers and not press: it may help to inject more poison.
• Use medication indicated by your allergist.
• Seek medical attention immediately or go to EMERGENCIES.

After making a precise diagnosis, your ALLERGIST will consider the necessity of a treatment:

• IMMEDIATE TREATMENT:
usually self-injectable ADRENALINE for severe reactions. Delaying the use of adrenaline by means of another medicines (corticosteroids, antihistamines) may cause death. However, adrenaline could not be effective enough in too extreme reactions. Patients can even forget bringing it with them. Therefore, adrenaline cannot guarantee a total safety in case of new stings.

• PREVENTIVE TREATMENT: by means of specific IMMUNOTHERAPY. If there are new stings, this is the only treatment able to stop symptoms (actually, maximal doses are usually equivalent to two stings).

Download and hand out the full brochure on Bee sting allergy here ! (490 KB)

Edited thanks to
European Hymenoptera Allergy Interest Group from EAACI.