NHS Direct Online Health Encyclopaedia Introduction
There are certain insects that sting (inject venom into the skin) as a defence mechanism. In the UK, these insects include bees (honeybees and bumblebees), wasps and hornets. Most stings are painful but harmless and only affect the area around the sting. However, some people can have an immediate and more widespread allergic reaction, such as an anaphylactic shock and this can be fatal (see Anaphylaxis topic). This is quite rare (approximately 3 people in 100) and normally only happens with a wasp sting. Most people who have an allergic reaction have been stung before without an allergic reaction. Some people never have another allergic reaction again after their first. This is why they are almost impossible to predict.
Symptoms When you are stung by an insect such as a wasp, the area around the sting will swell up and go red and a raised mark (weal) will form. It will be quite painful and itchy. This will last for approximately 48 hours. If you have a localised allergic reaction to the sting, a larger area around the sting will swell up and the swelling will last longer but should go down in a few days. Symptoms will be more severe if you are stung many times by one or more insects. This is because of the amount of venom they have injected into your skin. If you experience swelling or itching anywhere else on the body immediately after being stung, wheezing, headache, feeling sick, fast heart rate, feeling faint, difficulty swallowing, or a swollen face or mouth, you may need emergency treatment. Call 999 for an ambulance immediately as you may be having a generalised allergic reaction and this can be fatal.
Causes Wasps and bees sting as a defence mechanism and do so to warn you off if you have disturbed them. Unless you have an allergic reaction, a sting is not harmful, just painful and itchy. If you are allergic to wasp sting, you are not likely to be allergic to bee sting as well.
Treatment As soon as you realise you have been stung you should remove the sting with your fingers. If a child has been stung a responsible adult should remove the sting. You should be very careful not to spread the venom further under the skin as you remove the sting. Bee stings have a venomous sac; you should try not to puncture this as you remove the sting. Wash the area with soap and water. Put a cold flannel on the area. Raise the part of the body that has been stung to prevent swelling. Use a spray or cream containing local anaesthetic or antihistamine on the area to stop the itching and swelling. Take painkillers, such as paracetamol if it is very painful. Do not scratch the area as it may become infected. Keep childrens fingernails short and clean. If the redness and itching does not clear up after 48 hours see your GP. If you experience swelling or itching anywhere else on the body after being stung, or wheezing or difficulty swallowing, you should call 999 for an ambulance, as you may be having an allergic reaction. In this case you may need to have an adrenaline injection, antihistamines, oxygen and/or an intravenous drip. Afterwards you may be referred to an allergy clinic or immunologist. Your doctor may suggest venom immunotherapy treatment. This involves being injected on a regular basis with small doses of venom so that you become desensitised and eventually cured of your allergy.
Prevention If you encounter any wasps or bees you should move away from them slowly, without panicking. Do not wave your arms around. If you are planning to spend time outdoors, especially in the summer, use an insect repellent. Never disturb an insects nest and avoid clusters of flowers and piles of wood where insects gather. When eating or drinking outside, keep food and drink covered, especially sweet things. The best way to avoid being stung is to wear long sleeved tops and long trousers. You may also wish to wear socks and shoes. Insects are attracted to brightly coloured clothes and strong perfume and body lotion. To stop insects getting into the car while you are driving, keep the windows closed when you are in the car. To stop insects getting into the house, keep doors and windows closed or have thin netting over them. If you know you are allergic to wasp or bee stings, you should carry a syringe loaded with adrenaline, as well as instructions, with you at all times. Some people with known severe allergies choose to carry a card or wear some form of tag. See your GP.
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