Bee stings, which we encounter frequently during the summer months, can be life-threatening. Here’s what you need to know and do…
With the warming of the weather, insects took their place in nature. Insect stings and insect allergies have also become common. It is sometimes difficult to understand which of the reactions due to an insect sting is an allergy and which is normal. In this article, I will try to explain in detail bee allergy from insects.
Venoms of bees cause allergies. There are allergens that can cause a cross-reaction between wasp species. People who develop allergies to bee venoms develop symptoms of bee allergies with bee stings. A type 1 allergic reaction develops.
The symptoms gradually increase within 24-48 hours after the bee sting. It can continue for 7 days. Sometimes symptoms may appear after 72 hours.
Slight redness, swelling and pain can be seen in the place where the bee stings, and sometimes it can cause symptoms such as large swelling, fatigue and vomiting. Excess swelling after a bee sting is an indication that life-threatening allergic reactions (anaphylaxis) leading to severe shock will not be seen. The incidence of anaphylaxis in these individuals is 3-5%.
In the reactions seen immediately after the bee sting; There may be slight swelling at the sting site or it may be too much. Toxic reactions and severe allergic shock may develop. Although rare, days or months after a bee sting, serum sickness, Gullen-Barre syndrome, glomerulonephritis, myocarditis and vasculitis can be seen. Swelling at the bee sting is the most common symptom. However, this swelling is not due to allergies. Venom-induced reaction.
Sometimes it can be larger than 8-10 cm in diameter after a bee sting. It happens in only three out of a hundred people after a bee sting. The size of the swelling may increase up to 48 hours. Recovery may take up to 10 days. Sometimes there may be swelling in the entire arm or leg. If the reaction is severe, fatigue and nausea may occur.
Sometimes, the disease called serum sickness is seen immunologically. In this disease, 7 days after the bee sting, joint pain and itchy allergic disease of the skin, which we call hives, are seen. Those with serum sickness should also be vaccinated.
It develops if more than fifty bees sting at the same time. As the venom of many bees enters the body suddenly, headache, nausea, vomiting, fever, convulsions, low blood pressure, heart failure, shock and death can be seen due to the substances contained in the bee venom. This toxic reaction has nothing to do with allergies. Allergy may also develop after a toxic reaction. For this reason, skin test I against bees should be performed on people who develop a toxic reaction. If the skin test is positive, there is a risk of developing allergic shock in subsequent bee stings.
Serious reactions after bee stings are reactions due to Type 1 allergy.
Itching, redness, hives and angioedema may develop as a type 1 allergic reaction. If itching, redness, hives and angioedema develop in a place other than the bee sting, it can be considered as a sign of allergic shock. Therefore, people who develop itching, rash and hives are at risk of allergic shock in subsequent bee stings.
Allergic shock due to a bee sting usually occurs within the first 30 minutes, sometimes within an hour. Very rarely it can be delayed up to 72 hours.
Children who develop allergic shock should receive immediate treatment. The first drug to be administered is epinephrine. For the diagnosis and treatment of allergic shock, you can read the section on allergic shock.
First of all, it should be questioned whether it is a bee sting or not. If it is learned that a bee stings, the type of bee should be learned. If there is a sting in the sting, it is a honey bee. Bee pictures can also be helpful in identifying the type of bee. The most important point in a bee sting begins with determining the size of the reaction. Whether the reactions suggest allergy should be evaluated. Is there swelling only in the bee sting area, or is there an itchy rash with itchy rash, is there an itchy rash outside the bee sting area? It is checked whether the size of the reaction is greater than 8-10 cm.
In which cases should a child see an allergist?
If a large swelling develops at 8-10 cm, if more than fifty bees have stung, if shortness of breath, low blood pressure develops, if urticaria develops, the child should be evaluated by an allergist.
How is a bee allergy test done?
It is recommended to test for blood allergy to bee venom and skin allergy testing. Skin test is applied as skin prick and intradermal.
Children who develop allergic shock due to bee soma should have epinephrine with them. The family and the child should be educated on how to use the epinephrine auto-injector. It is also important for people with bee allergies to wear necklaces or bracelets that show they are allergic to bees. The use of blood pressure medications such as ACE inhibitors, angiotensin II receptor blockers, MAO inhibitors and tricyclic antidepressants should be avoided by people who develop bee allergy. Because these drugs prevent the effects of drugs used in the treatment of allergic shock.
If the reaction due to bee sting is considered as a venom allergy, bee venom allergy test should be done from blood and skin. According to the test results, which bee has an allergy, immunotherapy, which we call vaccine treatment, should be performed against that bee.
If the skin test against bee venom is positive for people who have not developed allergic shock before, there is a risk of allergic shock up to 10% in the next bee sting.
If the allergy test is positive in people who have developed allergic shock, the risk of developing allergic shock in these people is 40-70%. Bee Allergy Allergic Shock
A cold compress should be applied for swelling immediately after the bee sting. Painkillers may be given. It will be fixed in a few hours.
If the swelling is very large, cold compresses, elevation of the extremities, pain medications, oral antihistamines, and sometimes corticosteroids are used. In people with such a large swelling, the risk of developing allergic shock is 5-10% if the bee stings again. If there is such a large swelling, a pediatric allergist should definitely evaluate the child.
If itching, redness, hives and angioedema have developed and only skin findings are present and there is no change in blood pressure, antihistamines and corticosteroids can be given if necessary. It is beneficial to have an adrenaline auto-injector with the child, since children who develop such a reaction may develop allergic shock due to a bee sting again.
If signs of allergic shock develop, an epinephrine auto-injector should be used immediately. For this, you should read our article on the use of epinephrine autoinjector in the allergic shock section and you should definitely watch our video.
If the bee sting is left in the skin, it should be removed without squeezing it. A cold compress should be applied to the sting site. If the sting is an arm or a leg, a tourniquet should be applied to the part of the sting that is closer to the body. If allergic shock has developed before and a bee sting has developed, epinephrine should be administered before allergic shock symptoms develop and an ambulance should be called to go to the nearest hospital. If it is not possible to have an epinephrine auto-injector, an adrenaline ampoule of 1 mg and a syringe should always be kept, and training should be given on what dose to use. If the symptoms of allergic shock persist despite the first epinephrine, the second can be done 5-10 minutes later. Bee Allergy Allergic Shock
Does it recur later when allergic shock develops?
It can recur within 24 hours. Therefore, it is kept under observation.
Vaccine Treatment in Bee Sting
Vaccination against venom is the area where the vaccine gives the most effective results. If there is an allergy to bees in the blood and if the skin test is positive for bee allergy and allergic shock has developed before, vaccination should be done. Immunization is not recommended for children who develop mild allergies. It should be done if there is serious swelling at the place where the bee stings or if there is swelling in places other than the place where the bee stings.
Is the vaccine effective?
The effectiveness of the vaccine against bee allergy is very high. It is 75-100% effective.
How do I protect myself from a bee sting?
Measures should be taken to reduce encounters with bees. Gardening should be avoided as much as possible. Long-sleeved clothes should be worn and short pants should not be worn in areas where there is a possibility of bees. Bright, light-colored, flowery clothes should be avoided. White, green and brown colors attract less bees.
Garbage, food, sugary foods and beverages should not be kept in the open.
Very juicy fruit, litter boxes and piles attract wasps. Desserts, cold cuts such as salami, sausages, beer and other foods attract wasps. Wasps enter the beverage in the open. Care should be taken at the picnic.
The use of perfumes, scented deodorants, lotions, conditioners, and sunscreens attract bees. It should be avoided.
Sweating can also attract wasps and honey bees. For this reason, it is beneficial not to do sports that cause excessive sweating in open areas. When the bee approaches the individual, it is important to avoid sudden movements and to remain calm.
Source: https://www.milliyet.com.tr/pembenar/prof-dr-ahmet-akcay/ari-alerjisi-allergic-soka-neden-olüldür-2085292 Photo: https://twitter.com/ilahiseker/status/1276891911127740416& https://www.shutterstock.com/t