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Military Health System

Taking the stings out of summer fun

Image of Beekeeper in protective gear holds framework with bees and honey.. What you should know about preventing and treating bee, wash, and hornet stings.

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Bees, with more than 25,000 species, have a critical role in nature, as well as commerce. They are responsible not just for honey, their winter food, but for pollinating food crops, as well as flowers.

Wasps and hornets are also important as they hunt down aphids, caterpillars, and other pests that destroy plants and flowers -- including crops.

Epidemiology

For many, a bee, hornet, or wasp sting is just unpleasant; but for others, it can be fatal.

The Centers for Disease Control and Prevention reported that more than 1,100 people were stung from 2000 to2017; For about 62 people per year, it was fatal. The CDC reported the majority of deaths, about 80%, were males.

While estimates vary, the American College of Allergy, Asthma & Immunology estimates that insect sting allergies (includes fire ants, etc.) affect 5% of the population.

Severe Cases

Sting reactions can range from mild reactions to severe.

Bees can only sting once, but hornets and wasps can sting repeatedly. A sting's usual effect is pain, swelling, and redness around the strike area. Sometimes, more swelling will develop over a day or two. The pain may take a couple of hours to resolve.

More severe reaction can involve hives, a lot of itching, difficulty breathing, throat and tongue swelling, rapid pulse, a drop in blood pressure, nausea, vomiting, diarrhea, and even a change or loss of consciousness, which is called anaphylactic shock.

Treatment and Response

If you're attacked by a bee, wasp or hornet, run inside or, if can't do that, go toward a shaded area.

You want to get away from where the stinging insect is and where more could congregate. Don't swat at them as that can stimulate them to sting, and you're spending your energy in the same area, not in running away.

Jumping into water may not work as some stinging insects will hover above the surface, waiting.

If you are stung by a bee, and you can see the stinger, remove the stinger using tweezers, your fingernails, or even the edge of a credit card.

Wash the affected area with soap and water to decrease risk of infection.

If you're stung on an arm or leg, elevate it to decrease throbbing swelling, and apply ice as soon as you can, which will reduce pain, swelling and inflammation.

You can put half, or even full-strength ammonia, onto the sting site. That seems to neutralize at least some of the venom.

Taking an antihistamine (e.g., diphenhydramine) can help, as can ibuprofen, and applying calamine lotion or hydrocortisone cream.

Avoid scratching the site to avoid chance of infection.

According to the CDC, individuals who know they are allergic to stings and insect bites should carry epinephrine autoinjectors into areas there may be bees, wasps or hornets.

They should also tell family members and coworkers that they are allergic and how to inject the dose.

Remember, autoinjectors expire and should be kept out of extreme temperatures. Avoid storing them in your vehicle glove compartment. You should also consider wearing a medical alert bracelet.

Prevention

Besides the obvious recommendation of avoiding flying, stinging insect, there are some other precautions you can take.

The National Institute for Occupational Safety and Health (NIOSH) recommends wearing lighter color clothing that covers the body, as well avoiding perfumed soaps, deodorants, and shampoos, cologne, or perfumes. Staying away from flowering plants (where flying insects look for nectar), and any discarded food also decreases risk.

For anyone who had a severe reaction, with or without anaphylaxis, your primary care manager may refer you to an allergist to confirm your allergies and potentially start you on desensitizing immunotherapy (allergy shots). That can greatly reduce or eliminate risk of life-threatening reactions to future stings.

We need bees, wasps, and hornets, but treat them with a healthy level of respect and be prepared.

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Last Updated: August 18, 2022
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