Bee, Wasp, Hornet, and Ant Stings
Stings by bees, wasps, and hornets are common throughout the United States. Some ants also sting. The average person can safely tolerate 10 stings for each pound of body weight. This means that the average adult could withstand more than 1,000 stings, whereas 500 stings could kill a child. However, one sting can cause death from an anaphylactic reaction (a life-threatening allergic reaction in which blood pressure falls and the airway closes (see Section 16, Chapter 185)) in a person who is allergic to such stings. In the United States, 3 or 4 times more people die from bee stings than from snakebites. A more aggressive type of honeybee, called the Africanized killer bee, has reached some southern states as these bees travel north from South America. By attacking their victim in swarms, these bees cause a more severe reaction than do other bees.
In the South, particularly in the Gulf region, fire ants sting up to 40% of the people who live in infested areas each year, causing at least 30 deaths.
Symptoms
Bee stings produce immediate pain and a red, swollen area about ½ inch across. In some people, the area swells to a diameter of 2 inches or more over the next 2 or 3 days. This swelling is sometimes mistaken for infection, which is rare after bee stings.
The fire ant sting usually produces immediate pain and a red, swollen area, which disappears within 45 minutes. A blister then forms, rupturing in 2 to 3 days, and the area often becomes infected. In some cases, a red, swollen, itchy patch develops instead of a blister. Isolated nerves may become inflamed, and seizures may occur.
Treatment
A bee may leave its stinger in the skin. The stinger should be removed as quickly as possible without concern for the method of removal. An ice cube placed over the sting reduces the pain. A cream containing a combination of an antihistamine, an analgesic, and a corticosteroid is often useful. People who are allergic to stings should always carry a preloaded syringe of epinephrine, which blocks anaphylactic or allergic reactions.
People who have had a severe allergic reaction to a bee sting sometimes undergo desensitization (allergen immunotherapy (see Section 16, Chapter 185)), which may help prevent future allergic reactions.
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