Insect attacks or sting is quite common to be heard, particularly bees and wasps. What is uncommon is being allergic to the insect's venom. When an individual is allergic to insect venom, they develop an allergic reaction when stung. This reaction may be mild or life-threatening. There are proteins present in a wasp venom, and the most provoking is an enzyme known as Phospholipase A1 and Hyaluronidase. On the other hand, the most allergy-provoking enzyme found in bee venom is Hyaluronidase and Acid Phosphatase. Allergy to bee sting tends to occur mostly in high-risk groups which include primarily beekeepers, farmers and even gardeners.
Nowadays, test for allergy to wasp and bee venom is made possible due to the use of ImmunoCAP RAST blood test. It gives the exact measurement of venom antibodies present in the blood. However, this can only be used when it is likely possible that a person has developed an allergy due to a bite or sting. This means that a person can only develop an allergy after a sting. Allergies can never be developed if a person has never been stung before.
Redness, swelling or even itching happens typically after a sting, but these are not necessarily allergies, only a reaction to the venom. An individual who is allergic to stings and venom can develop symptoms such as, intense swelling, itching and pain, all occurring within a few minutes of the sting.
In severe cases, the swelling or itching spreads to other parts of the body including palms, soles of feet and even scalp; there is also fainting, sweating, headache, stomach cramps, urticaria, and possibly a tight feeling in the chest. In extreme cases, death occurs, caused after anaphylaxis shock. All this can happen within ten minutes of a sting, so early detection and intervention are very important.
Various treatments are available for varying levels of reactions. For mild reactions, a double dose of oral antihistamine is administered, while severe cases require intra-muscular administration of the same antihistamine. In very severe cases, where breathing is difficult, and shock is noticed, intra-muscular adrenaline must be immediately administered. Different quantities are given based on the age and repeated after 5 minutes if no improvement is noticed.
The best way to prevent sting allergy is to stay away from bees and wasps and other harmful venomous insects. Also, stay away from areas where they can be found. Swatting or slapping an approaching wasp or bee can frighten it, and hence provoke an attack, as they are social insects that only attack when threatened. Instead, gently blow them away if it lands on your skin. Also avoid dark colours or bright contrasting colours which might look like flowers, avoid fragrances and perfumes when threading unfamiliar places which could be possible colonies. When stung, do not squeeze skin, instead, flick off the stinger, and apply ice on the spot.
People prone to severe reactions should carry out emergency treatment in case of stings.
Immunotherapy can be considered in children to prevent severe reactions as they are less likely to react harshly than adults.