VENOM ALLERGY / BEE STING ALLERGY

• Anyone can became allergic to bee and wasp stings.
• Anyone who has suffered an anaphylactic reaction (see below) should be investigated in an allergy clinic and should preferably be desensitised to the relevant insect or alternatively carry an injectable form of adrenaline around with them all of the time.

Symptoms

• Localised reactions
Swelling at the site of the sting, which can be more than 10 cm in diameter and last for more than 24 hours. The rest of the limb may be involved but no generalized symptoms are present.
• Anaphylactic = Moderate / severe reactions
Any or all of the following symptoms may be present:
• Swelling of throat and mouth
• Difficulty in breathing
• Hives anywhere on the body
• Generalised flushing of the skin
• Abdominal cramps, nausea and vomiting
• Sudden feeling of weakness
• Collapse and unconsciousness

Diagnosis

Your insect allergy should be confirmed by measurement of the allergen specific IgE antibody in bloodor by skin prick testing.

Management

• Localised reactions (involving swelling of affected area, urticaria and flushing):
Use a non-sedating, rapid acting antihistamine as advised by your doctor or pharmacist. These take 15 minutes to start working.
Large local reactions can also be treated with oral steroid tablets 20-30 mg prednisolone as soon as one is stung and repeated daily for> up to 3 days. These tablets will need to be prescribed by your doctor.
• Anaphylactic reactions:
• An ambulance should be called immediately (112) and tell them that patient is suffering from anaphylaxis.
• Give an adrenaline (epinephrine) injection as soon as possible.
• Keep the patient lying down and observe them
• If the patient have not recovered in 5 minutes, give the second adrenaline (epinephrine) injection)
• Even if the patient feel better, the patient must still go to the hospital in case of delayed or repeated reactions.
• If the patient has asthma, the blue inhaler ( ventolin) should be used AFTER the adrenalin (epinephrine) injection.
• Give the used needle to the paramedic.

PLEASE READ CAREFULLY:

• It is essential that sufferers and families/ associates of anaphylactic individuals are experienced in the administration of adrenaline using one of the prescribed devices. All the companies can provide placebo practice devices. The necessary techniques should be practiced under the supervision of a trained allergy nurse or specialist. It is essential to ensure that the injection is not out of date. Allergic people should keep two dose units of adrenaline with them at all times. A repeat dose may be needed while awaiting the arrival of emergency services.
• When stung, if the sting has been left behind this will need to be gently eased out so as not to increase your dose of bee venom. This is best achieved by flicking the sting out with your nail, do not squeeze the area. If possible place an icepack (pack of peas will do) on the area of the sting and ideally sit down or lie down, especially if feeling faint.
• The adrenaline is really to make sure you have enough time to reach hospital where you can be supervised for some hours and given extra treatment as required.

USEFUL TIPS FOR ALLERGIC PERSONS TO BEE

• Wear a Medic Alert bracelet or medallion. This will have details of the allergy and treatment required.
• Inform teachers/work colleagues and occupational health advisors of your insect allergy, and treatment required.
• Do not drink out of cans (beer or soft drinks), as wasps can crawl inside cans where they are not seen until the drinker puts the can to their lips.
• Avoid walking barefoot on grass, especially if clover is present.
• Don't pick up fallen fruit, the side you cannot see may have a wasp in it.
• Get professional help if there is a wasps' nest in or near your home.

Always call an ambulance if you have used your adrenaline pen.

WHAT IS VENOM IMMUNOTHERAPY?

If you have had a serious reaction to an insect sting, make an appointment with an allergist. With proper testing, your allergist can diagnose your allergy and determine the best form of treatment. In many cases, insect venom allergy shots (or immunotherapy) are very effective.

The venom immunotherapy involves injections of diluted wasp or bee venom, initially at weekly intervals for at least 8 weeks, followed by monthly to 6 weekly intervals for up to 3 years. Desensitisation must be performed in a hospital as there is a slight risk of a reaction to the injection.

Clinics require one to wait at least one hour following injection for observation.

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