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Insect Stings And Bites: How Deadly Are They And When To Seek Medical Attention
As for people who have had an allergic reaction to insect stings, be prepared with an allergy action plan and have the necessary standby treatment on hand.
"They should carry an EpiPen (containing adrenaline) that can be administered immediately if necessary. Such patients should also be reviewed by an allergy specialist," Dr Tang from NUH said.
During their fieldwork, Mr Baptista and Mr Moo from Cuprina use insect repellent and are generally cautious around insect nests and habitats — something that they also ask the general public to do when outdoors.
"My advice to readers is to be aware of your surroundings, especially in nature, and avoid disturbing insects and their nests.
"Knowing how to react to a sting and when to seek medical help is also essential," Mr Baptista said.
What you can do:
1. Move to a safe location to prevent further stings.
2. Do not "suck the venom out" of a bite or sting site, be they from insects, snakes or spiders. This risks soft tissue injury. "Don't believe what you see on TV," Dr Tang said.
3. Try removing the stinger to reduce the venom load — but do this by scraping it away with a sideways movement using a card or fingernail.
"Avoid pinching or squeezing the stinger because this may force more venom to be injected into the wound," Dr Tang added.
4. Wash the affected area with soap and water, and apply a cold pack to reduce swelling and pain, Mr Baptista advised. Take antihistamines for itching and swelling, if necessary.
BODILY REACTIONS TO INSECT STINGSThe human body's reactions to insect stings can vary widely.
Dr Tang said that the majority of people usually have a mild local reaction that is self-limiting, including pain, swelling and redness over the affected site, which usually resolves within 24 hours.
"Larger local reactions (swelling of more than 10cm) can take up to a week to fully subside."
Dr Tan from TTSH said that most patients who suffer allergic reactions frequently have skin symptoms such as itch, flushing, wheals, eye or lip swelling.
However, if there is toxic envenomation, it usually results in damage to the internal organs and requires blood investigations to diagnose and monitor.
"It is difficult to predict if an insect sting will be uneventful (apart from pain and minor swelling at the sting site) or whether a reaction will develop.
"Therefore, individuals who have been stung should be vigilant for any evolving signs or symptoms that might suggest a reaction.
"It is advisable they stop what they are doing immediately and move to an area where help is readily available, should any reaction develop," Dr Tan added.
WHEN TO GET MEDICAL AID OR CALL FOR AN AMBULANCEDr Tang said that there is no antidote to reverse the effects of venom.
People who get emergency help at hospitals will be assessed for how severe the reaction is and whether there is any immediate threat to life, the doctors said.
Treatment ranges from removing stingers to getting patients to take anti-histamines and corticosteroids (anti-inflammatory medication).
Patients will be observed for six hours and discharged if they have no symptoms, Dr Tang added.
For cases of toxic envenomation, supportive care is the main treatment.
"(These patients) will be managed in the intensive care unit for organ support till recovery. For example, dialysis for kidney failure, medications to support blood pressure."
West Virginia Department Of Health Warns Residents Of Increased Bee Stings
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Venom Immunotherapy: Defusing The Danger Of Winged Insect Stings
For anyone with an insect venom allergy, there is a therapy that gets to the root of the problem - but it requires patience. Hendrik Schmidt/dpa
Bzzzzzzz ... Uh-oh! If you're allergic to the venom of bees or wasps, hearing them buzzing nearby can be scary - and maybe even make you panic. After all, a sting could, at worst, cause a severe, life-threatening overreaction of your immune system.
Called anaphylaxis or anaphylactic shock, its symptoms include difficulty breathing, a rapid heart rate, sudden drop in blood pressure and loss of consciousness.
Many people aware of their allergy arm themselves in summer against winged insects by keeping an emergency kit at hand that contains an epinephrine (adrenaline) auto-injector. Injected into the thigh, epinephrine reduces the body's allergic response.
Being thus forearmed may do little to allay their fear though. But as the German Dermatological Society (DDG) points out, there's a way to treat the cause of the problem and not merely the symptoms: venom immunotherapy.
How does it work? An allergist regularly injects small doses of the venom you're allergic to under your skin, gradually increasing the amount, in order to desensitize your immune system to the allergen so that it no longer overreacts.
The therapy takes three to five years to complete, the DDG says, and it's important to stick to the schedule. Injections are given once a week at first, and then every four to eight weeks. Besides allergists, doctors qualified to administer them include dermatologists, ENT specialists, GPs and paediatricians with additional training in allergology
Undergoing the full course of therapy is highly effective. The DDG estimates that it prevents 90% of anaphylactic shocks caused by insect venom.
Venom immunotherapy isn't for everyone who has an allergic reaction to insect bites or stings. Medical guidelines recommend it for those with at least stage two anaphylaxis ("moderate" - there are four stages in all). In addition to stage one symptoms - skin rash or redness, itching and hives - it's characterized by nausea, circulatory problems, difficulty swallowing and/or breathing.
Sometimes, however, the therapy is a good idea in stage one cases too, namely for people at a higher occupational risk of insect bites or stings since they work, for instance, in a bakery or garden centre.
According to the DDG, swelling of up to 10 centimetres around a bee or wasp sting is normal. But if it's much larger or lasts longer than 24 hours, you should see a doctor.
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