By Tony Burda DABAT and Sheri VanOsdol Pharm.D.

The incidence of bee stings tends to rise during the late summer and fall.  Recently, a suburban Chicago greenhouse worker died from a suspected reaction to a bee sting.  This unfortunate incident prompted us to summarize some simple first aid tips in the event that you are stung and how to avoid beestings. 

Bees, along with wasps, hornets and yellow jackets, belong to an insect group called “hymenoptera”.  All of these flying insects are capable of stinging humans and may cause symptoms ranging from minimal discomfort to life-threatening reactions.

Reactions to bee stings are typically divided into 3 different groups based on severity:

• Minor effects include localized swelling, itching, burning, redness, tenderness and minor pain, which does not radiate far from the sting site.  Fortunately, most people will not experience symptoms more severe than these.
• “Large local reactions” (LLRs) are defined as areas of swelling greater than 4 inches across, that develop 12-36 hours after the sting.  Swelling could include several fingers, a whole hand or foot.   Sometimes these stings may be associated with a bacterial infection that may be hard to differentiate from LLRs.
• Severe and potentially life-threatening allergic reactions (also known as anaphylaxis) are noted by: hives over the whole body, swelling of the mouth and/or throat, wheezing, shortness of breath, chest pain, nausea and vomiting and/or anxiety.  Life-threatening reactions typically occur within 90 minutes of the sting and require immediate medical attention.

Here are some first aid tips for home management of minor insect stings:

• Remove the stinger if one is left in the skin.  Avoid squeezing the stinger to prevent injecting more venom into the wound.  Note: only honey bees lose their stingers.
• Wash the skin with soap and warm water.  Avoid scratching the itchy area to prevent bacterial infection.
• If available within 15 minutes of the sting, apply a roll-on antiperspirant deodorant to the sting area.  The aluminum salts in these products actually inactivate the stinger venom.

Tony : My  entire family uses this method and it “works like a charm!”  My wife always carries one of these products whenever when we go camping, apple picking, etc.

• Ice may provide some relief, but place a cloth between the ice and skin to avoid freezing the skin.  Use no more than 20 minutes each hour to prevent any skin damage.
• Taking antihistamines by mouth (e.g., diphenhydramine or Benadryl®) may relieve some itching and swelling.  Caution: this product may cause drowsiness.  Children under 6 years of age should not be given diphenhydramine unless directed by a physician.
• Over-the-counter hydrocortisone cream or topical diphenhydramine may help with itching.  Antibiotic creams may assist in preventing infection.  Products containing local anesthetics (e.g., primoxine, lidocaine or benzocaine) may help to dull minor pain.
• Ibuprofen (Advil® or Motrin®) or acetaminophen (Tylenol ®) taken by mouth may help to relieve minor pain.
• Avoid using home remedies such as damp tobacco leaves or meat tenderizer.
• Update your tetanus vaccination if it has been more than 10 years since you last received it.
• If you suspect a bacterial infection on the bite site, seek medical attention.

Life-threatening anaphylactic allergic reactions require immediate action:

• If the patient has a prescription to carry an epinephrine autoinjector (EpiPen®, EpiPen Jr® or Twinject®), and the patient is beginning to show symptoms, administer this medication immediately.  Instructions are included.
•  Immediately transport the patient to the nearest emergency healthcare facility.  Call 9-1-1 if emergency medical services (EMS) are available in your area.
• If available, give diphenhydramine (Benadryl®) by mouth.
• Do not waste time with the first aid measures listed for minor symptoms as they will not prevent or reverse a serious allergic reaction.

Here are some ways to avoid stings:

• Avoid areas known to be inhabited by a large number of bees, wasps, or hornets, especially if you are allergic to these stings.  If confronted, do not swat at the flying insects.
• Avoid disturbing nests and hives.  Be aware that lawnmowers and other motorized equipment may provoke the insects.
• Avoid wearing brightly colored clothing and strong perfumes or colognes.   Also avoid drinking from bottles or glasses containing sugary drinks.  Keep outdoor dining and camping areas clean and free from garbage.
• Wearing long pants and long-sleeved shirts may provide some protection from stings.
• If you are allergic to stings, carry your prescribed epinephrine autoinjector kit and antihistamines with you at all times during bee season.  Be sure the kit has not gone beyond its expiration date.

You may not have thought this, but the Illinois Poison Center (IPC) is an excellent emergency service to call for any bite, sting, or envenomation.  Call the IPC at 1-800-222-1222 at any time if you have questions or any poisoning concern.  Enjoy the outdoors safely!