Overcoming the sting of summer

MILWAUKEE - As summer comes to an end you may notice an increase in the number of stinging insects buzzing around your backyard and garden. A nest that had a few dozen bees and yellow jackets in July may have thousands in mid to late September, forcing people with stinging insect allergies to take extra precautions.

For most people, getting stung results in temporary redness and swelling at the site of the sting. However, for those with severe allergies to insect stings, it can result in a sudden severe reaction called anaphylaxis. Anaphylaxis is a medical emergency and may be fatal if not treated immediately.

More than 5% of Americans are at risk for anaphylaxis from stinging insects, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). The most common stinging insects in the United States include yellow jackets, honeybees, bumblebees, paper wasps, hornets and fire ants.

Symptoms of anaphylaxis can include itching and hives over large areas of the body, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea and diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness and can cause death.

"Unfortunately most people don't even know they are allergic to insect stings until they actually experience an allergic reaction," according to allergist/immunologist David B.K. Golden, MD, FAAAAI, and past Chair of the AAAAI Insect Allergy Committee. "When an allergic person is stung for the first time, his or her body produces an antibody called Immunoglobulin E (IgE). If they are stung again, the venom reacts with the IgE antibodies. This triggers the release of histamine and other chemicals that cause an allergic reaction."

However, some people may experience a severe allergic reaction after being stung only once, while in others, it may take several stings before a reaction occurs. This fact highlights the need for proper diagnosis and management to prevent a severe reaction from occurring.

In the event that you are stung, the AAAAI recommends the following treatment tips to help alleviate the pain and take the proper actions in the event an allergic reaction occurs:

• Monitor carefully for symptoms of anaphylaxis. If you experience symptoms, call 911 to get emergency medical treatment.
• If you know you have a severe allergy, inject epinephrine immediately and call 911.
• If you are dizzy, lie flat on the ground until help arrives.
• Elevate the affected area and apply ice or a cold compress to reduce the pain and swelling.
• Gently clean blisters with soap and water to prevent secondary infections; do not break the blisters.
• Use topical steroid ointments or oral antihistamines to relieve itching.
• Do not pinch the area to remove the stinger. This can result in more venom being released into the skin.

PUT AN END TO YOUR WORRIES
Patients who think they are allergic to stinging insects should consider seeking the help of an allergist/immunologist. An allergist/immunologist is specifically trained in diagnosing the correct specific insect species that causes your allergy and can make recommendations for treatment and avoidance of the insect.

Rather than living in fear of stinging insects, severely allergic patients should receive venom immunotherapy treatments, a highly effective vaccination program that prevents future allergic sting reactions in 97% of treated patients. During venom immunotherapy, the allergist/immunologist administers gradually stronger doses of venom extract initially every week, but as maintenance doses are reached the interval is expanded to once a month or more.

With the help of an allergist/immunologist and armed with the knowledge of what to do if a reaction occurs, allergy sufferers can participate in regular outdoor activities.

To find an allergist/immunologist in your area, call the AAAAI Physician Referral and Information Line at (800) 822-2762 or visit the AAAAI Web site at www.aaaai.org/physref/.

AAAAI Topic of the Month
The topic of the month for September on the AAAAI Web site is "Stinging Insect Allergies." The topic serves to educate the public by offering:

• Which insects to look out for
• What to do before the sting
• How to prevent the sting
• How to treat the sting
• Links to additional educational resources

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information and a physician referral directory through its Web site at www.aaaai.org.

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Editors Note: Experts are available for interviews.