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Allergies

Allergy to bee and wasp stings

Anyone can become allergic to bee and wasp stings, but those most likely to become bee allergic are bee keepers. Those who work in gardens are also more likely to become either wasp or bee allergic. It is unusual to be allergic to both insects.

Small local reaction

On being stung by bee or wasps patients can get pain, redness, and mild swelling at the site of the sting. This tends to resolve on its own over a few hours or a day or so. This is a normal reaction to the venom in the sting and is not an allergy.

Large local reaction

In some individuals, bee or wasp sting can result in a large swelling contiguous to the site of the sting; it tends to be larger than 10 cm, and develops several hours after the sting. Quite often it is an inflammatory reaction to the various chemicals injected into the sting site at the time of the sting. These symptoms may last for 4-5 days. Majority of the patients do not develop systemic reactions to subsequent stings. However in a small minority the risk of a systemic reaction to a future sting may increase.

Systemic allergic reaction

Some individuals can develop cutaneous (involving the skin) systemic allergic reactions on being stung by bees or wasps. Symptoms tend to start within an hour of being stung and include urticaria (rash, nettle like hives or wheals) or angioedema. In severe cases patients may get symptoms of anaphylaxis (see anaphylaxis) with difficulty in breathing, swelling in the throat or fall in blood pressure.

Systemic allergic reactions are caused by specific IgE antibody to bee or wasp venom hence it is possible to perform allergy testing (skin prick test or blood test) to establish the trigger and confirm the diagnosis.

Treatment

Patients with systemic allergic reaction to bee or wasp venom are advised to take measures to avoid being stung again; they are advised to carry antihistamines and two adrenaline auto injectors with them. They are trained in how and when to use the adrenaline auto injector. They are advised to wear a medic alert device detailing their allergy. They can be offered desensitisation to bee or wasp venom.

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