What is bee or wasp sting allergy?

Allergic reactions to bee and wasp stings are uncommon. One in 50 children may be more prone to allergic reactions because of an excess of allergy (mast) cells in their bone marrow (mastocytosis).

It is normal to have some pain, redness and swelling where you have been stung. Some people consistently have large painful swelling around the sting. This is not an allergy, but a reaction to the venom. If very sore and swollen it may need medical attention.

Only a few people develop hives, breathing problems or faintness after bee and wasp stings. These are symptoms of allergy. The risk of an allergic reaction is greatest if a second sting occurs 2-8 weeks after the first. All patients suffering from allergic reactions to bees or wasps should seek medical attention and be referred to an allergy doctor.

People allergic to wasps may not be allergic to bee stings and vice versa. If you travel abroad, other insects such as fire ants (USA) and hornets (Europe, Asia, US) can cause allergic reactions, but these are not a problem in the UK.

Fire antHornet
Fire AntHornet

How can I avoid being stung?

Bees and wasps are most likely to sting in summer and early autumn. Wasps build nests in sheltered areas including trees and roof spaces. They are attracted to bright colours, sweetened, and flavoured drinks, fallen ripe fruit, and dust bins. Well-fitting lids on bins, and not leaving drinks & food around can reduce chances of being stung. Local councils can help to remove nests from homes and gardens.

What should I do if my child is stung?

Bees leave the stinger in the skin and die soon after stinging. Wasps do not leave their sting or die after stinging. They can sting again. Walk away calmly to prevent being stung repeatedly.

Removing the sting– Remove the sting and venom sac by scraping it out, either with a fingernail, or something with a hard edge such as a credit card, as shown in the picture.

remove-stingBe careful not to pinch or squeeze the venom sac (e.g. with tweezers) as this might spread the venom further under the skin.

For local, and large local reactions

  • wash the affected area with water
  • apply ice packs to the stung to reduce the swelling
  • painkillers such as paracetamol or ibuprofen can be given
  • antihistamines can reduce the itch
  • the swelling will usually start to improve within a few days

For allergy reactions

  • treat hives and generalised swelling with an antihistamine.
  • more severe reactions need urgent medical attention. These include difficulty breathing, wheeze, tightness in the throat, faintness, or collapse (anaphylaxis). They can occur with or without hives or generalised swelling.

Which patients should be referred to an allergist?

Patients with local reactions, even if large, do not need to see an allergist.

Patients who have an allergic reaction after a bee or wasp sting, including those with only a skin rash (hives) should be prescribed an adrenaline pen (auto-injector) by their GP, shown how to use it, and referred to an allergy doctor for further tests and treatment. Adults may be given injections (immunotherapy), but these are rarely required in children.

Who needs to know about this allergy?

It is important to inform the nursery/school and any after-school clubs. Any other carers will also need to know.

Is insect venom allergy life-long?

Only 10% of mild allergic reactions will recur after repeat stings.

Where can I find more information?

Anaphylaxis Campaignwww.anaphylaxis.org.uk