Alabama Allergy & Asthma Center

Stinging Insect Allergy

Stinging insects like bees, wasps, hornets, yellow jackets, or fire ants (the Hymenoptera family) inject venom when they sting their victims. In order to better understand stinging insect allergy, you need to be able to differentiate an allergic reaction from a normal local reaction. A normal reaction will result in pain, redness, and a swelling where the sting occurred.

An allergic reaction is when your immune system overreacts to an allergen, in this case, a sting. (Read more about allergies.) The first time an insect stings a person who is allergic, an antibody called immunoglobulin E (IgE) is produced. It is the IgE reacting with the insect venom that causes the reaction (release of histamine and other chemical mediators). There has to be at least one prior sting before an allergic response can occur. After a second sting by the same type of insect, the venom attaches itself to the IgE antibody and the reaction, this time usually more severe, is triggered. Yellow jackets and hornets tend to be cross reactive (a sting by one can lead to an allergy to both) while the others are not.

A normal reaction usually lasts for a few hours. Occasionally, the local reaction can be severe and last as long as two weeks. Allergic reactions to an insect sting can range from relatively mild symptoms like a short case of hives to severe anaphylaxis, which could be fatal. Symptoms of a severe allergic reaction (the first signs of anaphylaxis) are:

• Hives, itching, and swelling in areas other than the sting site
• Difficulty in breathing
• Difficulty swallowing
• Tightness in the chest
• Wheezing
• Hoarse voice
• Feeling of a lump in the throat
• Swelling of the throat, tongue, face, or lips
• Dizziness
• A feeling like there is something "very bad" or "very wrong"

This type of reaction will occur within minutes of exposure and may be life threatening. If you have had a severe allergic reaction to an insect sting, there is a 60 percent chance of similar or worse reactions if stung again.

Identifying Stinging Insects

In order to avoid stinging insects, it is important to learn what they look like and where they live.

Yellow Jackets

• Black with yellow markings
• Queen -- ¾ inch long
• Male and workers -- ½ inch long
• Less common in the southwestern United States
• Nests are made of papier-mache material and are usually found underground, but are sometimes inside walls of framed building, in cracks in masonry, or in woodpiles.

Hornets

• Black or brown with white, orange, or yellow markings
• Usually larger than yellow jackets, typically ¾ to 1 inch long
• Nests are gray or brown and football-shaped, made of papier-mache material, (similar to a yellow jacket nest) and are found high above ground on branches of trees, in shrubbery, or on gables.

Honeybees

• Brown with yellow markings
• ½ inch long
• Barbed stinger that is usually left in victim
• Dies after stinging
• Usually only stings when provoked
• Domesticated honeybees live in man-made hives
• Feral honeybees live in nests. Common sites for nests include holes in exteriors of homes, between fence posts, in old tires, or other partially protected sites.

Fire Ants

• Reddish brown
• 1/8 inch long
• Live in colonies underground with a prominent mound
• Fire ant beds are found along borders of sidewalks, driveways, and along roadsides.

Paper Wasps

• Black, brown, or red, usually with yellow markings
• Slender elongated bodies are ½ - 1 inch long
• Nests are made of papier-mache material and are usually found under eaves, behind shutters, in shrubs or woodpiles.

Avoiding Stinging Insects

• Hire a professional exterminator to destroy hives and nests around your home. Under no circumstance should an insect-allergic person attempt this task.
• Stay out of the territory of the stinging insects' nests.
• The smell of food attracts insects. Be careful when cooking, eating, or drinking sweet drinks (i.e., juice, soda) outdoors. Keep food covered until eaten.
• Avoid the use of perfume, hair applications, scented suntan lotion, and other sweet-smelling products.
• Cover garbage. Be sure to keep areas around trash containers clean.
• Wear closed-toe shoes outdoors and avoid going barefoot. Swimming pools and flower gardens are particularly high-risk areas.
• Avoid loose fitting clothes that can trap insects between your garment and skin.
• Use caution when using hedge clippers and power mowers and while gardening. Stinging insects live in trees, shrubs, and woodpiles; disturbing these nests could incite them to sting.
• If attacked don't run -- slowly remove yourself from the exposure site and seek immediate treatment if you are allergic.

Treatment for Stinging Insect Allergy

Anyone who is suspected of having had an allergic reaction should be evaluated by a Board Certified Allergist. Allergy shots have proven highly effective against stinging insect allergy.