Treatment of bumblebee stings and allergies

Treatment of bumblebee stings and allergies

Treatment of bumblebee stings and allergies

This resource offers valuable guidance to help you reduce the likelihood of being stung by a bumblebee, and provides information on potential reactions to a sting and recommended treatments. For a downloadable poster version of "Bumblebee Stings and Allergies," please use the link below.

Bumblebee, honeybee, and wasp stings

Bumblebees are widely found in natural environments across many countries. They, along with honeybees, play a vital role as pollinators in agricultural and horticultural crops. Bumblebees exhibit a range of subspecies with distinct appearances, including different colors and patterns. Generally, bumblebees are larger and hairier than honeybees, as well as wasps.

Understanding bumblebee stingersĀ 

Only bumblebee workers and queens possess stingers, similar to honeybees and wasps. Drones, on the other hand, are incapable of stinging. The bumblebee's stinger serves as a defensive mechanism, injecting venom into the recipient's body upon stinging. In humans, this typically leads to a brief but intense pain that subsides over time. However, in approximately 1% of cases, individuals may experience an allergic reaction to the injected venom.

How to prevent bumblebee stings?

Bumblebees rarely sting and the chances of being stung can be reduced by avoiding actions that provoke or agitate them. It is important to remain calm when working with bumblebees, refraining from waving arms, bumping the hive, touching or holding the bumblebees, and similar behaviors.

Additionally, it's important to be aware that bumblebees can react aggressively to certain smells such as alcohol, perspiration, perfumes, scented soaps, aftershave, and more. The use of rings, bracelets, and watches may also cause aggressive behavior due to the scent of oxidized material between the skin and the jewelry. Bumblebees are attracted to the color blue, including light blue clothing. Wearing protective clothing can help reduce the risk of stings, although bumblebees can sting through clothing.

Stung? Reactions and treatments

Usually, a bumblebee sting leads to a non-allergic local reaction, which includes swelling, itchiness, and redness at the site of the sting. These symptoms typically last for a couple of hours, occurring immediately or after a few hours. Swelling or itching may persist for hours or even days, and in some cases, the reaction may spread further. These local reactions are non-allergic in nature.

Treatment of a non-allergic, local reaction

Generally, medical treatment is unnecessary for non-allergic local reactions. However, some measures can be taken to minimize the local reaction, particularly if the sting occurred in a sensitive location, such as near the eyes. Taking an anti-inflammatory medication (such as aspirin or ibuprofen) as soon as possible after being stung can help. Applying cold compresses to the site is also beneficial. There are several anti-itch ointments available, some of which contain diethyl-m-toluamide.

In the rare event of a sting in the mouth or pharynx, immediate medical attention is necessary to address potential blocked airways. At the hospital, corticosteroids (such as prednisone) may be administered, and the patient will be kept under observation.

Allergic reactions

In approximately 1% of the population, repeated stings (or in some cases, only two or three stings) can trigger an allergic reaction, also known as a general allergic reaction, a systemic allergic reaction, or an anaphylactic reaction. Allergic reactions occur due to antibodies formed during previous exposure to an antigen, making it impossible to experience an allergic reaction after the first sting. Allergic reactions usually manifest shortly after the sting, ranging from a few seconds to half an hour afterward.

Allergic reactions are classified in four levels, in order of increasing severity:

Level 1: itching, redness and swelling (urticaria, hives) over the whole body
Level 2: level 1 symptoms plus intestinal problems (vomiting, diarrhoea)
Level 3: level 1 and/or 2 symptoms plus difficulties in breathing and/or a feeling of suffocating
Level 4: level 1 and/or 2 and/or 3 symptoms plus heart palpitations, fainting, anaphylactic shock (accompanied by dizziness, excessive sweating, and cold shivers)

Treating an allergic reaction to bumblebees

Treating an Allergic Reaction

In the case of a fever or grade 1 reaction, it is advisable to consult a general practitioner. The situation can be monitored, and hospital observation may be recommended as the reaction can progress over time.

If vomiting occurs or grade 3 or 4 symptoms manifest, immediate hospitalization is necessary.

For allergic reactions, the administration of a prescription-strength antihistamine (such as clemastine) is beneficial. Antihistamines help reduce swelling caused by the histamine present in the venom. In some cases, corticosteroids (such as DAF/Dexamethasone) may be prescribed. Level 3 or 4 reactions require the administration of adrenaline as the first course of action. Adrenaline stimulates the heart, constricts blood vessels, and opens the airways. Adrenaline can be self-administered using an adrenaline auto-injector (such as an EpiPen or Jext). These auto-injectors are available only by prescription, typically for individuals who have previously experienced an allergic reaction to a bumblebee sting. Depending on local regulations, some companies working with bumblebees may also provide access to adrenaline auto-injectors.

Toxic reactions

Toxic reactions only occur when the victim is stung dozens of times in a brief period. General allergic reactions can occur in the nervous or circulatory system, such as cardiac arrhythmia or difficulties with breathing. In this case as well, the victim should be taken to hospital for treatment and observation.

Hyperventilation

In addition to a severe, level 4 allergic reaction, hyperventilation, perhaps as a result of shock, may also cause loss of consciousness. In such cases it is also necessary to call the emergency medical services immediately.

Increased risk

People who use certain medicines (beta-blockers) and pregnant women are at increased risk when allergic reactions occur after a bumblebee sting.

Living with a bumblebee allergy

If you have had an allergic reaction once, you will not necessarily have an allergic reaction to the next sting. If you had a level 1 or 2 reaction in particular, the chance is small. Reactions to bumblebee stings may differ in each case. These days it is possible to take a test using purified bumblebee venom to determine whether you will have an allergic reaction the next time you are stung. It is also possible to use the purified venom for a hyposensitization treatment.

Immunotherapy with honeybee venom does not necessarily protect patients with bumblebee allergy. This treatment is intended to desensitize the body to bumblebee venom. If you do not wish to undergo hyposensitization treatment, you can obtain a prescription for an adrenaline auto-injector (such as an EpiPen or Jext) from your doctor. This can be carried with you and is used to inject epinephrine into the thigh in the case of a sting.
Tests and treatments are available at the Allergology department of the RdGG (Dr de Groot) at the Diakonessehuis location in Voorburg.

Information for doctors

Detailed information regarding medical treatment of allergic reactions is available from Koppert on request.
For further information, contact an allergologist or a doctor of internal medicine.

Literature
De Groot, H. Allergie voor insecten, Huisarts en Wetenschap 2002; 45 (7): 362-7.
De Groot, H. Allergy to bumble bees. Curr Opin Allergy Clin Immunol 2006; 6: 294-7.

A printed poster showing the images is available from Koppert. This poster is also available as a download (URL).
Tip: Add the contact information for seeking medical assistance and emergency medical treatment on the poster.

This information is intended as an education resource only and should not be used for diagnosing or treating a health problem as it is not a substitute for medical care. If you have or suspect you may have a health problem, please consult medical care.

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