What is Insect Sting Allergy – Overview

Many children experience insect stings every year. For most of them, these stings only cause mild pain and discomfort lasting for just a period of hours. Symptoms might include swelling, itching, and redness at the sting site.

However, some children are allergic to insect stings. When they are stung by an insect to which they are allergic, their bodies produce an antibody called immunoglobulin E (IgE), which reacts with the insect venom and triggers the release of various chemicals, including histamine, that cause the allergic reaction.

Stinging insects found in the United States include honeybees, yellow jackets, hornets, wasps, and fire ants. While not everyone is allergic to insect venom, reactions in the skin such as mild pain, swelling, and redness may occur with an insect sting.

Who is at Risk for Insect Sting Allergies?

Over 2 million Americans are allergic to stinging insects. The degree of allergy varies widely. Most people are not allergic to insect stings, and most insect stings result in only local itching and swelling. Many, however, will have severe allergic reactions. Severe allergic reactions to insect stings are responsible for at least 50 deaths each year in the U.S.

If you are known to be allergic to insect stings, then the next sting is 60% likely to be similar or worse than the previous sting. Since most stings occur in the summer and fall, you are at greatest risk during these months. Males under the age of 20 are the most common victims of serious insect-sting allergic reactions, but this may reflect a greater exposure to insects of males, rather than a true predisposition.

What Types of Insect Sting Reactions Occur?

Nonallergic Reactions

Most insect-sting reactions are not allergic and result in local pain, itching, swelling, and redness at the site of the sting. Some extension of the swelling is expected. Local treatment is usually all that is needed for this type of reaction. Disinfect the area, keep it clean, and apply ice. Topical corticosteroid creams are sometimes used to decrease inflammation, and antihistamines can help control itching.

Large local reactions may involve increased swelling (that lasts for 48 hours up to one week) that may be accompanied by nausea and vomiting. Large local reactions occur in about 10% of insect stings and are not allergic in origin. Occasionally, the site of an insect sting will become infected, and antibiotics are needed.

Allergic Reactions

Systemic (body-wide) reactions are allergic responses and occur in people who have developed antibodies against the insect venom from a prior exposure. It is estimated that between 0.3%-3% of stings trigger a systemic allergic reaction.

The allergic reaction to an insect sting varies from person to person. Symptoms of an allergic reaction can include itching, hives, flushing of the skin, tingling or itching inside the mouth, and nausea or vomiting. The most serious allergic reaction is called anaphylaxis, which can be fatal.

Difficulty breathing, swallowing, hoarseness, swelling of the tongue, dizziness, and fainting are signs of a severe allergic reaction. These types of reactions usually occur within minutes of the sting but have been known to be delayed for up to 24 hours. Prompt treatment is essential, and emergency help is often needed.