Bee, Wasp, and Hornet Stings

Abstract

Insect stings are a common pediatric problem. The vast majority of such stings are nothing more than a brief and relatively trivial annoyance, producing only a mild local reaction. However, allergic reactions to stings from venomous insects are not rare and can be potentially life threatening. Actuarial surveys indicate that at least 40 deaths per year occur in the United States as a result of severe reactions to venomous insect stings. This article will review the nature of reactions to stinging insects, discuss the diagnostic and therapeutic approaches to stinging insect allergy, and point out some of the problems that remain incompletely resolved in these areas. STINGING INSECTS Bees, wasps, and hornets (Figure) are members of the order Hymenoptera and account for the majority of anaphylactic reactions to venomous animals and insects in the United States. The apid family includes the bumblebee and the honeybee, both of which are relatively nonaggressive. The bumblebee is large, slow moving, and noisy, rarely accounting for stings. Honeybees cause problems particularly among beekeepers and their families but may also be encountered by people who are gardening or mowing lawns in aareas where the bees are pollinating flowers or clover. Children are most commonly stung by honey bees while barefoot.