Abstract
Although massive sting attacks by Africanized bees are currently rare, this type of bee is now endemic in parts of Arizona and Texas, and will probably spread to other warm climate areas in the United States. Treatment of severe toxic reactions to multiple stings usually includes management of shock, hypoxia, and other effects of organ damage. New approaches to reduce blood levels of venom including production of a bee antivenom and hemodialysis require further study. Patients with a trivial allergy to single stings could be at risk from systemic anaphylaxis to multiple bee sting. Those who wish to remain in endemic areas in spite of histories of systemic anaphylaxis to bee stings should be treated with venom immunotherapy, possibly administered more intensively and for longer periods than currently recommended. Continued public education is needed to limit contact with aggressive Africanized bee colonies.
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