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Stinging insects belong to the order hymenoptera. Only three families within this order contain insects that routinely sting humans. The families Apidae (bees), Formicidae (ants), and Vespidae (wasps, hornets, yellowjackets) are responsible for most of the cases of allergy to insect stings. 

 Every year millions of Americans are stung. Everyone will react in some way to the venom of stinging insects, but as many as 5% of the population are truly allergic.

 Types of Insect Sting Reactions

 Most people are not allergic to insect stings and should recognize the difference between an allergic reaction and a normal or large local reaction. This will prevent unnecessary worry and expense.

 The severity of an insect sting reaction varies from person to person. A normal reaction will result in pain, swelling, and redness confined to the sting site. Simply disinfect the area and apply ice to reduce the swelling. A large local reaction will result in swelling that extends beyond the sting site. For example, a person stung on the forearm may have his/her entire arm swell to twice its normal size. Although alarming in appearance, this condition is often treated the same as a normal reaction. However because this condition may persist for 2-3 days, antihistamines and steroids are sometimes prescribed to lessen the discomfort. The most serious reaction to an insect sting is a systemic allergic response. This condition requires immediate medical attention. Symptoms of an allergic reaction or anaphylaxis may include one or more of the following:

 Hives, itching, or swelling in areas other than the sting site.

Tightness in the chest and difficulty breathing.

 Hoarse voice or swelling of the tongue.

 Dizziness or a sharp drop in blood pressure.

 Unconsciousness or cardiac arrest.

 This type of reaction can occur with in minutes after the sting and may be life-threatening or even fatal. People who have experienced a systemic allergic reaction to an insect sting have a 60% chance of a similar or worse reaction if stung again.

 Treating Allergic Reactions

 An anaphylactic reaction is treated with epinephrine, either by self-injection or administered by a doctor. In some cases, intravenous fluids, oxygen and other treatments are necessary as well. Once stabilized, these patients are sometimes required to stay overnight at the hospital under close supervision. People who have had previous systemic reactions and rely on the protection of epinephrine must remember to carry it with them where ever they go. Also, because one dose may be insufficient in reversing a reaction, immediate medical attention following an insect sting is recommended. 

 Preventing Allergic Reactions

 Systemic allergic reactions to insect stings can be prevented with venom immunotherapy, a treatment that is 97% effective in preventing future occurrences. It involves administering gradually increasing doses of venom which stimulate the patients own immune system to become less sensitive to the venoms allergens. Over time, people who previously lived under the constant threat of severe reactions to insect stings can go about leading normal lives.

 Finding Out More About Immunotherapy

 Ask your doctor to send you to an allergist, a physician who is a specialist in the diagnosis and treatment of allergic disease. Based on your past history and certain tests, the allergist will determine if you are a candidate for immunotherapy.

Reference: ACAAI Patient Information Pamphlet

Link to ACAAI  http://www.acaai.org/allergist/allergies/Types/insect-sting-allergies/Pages/default.aspx