Thursday, August 6, 2020

Bee Stings and Allergy

Bee Allergy, Symptoms and Treatment

Bee Stings and Allergy

What are the symptoms of bee stings? How is a bee sting allergy detected?


Every year in the United States, 50 people die from allergies caused by insect bites. One in every 10 adults in Turkey is allergic to insect bites. The most dangerous and lethal of the insects are the bees. Insects can sting or bite people with their needles. However, insect stings caused by bees are most common in daily life. Bees are membrane-winged insects that can sting humans with their needles. There are very few people in the community who have not been stung by a bee during their lifetime. But very few people are likely to end up dead. Biting insects such as mosquitoes, ticks, spiders, ants, bedbugs and fleas rarely cause a systemic allergic response.

Bees have venom sacs, and some people may develop allergies to bee venom called “venom”. Some people may have allergies as a result of repeated bee stings. If a large number of bees sting at the same time, then a toxic reaction can occur. This condition is similar to allergy symptoms, but tests can not detect allergic sensitivity.

In Turkey, there are Apis mellifera, most commonly known as honeybee, and Vespula vulgaris, also known as wasp or yellow bee.

Which of the insects is the most dangerous and lethal species?


With the start of the summer months, insect stings increase, especially bee stings. Although bee stings are not generally considered, they pose a serious danger to people with allergies. Yellow wild bees, honey bees and large bee stings are more common in the summer months. Large bees are more dangerous than smaller yellow wild bees. Ants can also stick with its jaw and sting from several places along with its circular movements around its head. Pustules develop where it stings. Ants are also known to increasingly threaten health in recent years.

What are the symptoms of bee allergy?


Bee stings can be encountered frequently, especially in the summer months. The symptoms of a bee allergy after a bee sting are very important in terms of early detection of the allergy. Bee stings can have minor itches. These usually disappear within 24 hours. Sometimes redness and swelling may occur within 2 days. These disappear for between 2 and 7 days. The symptoms of bee allergies may include hives, angioedema, and anaphylaxis. These reactions can even lead to death. The symptoms of bee allergy may be present immediately or after 1-2 hours. Edema in the throat, hoarseness, shortness of breath, circulation disorders may occur with shock. Death events due to bee allergy are generally more common in men over the age of 50.

Bee allergy can cause allergic shock!


The venoms of bees cause allergies. There are allergens that can cause cross-reaction between Wasps species. People who develop allergies to the poisons of bees develop symptoms of bee allergies with bee stings. Type 1 allergic reaction is developing.

Symptoms gradually increase within 24-48 hours after a bee stings. It can go on for 7 days. Sometimes after 72 hours, symptoms may appear.

It can sometimes cause symptoms such as swelling, tiredness, vomiting, and mild redness where the bee stings. The presence of swelling after a bee sting is an indication that allergic reactions (anaphylaxis) leading to severe shocks that threaten life will not be seen. The incidence of developing anaphylaxis in these people is 3-5%.

In the reactions that occur immediately after a bee sting, there may be slight swelling in the stings or there may be too much. Toxic reactions and severe allergic shock may develop.

Serum disease, Gullen-Barre syndrome, glomerulonephritis, myocarditis and vasculitis may occur days or months after a bee sting, although rare.

Swelling where the bee stings is the most common symptom. However, this swelling does not happen due to allergies. It is the Venoma-bound reaction.

It can sometimes be greater than 8-10 cm in diameter after a bee sting. Only three out of a hundred people after a bee sting happen. Swelling size can increase up to 48 hours. It could take 10 days to recover. Sometimes there may be swelling in the entire arm or leg. If the reaction is severe, fatigue and nausea may occur.

Bee Stings


What is serum sickness?


Sometimes immunologically the disease is called serum disease. 7 days after a bee sting in this disease joint pain and hives we call skin itchy allergic disease is seen. The vaccine should also be given to those who have Serum disease.

Toxic reaction


It develops if it stings more than fifty bees at once. Many bees enter the body as a result of the poison of the Bee's substances in the headache, nausea, vomiting, fever, remittance, blood pressure drop, heart I failure, shock and death can be seen. This toxic reaction has nothing to do with allergies. Allergies can also develop after a toxic reaction. Therefore, people who develop toxic reactions should be tested against bees. If the skin test is positive, there is a risk of developing allergic shock in subsequent bee stings.

Serious reactions


Severe reactions after bee stings are reactions due to Type 1 allergies.

Itching, redness, hives, and angioedema may develop as a type 1 allergic reaction. If you develop itching, redness, hives, and angioedema in a place other than where the Bee is stung, it can be considered as a precursor to allergic shock. People who develop itching, redness and hives are therefore at risk of allergic shock in subsequent bee stings.

Allergic shock due to bee stings usually occurs within the first 30 minutes, sometimes within 1 hour. Very rarely, it can be delayed up to 72 hours.

Children who develop allergic shock should be treated urgently


How is bee allergy diagnosed?


First, whether it is a bee sting should be questioned. If a bee is found to be stinging, the type of bee must be found out. If there's a needle in the stings, it's the honeybee. Bee pictures can also help in identifying the species of the Bee. The most important point in bee stings begins with the determination of the size of the developing reaction. Reactions should be evaluated whether they suggest allergy. Is there just swelling in the area where the Bee was stung, or is there a rash with itchy rash, or is there an itchy rash outside the area where the Bee was stung? symptoms such as low blood pressure, increased heart rate, weakness, nausea, abdominal pain, shortness of breath are questioned. The size of the reaction is greater than 8-10 cm. Blood allergy to bee venom and skin allergy testing is recommended. Skin testing is performed as a skin prick and intradermally.


Diagnosis with a bee allergy test!


In the diagnosis of bee allergy, questioning the patient, skin tests and laboratory blood tests are important. The patient should be questioned very well, the time of past bee stings, what characteristics they carry, how the reaction is monitored and what complaints occur with them should be investigated. After a bee allergy occurs, panic, fear, excessive heat, excessive exercise and alcohol intake can increase the allergic reaction. Skin tests with bee venom help in diagnosis. Skin tests should be evaluated together with a history of the disease.


Bee allergy is an unpredictable condition 


When a bee stings a person, there may be only temporary mild pain where it stings, burning, itching and redness along with a small swelling. This is a normal reaction and usually heals without treatment. In some people, the swelling in the area stung by the bee may grow. In very few people, the symptoms appear immediately (within 30 minutes) in the parts of the body far from where they are put. In this case, we call” allergic shock " table shortness of breath, wheezing, palpitations, fainting, abdominal pain, nausea and vomiting, diarrhea, itching and redness all over the body, face and tongue, skin swelling may occur. Life-threatening symptoms include swelling of the tongue in the throat, hoarseness and blood pressure. One or more of these symptoms can be found together. This may indicate a systemic, general allergic reaction, and may rarely result in death.

People at risk for bee allergy


Some at-risk individuals may experience more severe bee allergy symptoms. These include older individuals, patients with heart disease and hypertension, patients with mastocytosis who use certain blood pressure and heart medications.


How is bee stings treated?


Cold compresses should be done for swelling seen immediately after a bee sting. Painkillers can be given. Resolves in a few hours.

If the swelling is too large, cold compresses, high extremities, pain medications, antihistamminics in the mouth, and sometimes corticosteroids are used. In people with such a large swelling, the risk of developing allergic shock is 5-10% if the bee stings more sonar again. If there is such a large swelling, a child allergy specialist should evaluate the child.

Antihistamines and corticosteroids may be given if you develop itching, redness, hives, and angioedema, and only if there are signs of skin and blood pressure changes. Children who develop reactions in this way may develop allergic shock after a bee sting again, so it is useful to have an adrenaline auto-injector next to the child.

If symptoms of allergic shock develop, epinephrine auto-injector should be used immediately. For this, you should read our article on the use of epinephrine autoinjector in the allergic shock section and watch our video.

If the bee sting remains on the skin, it should be removed without being squeezed. Cold compress should be applied to the inserted place. If the insertion site is an arm or leg, a tourniquet should be applied to the part of the insertion site close to the body. If you have previously developed allergic shock and were stung by a bee, epinephrine should be administered before symptoms of allergic shock develop and an ambulance should be called to the nearest hospital. If it is not possible to have epinephrine auto-injector, adrenaline bulb 1 mg and injector should be kept at all times and training should be given on which dose to use. If the symptoms of allergic shock persist despite the first epinephrine, the second may be done after 5-10 minutes.

How is allergy treated in bee stings?


One of the most curious in the treatment of bee allergy is how the Bee's needle should be removed. If you want to remove the Bee Stinger, you must take care to remove the Stinger without squeezing the venom sac. For this reason, after a bee sting, a health care provider should be contacted immediately and the help of a specialist in the hospitals that perform Bee testing and treatment should be obtained. 

Patients who experience the symptoms described above as a result of bee stings should consult an allergy specialist. Allergy tests and severe reactions in people who are allergic to the responsible Bee should be treated with the vaccine lasting 3-5 years. The success of this treatment is quite high and improves the quality of life of patients. These patients should be prescribed adrenaline auto-injectors that are ready to carry them with them continuously and also to use them on their own until they go to a center in case of emergency. These patients may be advised to take precautions to protect them from bee stings, although this may be difficult. Honeybees are calmer, and after stinging it, it releases its sting and dies. Wasps, on the other hand, are more aggressive and can sting several times.  In cases affecting the risk of insect bites, outdoor activities, picnic areas, exposed food and garbage bins around, building eaves, tree troughs, underground hollows close to the soil, beehives around, eating outdoors, walking barefoot in the grass may be dangerous in this respect. The beehives should decry for a while.


Bee allergy prevention methods


Preventive treatment is very important if you want to protect yourself from bee stings. Long socks, gloves and shoes can protect you against bee stings if you work in the garden or field. Beehives found around the House must be removed or destroyed. Since wasps may come to sugary and open foods, they should be stored indoors. Bee allergy sufferers are advised not to wear bright and flowery clothes and not to use perfume. Automatic epinephrine injector (epi-fen) should be carried alongside those with bee allergies. Dangerous reactions should be injected immediately. In order to prevent bee allergies, a vaccine can be administered in hospitals that provide a bee vaccine. The bee allergy vaccine must be administered at the hospital.

What are the things to know about bee stings?


Children who develop allergic shock due to bee Soma should have epinephrine next to them. The family and child should be taught how to use the epinephrine auto-injector. It is also important that people with bee allergies wear necklaces or bracelets that indicate that they are allergic to bees. The use of blood pressure medications such as ACE inhibitors, angiotensin II resöptor blockers, MAO inhibitors and tricyclic antidepressants should be avoided in people with bee allergies. Because these drugs prevent the effects of the drugs used in the treatment of allergic shock.

If the reaction due to bee stings is thought to be venom allergy, the blood and skin of the bee venom allergy test should be done. According to the results of the test, which bee allergy if there is a vaccine against the Bee treatment called immunotherapy should be done.

People who have not previously developed allergic shock have up to a 10% risk of allergic shock in the next bee sting if the skin test is positive for bee venom.

If the allergy test is positive in people who have developed allergic shock, the risk of developing allergic shock is 40-70%.

Does it recur later when allergic shock develops?


It could repeat within 24 hours. He is therefore kept under observation.

Immunotherapy treatment in bee stings 


Immunotherapy treatment against Venoma is the area where the vaccine delivers the most effective results. If there is an allergy to bees in the blood and if the skin test is positive for a bee allergy and allergic shock has developed before, vaccine treatment should be done. Immunotherapy treatment is not recommended for children who develop mild allergies. It should be done if there is serious swelling in the place where the bee stings or if there is swelling in other places where the bee stings.

Is the immunotherapy effective?


The effectiveness of the vaccine against bee allergy is very high. It is 75-100% effective.

How long will immunotherapy treatment take?


It is continued for about 5 years. The first 4 months are done once a week then once a month.

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