bee sting envenomation

 

Generally what is the cause of the widespread fear of bees in the community?  It is the fear of bee stings.  Not only do bee stings hurt but vast numbers of people believe that because they swell at the sting site they are allergic to bees.

True allergy to bee stings is extremely rare.  Estimated at .03% to .05% of the population.  Nevertheless it is a serious problem accounting for at least 1 death per year in Australia, 40 per year in America.  In Australia between 1980 and 1990 there were 20 deaths from bee stings and 19 from lightning strikes.  (ref. Stevens & Paxton, 1992) 

The purpose of my talk is to establish the

  • Normal response to the toxic responses of bee venom (stings)
  • Abnormal response, allergy or hypersensitivity.

So what is the difference between those highly allergic and a sensitivity.

ALLERGY is a hypersensitivity response or anaphylaxis.

 The normal reaction is general swelling at the sting site.  This can continue for several hours, the softer the tissue the more it swells, e.g. face, forearms and heaven forbid the genitals.  This may last several days, turn a dull red and become itchy.  

I have noticed I get thirsty and cannot drink enough fluids – this is a sign of shock.

People who suffer a higher than normal swelling which is more extensive, angry looking, very itchy and lasts much longer, could be the beginning of an anaphylactic reaction.  

What to do:

  • Take antihistamine tablets
  • Put on ice packs
  • Stingoes cream
  • You need to see a doctor.  To alleviate this reaction the doctor will give a prescription for steroids.

In contrast a truly allergic person’s first sting is potentially fatal.

Normally, when stung, aperson’sbody sets up antibodies as a defence reaction, a normal response to the next time you are stung.  This is what some beekeepers call “immunity”.

In the allergic person the body produces an antigen which reacts with the antibody and white cells to produce a toxic and dangerous substance called histamine, which produces the physiological effects we know as an allergic reaction.  

In these extreme cases the bronchial tubes go into spasm narrowing the airway causing breathing difficulties, low blood pressure.  The patient goes into shock and potentially can lead to death.

Fatality solely due to the toxic effects of bee venom is approximately 1400 stings for the average male and 1100 stings for a female.  However, death has been recorded after as few as 50 stings.  As a byline 500 bee stings equate to a rattle snake bite.

Now with all this knowledge for the lay person the signs to look for are:

  • Swelling distal from the site of the sting
  • Swelling of eyelids or lips
  • Hives or welts over body
  • Red and white blotchy skin
  • A persistent cough trying to clear throat because of breathing difficulty
  • Weak and thready pulse
  • Finally unconsciousness
  • In young children pale and floppy

The patient needs adrenalin in the form of an Epipen.   The cost currently is $126 without a prescription, or $38 with a prescription.   An Epipen is a once only use.

However, people who have not been allergic can develop allergies over time.  Signs to look for:

  • Blotchy skin
  • Itchiness all over.

TREATMENT of bee stings.  Normal effects require no special treatment, however as beekeepers you should scratch out the sting immediately.  Either puff smoke, or rub honey on sting site, this takes the smell of the sting site away.  The reason being the stinger’s sisters are attracted to the sting site and if working a number of hives you could get multiple stings.

WHAT IS BEE VENOM

A complex mixture of chemical substances including enzymes, peptides, amines, including histamine and noradrenalin.  The enzymes are highly allergenic and include Hyaluronidase, Phospholiphase and Acid Phosphatase.

I would suggest to any prospective beekeepers they deliberately get stung to assess their reaction before outlaying a lot of money to start keeping bees.

 
Stuart Garske