What Is an Insect Sting Allergy?

Insect stings usually are minor annoyances. But they can cause serious reactions in people who are allergic to them.

Insects that can trigger allergic reactions include honeybees, yellowjackets, hornets, wasps, and fire ants. When they sting, they inject venom into the skin.

Allergic reactions to stings usually don't happen when a child is stung for the first time. Most happen when the child is stung for a second time, or even later.

If you think that your child might have had an allergic reaction to an insect sting, call your doctor. The doctor can help you understand the difference between what usually happens with an insect sting and what happens with an allergic reaction. If your child does have an allergy, the doctor will prescribe epinephrine auto injectors to use in case of a severe reaction.

What Happens in an Insect Sting Allergy?

When someone is allergic to insect stings, the body's immune system, which normally fights infections, overreacts to proteins in the insect's venom. When stung, the body sees these proteins as harmful invaders.

The immune system responds by working very hard to fight off the invader. This causes an allergic reaction, in which chemicals like histamine are released in the body. This release can cause symptoms such as:

• wheezing
• trouble breathing
• coughing or nasal stuffiness
• hoarseness or trouble speaking
• throat tightness
• stomachache
• vomiting
• diarrhea
• itchy, watery, or swollen eyes
• hives
• red spots
• swelling
• itching
• a feeling like something bad is about to happen
• a drop in blood pressure, causing lightheadedness or passing out

A serious allergic reaction is called anaphylaxis. Anaphylaxis (an-eh-fil-AK-siss) can cause different symptoms at different times. A reaction is considered anaphylaxis if someone has:

• any severe symptoms, such as trouble breathing, repeated vomiting, passing out, or throat tightness
  or
• two or more mild symptoms, such as hives with vomiting or coughing with belly pain

Anaphylaxis can begin with some of the same symptoms as a less severe reaction, but these can quickly become worse. Anaphylaxis that's not treated can be life-threatening. A person with anaphylaxis needs treatment with injectable epinephrine right away.

How Are Reactions From an Insect Sting Treated?

If your child has been diagnosed with an insect sting allergy, always keep two epinephrine auto-injectors on hand in case of a severe reaction. If your child starts having serious allergic symptoms, like throat swelling or trouble breathing:

• Give the epinephrine auto-injector right away. Every second counts in an allergic reaction.
• Then call 911 to take your child to the emergency room. Your child needs to be under medical supervision because even if the worst seems to have passed, a second wave of serious symptoms can happen.

An epinephrine auto-injector comes in a small, easy-to-carry container. It's simple to use. Your doctor will show you how to use it. Kids who are old enough can be taught how to give themselves the injection.

Your doctor also might instruct you to give your child antihistamines in some cases. But always treat a serious reaction with epinephrine. Never use antihistamines instead of epinephrine in serious reactions.

Share emergency plans with anyone who cares for your child, including relatives and school officials. Together, agree on a plan in case of a serious reaction at school, including making sure that injectable epinephrine is available at all times. If your child is old enough to carry the epinephrine, it should be in a purse or backpack that's with your child at all times, not in a locker. Also consider having your child wear a medical alert bracelet.

How Can Parents Help?

The best way to prevent allergic reactions to insect stings is to avoid getting stung in the first place. Teach your child to:

• Avoid walking barefoot while on the grass.
• Avoid playing in areas where insects like to be, such as flower beds.
• Avoid drinking from open soda or juice cans and be sure to keep food covered when eating outside. Check for insects in drink cups and straws when outside.
• Remain calm and quiet around stinging insects. Moving slowly, back away without any arm-waving or swatting.
• Never disturb an insect nest. Have an exterminator get rid of nests near your home.
• When in wooded areas, keep as covered up as possible. Long-sleeved shirts, long pants, socks, and closed-toe shoes can help keep the bugs away. (Loose clothing can allow insects to get between the clothes and skin.)
• Avoid perfumes, scented body products, and brightly colored and flowered clothing because they all attract insects.

If your child is stung and a stinger remains in the skin, use your fingernail or a credit card to scrape the stinger from the skin. Removing the stinger quickly can help prevent more venom from going into the body. Don't use tweezers because they can cause more venom to be released.

Talk with your doctor about whether your child should see an allergy specialist about getting allergy shots. These can help the body react less to insect venom, which can make a serious reaction less likely.