What to Do if You Have a Venom Allergy
Spring is in the air and while many of us deal with seasonal allergies, there is a more dangerous allergy issue that some people face in the warmers months. Along with snow cone stands and swimming pool days we in Texas face a less pleasant aspect of the season: FIRE ANTS!
To some these are just an annoyance but to those with true fire ant allergy, a bite can be life threatening. Severe allergic reactions to stinging insect attack causes >40 deaths per year in the US. Up to 1% of children and 4% of adults experience serious life threatening insect sting reactions. This includes reactions to bee stings, wasp stings and ant bites.
But Who Is at Risk?
Many of us have had the typical local reactions to insect stings (including pain and swelling at the site of the bite or sting). Most of the time an ice pack, a little anti-itch cream, or even a dose of antihistamine is all we need to relieve the discomfort of stings.
Sometimes this swelling at the site of the sting can extend to a large part of a limb or body area - that is called a large local reaction. Of those who experience these large local reactions, a few (4-10%) may be at increased risk of having a more severe reaction in the future. That's also true for those who get even brief hives as a result of being stung.
Two Kinds of Reactions Can Occur After Stings: Toxic Reactions and Allergic Reactions
Toxic symptoms can occur as a results of the effects of the venom itself which can include pain, burning, swelling and even systemic symptoms like headache and fever. The risk of a dramatic toxic reaction is higher if a person is stung multiple times, but it also depends on individual sensitivity to the poison in the sting or bite.
Allergic reactions happen because the immune system is already on high alert and has elevation of specific IgE (an allergen recognition protein in the blood) so the system responds to even a small introduction of the insect venom.
How to Take Care of It
To minimize the effect of an ant or bee sting, and reduce the dose of injected venom, it is important to remove the a bee stinger from the body (which can be left embedded in the skin ) with a soft scraping or brushing motion (you can use a card or a long fingernail).
Then clean the sting with warm soapy water and apply itch cream and ice pack. Ants can also stay attached (hanging on by their jaws) and can sting again if not brushed off. So if you see the culprit, remove it immediately by brushing it away (preferably without touching it with your hand as it can hang on and bite you again!
Allergy? Or Toxic Reaction?
We should be knowledgeable and prepared to handle stings in the moment, but we should also know when to get tested to see if a true allergy exists. If you have any kind of dramatic sting reaction, you should go to your allergist and discuss it—sometimes it can be difficult to distinguish between a toxic or allergic reaction.
In someone who has never had a severe allergic reaction to a sting, getting tested without a history of reaction can lead to false positive results in up to 20% of cases, leading you to believe you are allergic when you really are not.
But if you or a family member has had any signs of anaphylaxis ( a severe allergic reaction)—these can include dizziness, nausea/vomiting, all over body hives, throat/face/ tongue swelling, or passing out—then an evaluation is definitely required.
Insect sting allergies are not necessarily inherited and so having a family member with one does not mean you will have one, and the most important predictor of an allergy is history of previous reaction to a sting. The severity of reaction can also vary over time and depending on the the number of stings and the situation. If you're not sure if your reaction warrants evaluation, we encourage you to call or come in for a consultation.
Those with allergy to hymenoptera insects, which include vespids (wasps), apids (bees) and formicids (ants) can have cross sensitization reactions. That means someone who is allergic to bees can also become allergic to wasps . Multisensitization can happen as well and someone can be allergic to bees, wasps and fire ants. So it may be recommended to get tested to all of these if you have had a reaction to one type of insect.
The testing can be done in the office with a hymenoptera skin test protocol that is safe and reliable. Blood tests may also be required in certain cases.
If you are found to have insect allergy, we can offer venom immunotherapy (allergy shots) to desensitize you so that a bite or sting does not cause a life threatening reaction. Venom immunotherapy (VIT) has been shown to increase both safety and quality of life in people who are allergic. Those who undergo VIT report less anxiety and less lifestyle limitation than those with allergy trying to practice avoidance and anaphylaxis preparedness. VIT is especially recommended in Fire Ant allergy since these creatures are so difficult to avoid in our region.
You would also be prescribed an epinephrine autoinjector in case of a severe allergic reaction. We are here to support you if you know you have an allergy and help you find out if you're not sure.
For more information about insect venom allergy, and tips on avoiding stings, check out these resources: