Bee Stings

Bee stings are one of the unfortunate side effects of beautiful, warm weather, and flowering greenery. For most people, bee stings are merely annoying, but for others, bee stings may be potentially fatal.

• About 2 million people in the United States are allergic to bee stings.
• Three percent of children who are stung will experience allergic reactions.
• In the most severe cases, an allergic reaction to a bee sting can cause anaphylactic shock, requiring treatment with a shot of epinephrine.
• About 100 Americans die every year from bee stings.

Allergic reactions may include:

• Hives
• Itching
• Swelling
• Low blood pressure
• Difficulty breathing
• In the worst cases, anaphylactic shock

Anaphylaxis, also called anaphylactic shock, is a severe and sometimes life-threatening reaction to an allergen. Symptoms may include:

• Tightness or swelling of the throat
• Severe itching of the skin
• Nausea and vomiting
• Stomach pain
• Heart failure
• Irregular heart beats
• Lowered blood pressure

Anaphylactic shock is usually an emergency. If your child is in anaphylactic shock, seek medical attention immediately.

Anaphylactic shock is rare after your child's very first bee sting, even if he or she has an allergy. But if your child does have an allergy, future bee stings will likely cause more severe reactions.

• Only about 1 percent of bee stings result in anaphylactic shock, with it more likely to happen in people over the age of 25. This is because the more an allergic person is stung, the more severe the reactions get.
• Children, who likely have only been stung one or two times, will rarely experience such extreme reactions.

For most people, bee stings are a painful annoyance that passes with some local swelling, minor pain, and redness that disappears within a few hours.

Multiple bee stings are more dangerous in children than they are in adults, as a child's body won't be able to handle as much bee venom.

Any break of the skin, including a bee sting, is susceptible to infection. Avoid scratching the site of the sting.

Allergies are generally hereditary, so an allergic parent should be more cautious with her child, although children will often outgrow their allergy. If a severe reaction occurs, an allergist should be seen as soon as possible. Future stings could result in reactions that are up to 60 percent worse than the first allergic reaction.

There are two types of tests and, unfortunately, neither of them is extremely reliable.

• A blood test, called the RAST test, is the simplest test, but has about 20 percent false-negative, false-positive results.
• The other, more sensitive, test is a scratch test on the skin that is performed with purified, freeze-dried venom. It can alert the patient and doctor to the severity of the allergy, while a blood test will only point to the fact that an allergy exists. Luckily, only about 20 percent of patients with positive skin test results will later experience severe allergic reactions.

Testing for bee sting allergies before a serious reaction has occurred is unnecessary.

• It is often a lengthy process and so few people are actually allergic.
• One should wait until a systemic reaction has occurred before worrying about allergies.
• The first allergic reaction is rarely that bad, but once again, see an allergist if a reaction spreads beyond the sting site.

• Your child should always carry a bee sting kit that includes a bronchodilator epinephrine shot or inhaler, which will dilate the airways and allow your child to breathe.
• Your child should also wear a medical alert bracelet or necklace.

For future bee stings, the most extreme option is venom immunotherapy, wherein the patient receives weekly shots of increasing amounts of bee venom to build up tolerance. It can reduce the chance of future severe reactions from 60 percent to about 5 percent.

For normal reactions, a cold compress and an aspirin or acetaminophen does the trick, and you'll be back out enjoying the sun.

• Avoid brightly colored and flower print clothing will help keep bees away.
• Avoid fragrances or cosmetics with floral scents.
• Always be careful with food and sweet drinks such as soda. Bees will often fly into the can and sting the drinker when he or she takes a sip.
• If you are going into a field where there will likely be bees, wear long pants and shoes that cover your whole foot.
• If there are bees around or on you, don't run. Standing still will keep the bees calm and, most likely, they will fly away without causing harm.

One of the most important things you can do for your child is to recognize whether he or she may have an allergy to bee stings. At Boston Children's, we can help you figure out if your child is at risk, what tests are necessary, what treatments are needed, and how to avoid bee stings in the first place.