Table of ContentsView AllTable of ContentsOverviewSigns and SymptomsInsects That Cause Venom AllergiesPreventionAllergy TestingSting TreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Overview
Signs and Symptoms
Insects That Cause Venom Allergies
Prevention
Allergy Testing
Sting Treatment
Frequently Asked Questions
While some people have mild reactions to insect bites or stings, others are highly allergic and developanaphylaxis, which can be fatal. Around 5% of all people will have a severe allergic reaction to a sting, so it’s good to be prepared just in case.
This article covers the signs and symptoms of allergic reactions to flying insect stings along with how they are treated. It also breaks down the types of stinging insects you are most likely to come across.
Verywell / Cindy Chung
When an insect stings, it uses its stinger to inject venom into your skin. That venom contains proteins, which trigger pain, swelling, redness, and itching around the sting area.
For most people, these mild symptoms stay contained to the sting area. But for people who are allergic to the venom, theirimmune systemreaction can becomesystemic. In other words, it can affect other systems in the body, such as the respiratory system, making it hard to breathe.
According to the American College of Allergy, Asthma & Immunology (ACAAI), the number of people who have allergies to insect stings is on the rise.
Each year, thousands of people seek medical care for severe reactions to flying insect stings. What’s more, the ACAAI reports that about between 90 and 100 people die from insect sting anaphylaxis each year.
Anyone can have a severe allergic reaction to an insect sting. Those who have already had a severe reaction to a sting are at higher risk of a life-threatening reaction if they are stung again.
For someone who is allergic to insect venom, anaphylaxis can develop within minutes to hours after the sting. During ananaphylacticreaction, any or all of the following symptoms can occur:
When to Seek Medical AttentionCall 911 at the first sign of anaphylaxis. Don’t wait for symptoms to get worse. If you have an EpiPen or AUVI-Q, inject it right away, then go to the hospital. Anaphylaxis can return, so you will still need to be monitored.
When to Seek Medical Attention
Call 911 at the first sign of anaphylaxis. Don’t wait for symptoms to get worse. If you have an EpiPen or AUVI-Q, inject it right away, then go to the hospital. Anaphylaxis can return, so you will still need to be monitored.
How to Safely Use an EpiPen
Bees are some of the more well known flying insects that sting. But they aren’t the only ones. Yellow jackets, hornets, wasps, and fire ants are also known to cause allergic reactions with their stings. These, along with bees, all belong to the insect orderHymenoptera.
Knowing which bugs can cause anaphylaxis and what those bugs' habits are can help you avoid them.
Honeybees
Honeybees prefer to nest in tree hollows, logs, or buildings. They don’t tend to be aggressive when they are away from their hive. They are much more likely to attack when they feel their hive is under threat.
Honeybees collect nectar from all kinds of plants. One of their favorites seems to be clover. This explains why people often get stung while walking barefoot through a lawn filled with clover.
One thing to note is that honeybees are the only stinging insect that routinely leaves a stinger in their victim’s skin. Other insects can too, but it’s far less common.
There are many different ways toremove a stinger. But the best way to remove it is the one you can do the fastest, within 30 seconds. The longer the stinger is in the skin, the more venom it can inject.
Aside from staying away from honeybee hives, one of the best ways to avoid their stings is to wear full-length pants and shoes that cover your whole foot when you walk outside.
Africanized (Killer) Honeybees
Killer honeybees live in small colonies, which means they can (and will) nest just about anywhere. They have been known to build hives in tires, flower pots, barbecue grills, mailboxes, and any other cavity they can find.
Killer honeybees are far more aggressive than normal honeybees, but their venom is not so different.So if you are allergic to honeybees, you will also be allergic to killer honeybees.
Killer honeybees come with a distinct risk, though. They tend to sting in groups of hundreds or more, making the chances of a lethal attack that much greater.
According to the U.S. National Park Service, if a colony of killer bees thinks you are a threat, they will send a few bees to “head butt” you as a warning before the full hive attacks.
If you notice a few bees hovering, don’t flail your arms and don’t try to fight them off. Killing a bee causes them to release a scent that warns their hive and attracts other bees.
Killer honeybees target your eyes, nose, and mouth when attacking. The best thing you can do in an attack is cover your head with your shirt or jacket and run.
Bumblebees
Bumblebees rarely sting people. They are not aggressive and typically mild-mannered. They will sting if provoked or if their nest is disturbed. But they are so loud and slow that a person usually has plenty of time to escape.
Bumblebees feed on insects and flower nectar. They nest on the ground, or in piles of grass clippings or wood. Once again, if you are walking around outdoors, make sure to wear shoes.
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Yellow Jackets
Yellow jacketslive in mounds built into the ground and tend to be aggressive. They are a common bother at picnics where there are lots of sugary drinks and food. You might also find them near trash cans.
Hornets
Unlike honeybees, hornets will not leave their stinger in you. That means they can sting you multiple times. Hornets also aim for the eyes, so your best defense is to cover your face and run.
Wasps
Wasps build honeycomb nests under the eaves of a house, or in a tree, shrub or under patio furniture. They tend to be less aggressive than yellow jackets and hornets, and mostly feed on insects and flower nectar.
RecapFlying insects have slightly different preferences for where they build their hives. They are most likely to attack when they feel their hive is under threat, but some (like hornets) can be more aggressive. If they attack you, your best defense is to run.
Recap
Flying insects have slightly different preferences for where they build their hives. They are most likely to attack when they feel their hive is under threat, but some (like hornets) can be more aggressive. If they attack you, your best defense is to run.
Put simply, the best way to prevent an allergic reaction is to avoid being stung. Here are a few tips:
There are two ways to test for insect allergy:skin testingand blood testing (serum allergen specific IgE testing).
Skin testing is typically the go-to method. It’s the most reliable way to test for allergens and similar to testing for pollen or pet allergies. However, you might be given a blood test if you have a skin condition or take a medication that would interfere with the skin test.
For the skin test, a healthcare provider will place a small drop of insect venom just under the surface of your skin. You will feel a little prick when this happens. Then, after about 15 minutes, the provider will check for redness, hives, or other signs of a reaction.
A blood test works a little differently. Whereas a skin test looks for your skin’s reaction to the venom, a blood test measures theantibodiesyour body makes in response to the venom.
For the blood test, a lab technician draws a sample of your blood. Then, at a testing lab, the allergen in question is added to your blood sample and the amount of antibodies your blood produces to attack the allergen is measured.
Studies show that most people can’t identify which type of insect stung them. So, allergists usually test for all stinging insects, from bees to wasps and more.
Who Should Be Tested
Someone who has a large local reaction (such as swelling at the sting site), without signs of anaphylaxis, usually doesn’t need venom testing.
There are two min scenarios in which you should be tested for insect allergy: you have previously had symptoms of anaphylaxis after a sting. Or, you have a high risk of getting stung, for example, if you are a beekeeper.
If you have had anaphylaxis symptoms after being stung, there is a 30% to 60% chance that you will have a similar (or worse) reaction to an insect sting in the future.
Treatment for venom allergy involves managing allergic reactions when they occur, and preventing them in the future.
Immediate Treatment of Acute Reactions
When it comes treating anaphylaxis in the moments after a sting, epinephrine is the treatment of choice.
Epinephrine is the drug form of the hormone adrenaline. Your body produces this hormone on its own. Injecting epinephrine in an allergic emergency reverses the symptoms of anaphylaxis. It increases blood flow, opens your airways, and more.
People with a known venom allergy are encouraged to carry a self-injectable form of epinephrine, such as an Epi-Pen or AUVI-Q, or an epinephrine nasal spray, such as Neffy. Since anaphylaxis can return after usage, you will still need to call 911 or go to an emergency room right away.
When itching or hives are your only symptoms, anoral antihistaminemay be all you need. Since a mild allergic reaction can rapidly progress to anaphylaxis, you should still get to the hospital if you suspect you are having an allergic reaction.
Any time a stinger is left in your skin, it should be quickly removed. Do not squeeze the stinger or skin around it. Instead, scrape the stinger out with the edge of a credit card. Put ice or a cold compress at the sting site to reduce local swelling.
Treatment of Future Reactions
The only way to fully prevent reactions to insect stings is to avoid being around stinging insects. Granted, this is easier said than done, especially for people who work or live near them.
The first-line treatment for insect allergy is venom immunotherapy (VIT). Theseallergy shotscontain purified venom from the type of insect to which a person is allergic. They are given in much the same way as pollen allergy shots, generally over the course of four to six months.
Once a person starts venom allergy shots, their chance of a reaction from future stings is reduced to less than 5%. After taking allergy shots for at least three to five years, most people can stop taking shots without any major increase in their chances of having an allergic reaction.
There are some cases in which a person will need to take venom allergy shots for the rest of their life. This includes people who have severe, life-threatening reactions from insect stings, and those who have had anaphylaxis from the venom allergy shots themselves.
VIT is widely considered safe and effective. Still, there is a small chance that a person could have an allergic reaction to the shots themselves. Reactions to VIT are usually mild and contained to the injection site. As of 2017, no deaths due to VIT-induced anaphylaxis have been reported.
For those with severe allergies who have a higher risk of getting stung,rush immunotherapy(RIT) should be considered. RIT works similarly to VIT. But whereas VIT shots are spread out over the course of several months, RIT shots are condensed into a program that lasts four to six weeks.
RIT does come with an increased risk of allergic reactions. But it can also get a venom allergy under control much faster than VIT. These are factors you will need to discuss with your allergist.
After Allergy Shots for Bee Allergy
Studies suggest that many children who begin allergy shots for bee stings do not complete their therapy.
For this reason, some allergists order venom allergy tests after venom immunotherapy has been given for a period of time. This is to ensure that the full course of therapy has been done and the allergy is under control.
Allergy shots can reduce the chances of a life-threatening allergic reaction in the future. But in order for this to happen, the full course oftreatmentneeds to be completed.
RecapDuring an allergic reaction, an EpiPEn or AUVI-Q can reverse anaphylaxis symptoms. Even when the shot is taken, it’s still important to get to the hospital for observation in case anaphylaxis returns. For prevention, venom immunotherapy can reduce and even cure the insect allergy.
During an allergic reaction, an EpiPEn or AUVI-Q can reverse anaphylaxis symptoms. Even when the shot is taken, it’s still important to get to the hospital for observation in case anaphylaxis returns. For prevention, venom immunotherapy can reduce and even cure the insect allergy.
Summary
The only surefire way to prevent getting stung is to avoid stinging insects completely. But since stings can’t always be prevented, you should still be prepared if you encounter one. Remember, your best defense is to cover your face and run.
Whether you have a known insect allergy or not, you should also know the symptoms of anaphylaxis and what to do if it occurs. The moment you notice symptoms starting, call 911 and use your EpiPen or AUVI-Q if you have one.
Most people with mild reactions will not need allergy shots. But if you have a severe insect allergy or have a high risk of getting stung, ask your allergist if venom immunotherapy is right for you.
Most fatalities due to bee sting allergy occur in those who do not have a known allergy.Everyoneshould be familiar with thesigns and symptoms of anaphylaxisand how to contact emergency help if needed.
A Word From Verywell
All people with a history of allergic reactions to insect stings should have someform of medical alert. This could be a bracelet, wallet card, or scroll I.D. that states their medical condition. It should also state that they have an injectable form of epinephrine on them that needs to be used.
If you have an EpiPen, you should carry it with you wherever you go. The Transportation Security Administration (TSA) generally allows you to carry your EpiPen with you in your carry-on if you fly, but check ahead to make sure.
Frequently Asked QuestionsMinor swelling, redness, burning, and pain at the sting site is normal and can last up to a week. Call 911 if you develop any signs of anaphylaxis, even if it’s just one or two symptoms. You should also call 911 if there are multiple stings.Allergic reactions can start within minutes to hours after a sting. You will know you are allergic if you develop itching, hives, or swelling that goes beyond the sting site. Systemic symptoms, like trouble breathing, are a sign of anaphylaxis that require immediate medical attention.It is possible to outgrow a bee sting allergy, but it doesn’t happen for everyone. Allergy shots, known as venom immunotherapy, are a safe and effective treatment for insect allergy that may even cure it.
Minor swelling, redness, burning, and pain at the sting site is normal and can last up to a week. Call 911 if you develop any signs of anaphylaxis, even if it’s just one or two symptoms. You should also call 911 if there are multiple stings.
Allergic reactions can start within minutes to hours after a sting. You will know you are allergic if you develop itching, hives, or swelling that goes beyond the sting site. Systemic symptoms, like trouble breathing, are a sign of anaphylaxis that require immediate medical attention.
It is possible to outgrow a bee sting allergy, but it doesn’t happen for everyone. Allergy shots, known as venom immunotherapy, are a safe and effective treatment for insect allergy that may even cure it.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ludman SW, Boyle RJ.Stinging insect allergy: current perspectives on venom immunotherapy.J Asthma Allergy. 2015;8(1):75–86. doi:10.2147/JAA.S62288Golden DB.Advances in diagnosis and management of insect sting allergy.Ann Allergy Asthma Immunol. 2013;111(2):84-89. doi:10.1016/j.anai.2013.05.026American College of Allergy, Asthma & Immunology.Insect sting allergy.Golden DB, Demain J, Freeman T, et al.Stinging insect hypersensitivity: A practice parameter.Ann Allergy Asthma Immunol. 2017;118(1):28-54. doi:10.1016/j.anai.2016.10.031American College of Allergy, Asthma and Immunology.Anaphylaxis.American Academy of Allergy Asthma & Immunology.Stinging insect allergy.U.S. Department of the Interior. National Park Service.Africanized honey bees.Mount Sinai.Allergy testing - skin.Pucci S, D’Alò S, De Pasquale T, Illuminati I, Makri E, Incorvaia C.Risk of anaphylaxis in patients with large local reactions to hymenoptera stings: a retrospective and prospective study.Clin Mol Allergy. 2015;13(1):21. doi:10.1186/s12948-015-0030-zKołaczek A, Skorupa D, Antczak-Marczak M, Kuna P, Kupczyk M.Safety and efficacy of venom immunotherapy: a real life study.Postepy Dermatol Alergol. 2017;34(2):159-167. doi:10.5114/ada.2017.67082UT Southwestern Medical Center.Faster relief for tough allergy symptoms.Fiedler C, Miehe U, Treudler R, Kiess W, Prenzel F.Long-term follow-up of children after venom immunotherapy: Low adherence to anaphylaxis guidelines.Int Arch Allergy Immunol. 2017;172(3):167-172. doi:10.1159/000458707Additional ReadingJameson JL, Fauci AS, Kasper DL et al.Harrison’s Principles of Internal Medicine, 20th Ed. McGraw-Hill Education.Vachová M, Panzner P, Malkusová I, Hanzlíková J, Vlas T.Utility of laboratory testing for the diagnosis of Hymenoptera venom allergy.Allergy Asthma Proc.2016;37(3):248-55. doi:10.2500/aap.2016.37.3934
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ludman SW, Boyle RJ.Stinging insect allergy: current perspectives on venom immunotherapy.J Asthma Allergy. 2015;8(1):75–86. doi:10.2147/JAA.S62288Golden DB.Advances in diagnosis and management of insect sting allergy.Ann Allergy Asthma Immunol. 2013;111(2):84-89. doi:10.1016/j.anai.2013.05.026American College of Allergy, Asthma & Immunology.Insect sting allergy.Golden DB, Demain J, Freeman T, et al.Stinging insect hypersensitivity: A practice parameter.Ann Allergy Asthma Immunol. 2017;118(1):28-54. doi:10.1016/j.anai.2016.10.031American College of Allergy, Asthma and Immunology.Anaphylaxis.American Academy of Allergy Asthma & Immunology.Stinging insect allergy.U.S. Department of the Interior. National Park Service.Africanized honey bees.Mount Sinai.Allergy testing - skin.Pucci S, D’Alò S, De Pasquale T, Illuminati I, Makri E, Incorvaia C.Risk of anaphylaxis in patients with large local reactions to hymenoptera stings: a retrospective and prospective study.Clin Mol Allergy. 2015;13(1):21. doi:10.1186/s12948-015-0030-zKołaczek A, Skorupa D, Antczak-Marczak M, Kuna P, Kupczyk M.Safety and efficacy of venom immunotherapy: a real life study.Postepy Dermatol Alergol. 2017;34(2):159-167. doi:10.5114/ada.2017.67082UT Southwestern Medical Center.Faster relief for tough allergy symptoms.Fiedler C, Miehe U, Treudler R, Kiess W, Prenzel F.Long-term follow-up of children after venom immunotherapy: Low adherence to anaphylaxis guidelines.Int Arch Allergy Immunol. 2017;172(3):167-172. doi:10.1159/000458707Additional ReadingJameson JL, Fauci AS, Kasper DL et al.Harrison’s Principles of Internal Medicine, 20th Ed. McGraw-Hill Education.Vachová M, Panzner P, Malkusová I, Hanzlíková J, Vlas T.Utility of laboratory testing for the diagnosis of Hymenoptera venom allergy.Allergy Asthma Proc.2016;37(3):248-55. doi:10.2500/aap.2016.37.3934
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ludman SW, Boyle RJ.Stinging insect allergy: current perspectives on venom immunotherapy.J Asthma Allergy. 2015;8(1):75–86. doi:10.2147/JAA.S62288Golden DB.Advances in diagnosis and management of insect sting allergy.Ann Allergy Asthma Immunol. 2013;111(2):84-89. doi:10.1016/j.anai.2013.05.026American College of Allergy, Asthma & Immunology.Insect sting allergy.Golden DB, Demain J, Freeman T, et al.Stinging insect hypersensitivity: A practice parameter.Ann Allergy Asthma Immunol. 2017;118(1):28-54. doi:10.1016/j.anai.2016.10.031American College of Allergy, Asthma and Immunology.Anaphylaxis.American Academy of Allergy Asthma & Immunology.Stinging insect allergy.U.S. Department of the Interior. National Park Service.Africanized honey bees.Mount Sinai.Allergy testing - skin.Pucci S, D’Alò S, De Pasquale T, Illuminati I, Makri E, Incorvaia C.Risk of anaphylaxis in patients with large local reactions to hymenoptera stings: a retrospective and prospective study.Clin Mol Allergy. 2015;13(1):21. doi:10.1186/s12948-015-0030-zKołaczek A, Skorupa D, Antczak-Marczak M, Kuna P, Kupczyk M.Safety and efficacy of venom immunotherapy: a real life study.Postepy Dermatol Alergol. 2017;34(2):159-167. doi:10.5114/ada.2017.67082UT Southwestern Medical Center.Faster relief for tough allergy symptoms.Fiedler C, Miehe U, Treudler R, Kiess W, Prenzel F.Long-term follow-up of children after venom immunotherapy: Low adherence to anaphylaxis guidelines.Int Arch Allergy Immunol. 2017;172(3):167-172. doi:10.1159/000458707
Ludman SW, Boyle RJ.Stinging insect allergy: current perspectives on venom immunotherapy.J Asthma Allergy. 2015;8(1):75–86. doi:10.2147/JAA.S62288
Golden DB.Advances in diagnosis and management of insect sting allergy.Ann Allergy Asthma Immunol. 2013;111(2):84-89. doi:10.1016/j.anai.2013.05.026
American College of Allergy, Asthma & Immunology.Insect sting allergy.
Golden DB, Demain J, Freeman T, et al.Stinging insect hypersensitivity: A practice parameter.Ann Allergy Asthma Immunol. 2017;118(1):28-54. doi:10.1016/j.anai.2016.10.031
American College of Allergy, Asthma and Immunology.Anaphylaxis.
American Academy of Allergy Asthma & Immunology.Stinging insect allergy.
U.S. Department of the Interior. National Park Service.Africanized honey bees.
Mount Sinai.Allergy testing - skin.
Pucci S, D’Alò S, De Pasquale T, Illuminati I, Makri E, Incorvaia C.Risk of anaphylaxis in patients with large local reactions to hymenoptera stings: a retrospective and prospective study.Clin Mol Allergy. 2015;13(1):21. doi:10.1186/s12948-015-0030-z
Kołaczek A, Skorupa D, Antczak-Marczak M, Kuna P, Kupczyk M.Safety and efficacy of venom immunotherapy: a real life study.Postepy Dermatol Alergol. 2017;34(2):159-167. doi:10.5114/ada.2017.67082
UT Southwestern Medical Center.Faster relief for tough allergy symptoms.
Fiedler C, Miehe U, Treudler R, Kiess W, Prenzel F.Long-term follow-up of children after venom immunotherapy: Low adherence to anaphylaxis guidelines.Int Arch Allergy Immunol. 2017;172(3):167-172. doi:10.1159/000458707
Jameson JL, Fauci AS, Kasper DL et al.Harrison’s Principles of Internal Medicine, 20th Ed. McGraw-Hill Education.Vachová M, Panzner P, Malkusová I, Hanzlíková J, Vlas T.Utility of laboratory testing for the diagnosis of Hymenoptera venom allergy.Allergy Asthma Proc.2016;37(3):248-55. doi:10.2500/aap.2016.37.3934
Jameson JL, Fauci AS, Kasper DL et al.Harrison’s Principles of Internal Medicine, 20th Ed. McGraw-Hill Education.
Vachová M, Panzner P, Malkusová I, Hanzlíková J, Vlas T.Utility of laboratory testing for the diagnosis of Hymenoptera venom allergy.Allergy Asthma Proc.2016;37(3):248-55. doi:10.2500/aap.2016.37.3934
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