Shoo fly!
Author: Sara Rider

Ah, spring! Warm weather (but not too warm), green leaves and blooming plants, and spring break trips and special camps. It’s a great time to live in Texas. Unfortunately, it’s not only people who enjoy the great weather – the flying, crawling, stinging insects that we share our lawns and parks with also think it’s a great time to be outside.

For most of us, insects like fire ants, bees, yellow jackets and wasps are just a nuisance. While their stings may be painful, they are easily remedied with over-the-counter treatments. But for some children – and adults – a sting can be more than an “ouch!” – it can lead to serious and even life-threatening reactions.

One sting and then another
Like many things, the path to a serious reaction from an insect sting begins with the first occurrence. The initial sting from a fire ant, bee, wasp, yellow jacket or hornet “never causes an allergic reaction, but may cause a minor, normal reaction at the site of the sting,” says Tom Smith, M.D., an Austin Diagnostic Clinic board-certified allergist who is also a board-certified pediatrician.

The threat of a more serious reaction begins when someone is stung again – what is called a “repeat sting,” which can happen days, weeks or months later.

“About 10 percent of the time, repeat stings may cause local allergic reactions, some of which may be large in size. They are uncomfortable, but pose no risk,” assures Dr. Smith. But infrequently, less than three percent of the time, a sting can cause a systemic allergic reaction. In these instances, Dr. Smith explains the symptoms go well beyond the reaction at the site of the sting.

“These symptoms may include hives and itching, difficulty breathing, swelling of the throat and tongue, a weak and rapid pulse, nausea, vomiting or diarrhea, dizziness or fainting and loss of consciousness,” clarifies Dr. Smith. “Obviously, some of these can be life-threatening.” If someone has experienced a systemic reaction, the chance of suffering a subsequent systemic reaction after a sting goes up to 30 to 60 percent, he cautions.

If your child has experienced a systemic reaction to a sting, you should consider reducing the risk of a more serious future reaction by beginning a program of allergy shots to reduce your child’s allergic reaction to the venom. Children who have had a systemic reaction to an insect sting in the past should always carry two doses of epinephrine with them and wear a MedicAlert bracelet, suggests Dr. Smith.

Safe at school and camp
If your child has had a systemic reaction to insect stings, it’s important that the staff at your child’s school and/or camp knows about the allergy.

“The caregivers and staff need to know that the child is allergic,” warns Dr. Smith.

“The two doses of epinephrine, (commonly sold as EpiPens or EpiPen Jrs.) should be kept with the child, not in the nurse’s office or first aid station. School staff and camp counselors need to know when and how to administer epinephrine and what to do afterward.” Epinephrine should also be available in the nurse’s office or first aid station for the safety of children who may experience their first systemic allergic reaction to an insect sting.

Dr. Smith also advises that if a child has severe allergies, “he or she should never be alone when hiking, boating, swimming, golfing or involved in other outdoor activities, because the child may need prompt medical attention if stung.”

Avoiding bites and stings
While knowing how to treat an allergic reaction can be a true lifesaver, knowing how to help your children avoid ever getting stung in the first place is also important. To reduce the risk of your children being bitten or stung, Dr. Smith recommends teaching them how to recognize insect nests and mounds.

“Children need to learn to recognize insect nests and avoid them,” explains Dr. Smith. Children should be aware that other insects – like certain fuzzy caterpillars – can also cause a painful sting, though not a systemic reaction. “The puss, or asp, caterpillar is completely covered with gray to brown hairs,” he describes. “Under the soft hairs are stiff spines that are attached to poison glands. Their sting can cause intense pain and may cause local tissue damage.”

Dressing appropriately for the outdoors can also reduce your likelihood of being stung, or having a bad encounter with a caterpillar. But some of the recommendations will not be too popular with flip-flop loving children and teens.

“Always wear shoes and socks when outdoors,” advises Dr. Smith, “and also wear long-sleeved shirts and long pants in wooded and rural areas.” Since perfumes and bright colors tend to attract insects, Dr. Smith advises avoiding both of these.

Outdoor behavior
Sometimes when a bee or yellow jacket starts buzzing around your head, the first thing you want to do is swat at it. Instead, Dr. Smith suggests you “gently brush it aside or patiently wait for it to leave.” And avoid that open can of Coke or Dr Pepper; stinging insects are attracted by sweet beverages and can crawl inside the can, which can lead to an unhappy surprise for both you and the bee or wasp. You can also reduce the number of stinging insects around your home, “if you spray garbage cans regularly with insecticide and keep the cans covered.”

According to the American College of Allergy Asthma and Immunology (ACAAI), an estimated two million Americans are allergic to insect stings, and many of these individuals are at risk of suffering life-threatening reactions to insect venom. The ACAAI reports that insect stings send more than 500,000 Americans to hospital emergency rooms every year.

But with some education, simple precautions and awareness of what the risks can be, you can reduce the chances that you or your children will have to interrupt a warm spring day with an unanticipated trip to the ER.

Sara Rider is a native Austinite who has worked with physicians and hospitals throughout Texas. She frequently writes freelance articles on health topics for newspapers and magazines

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