Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

feeling fine

feeling fine

Taking the sting out of severe insect allergies

Sonia was out shopping for her bridal gown on a sweltering summer day. She stopped on the sidewalk to throw away her smoothie cup. Buzzing around the trash bin was a yellow jacket that stung her on the arm.

Within 15 minutes Sonia was covered in hives from head to toe. She began coughing and became short of breath and lightheaded.

Luckily she was with a friend who is a pharmacist. She quickly ran into a drugstore and gave Sonia a dose of Benadryl and a puff of her own rescue inhaler.

Sonia is among the 3 percent of American adults who suffer a systemic allergic reaction to stinging insects. Fifty deaths occur every year from such reactions. Most occur in adults and in those without a prior history of a stinging insect reaction.

Having hay fever, food allergies or allergic asthma puts you at no higher risk than average of what are known as venom allergies. Nor does having a family member with a stinging insect allergy mean you're more likely to have one.

Stinging insects are found in many places. Generally honeybees nest in hollow trees. Yellow jackets scavenge for food, often around trash cans and Dumpsters. Hornets create nests that may hang from soffits of roofs. Wasps' nests look like honeycombs and are usually found on roof overhangs, behind shutters or in dryer vents. Fire ants are found throughout the Southeast and create underground nests with those tell-tale sandy mounds. Their stings are usually in a semi-circular pattern and often lead to pustules.

Everyone who gets stung by a bee, wasp , yellow-jacket, hornet or fire ant will experience pain, itching, redness, and swelling, normal reactions to the chemical properties of the venom. If there's just a sting or two, symptoms generally subside in an hour or so, longer if there are more stings.

Less common is a larger area of swelling that can extend to involve the nearest joint. Children that experience diffuse skin symptoms far away from the sting site — such as hives — need to be evaluated by an allergist. But rarely are they likely to develop a life-threatening reaction to a future sting.

Symptoms of a systemic allergic response can include:

1 Skin involvement: Hives, flushing, swelling.

2 Respiratory involvement: Difficulty breathing, coughing, wheezing, shortness of breath, chest tightness.

3Cardiovascular involvement: Chest pain, dizziness, low blood pressure, fainting.

4Gastrointestinal involvement: Nausea, vomiting, diarrhea, abdominal cramping.

Symptoms will usually occur within minutes of a sting and may include all or only a few of the above symptoms. Skin symptoms are, by far, the most common symptoms but rarely occur alone in allergic patients.

Acute systemic symptoms should be treated with Benadryl. Systemic symptoms involving the respiratory or cardiovascular tract require immediate emergency care and require injectable epinephrine.

Ice packs and analgesics, like Tylenol or ibuprofen, also help with pain and swelling.

Any symptoms other than just localized swelling and pain should be evaluated by an allergist to identify a true allergy to venom. This may involve a basic evaluation, as well as skin testing if appropriate

Once a venom allergy is identified, patients can learn how to avoid situations where they might be stung. Since not all stings can be prevented, they also should carry an injectable epinephrine device (commonly known as an Epi-Pen) and know when and how to use it. An identification bracelet or tag that can make others aware of this allergy is also a good idea.

Venom immunotherapy — monthly allergy shots — is the best way to prevent a life threatening reaction in allergic patients.

Sonia was skin-tested and was found to be allergic to wasp venom only. She carries an Epi-pen and is very cautious to avoid further stings. She will likely begin immunotherapy as soon as the allergist in her family can convince her to start.

I'm working on her now — she's my sister.

Dr. Mona V. Mangat is a board-certified allergist and immunologist in St. Petersburg at Bay Area Allergy & Asthma. You can find her at

Taking the sting out of severe insect allergies 05/17/13 [Last modified: Thursday, May 16, 2013 12:08pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Trump condemns killing of pair who tried to stop racist rant


    President Donald Trump on Monday condemned the fatal stabbing of two good Samaritans trying to help a pair of young women targeted by an anti-Muslim tirade on a Portland, Ore., light rail train.

    Coco Douglas, 8, leaves a handmade sign and rocks she painted at a memorial in Portland, Ore., on Saturday for two bystanders who were stabbed to death Friday while trying to stop a man who was yelling anti-Muslim slurs and acting aggressively toward two young women. From left are Coco's brother, Desmond Douglas; her father, Christopher Douglas; and her stepmother, Angel Sauls. [Associated Press]
  2. What major sporting event could Tampa Bay land next?

    Lightning Strikes

    We are on quite a roll as a community. First, we had a Super Bowl drop from the storm clouds into our lap. It just reaffirms the fact that Tampa Bay is great at lap. And Monday it became official: Next year's NHL All-Star Game will be held at Amalie Arena. The best in the world will be here to shoot and score. And …

    MVP Wayne Gretzky is congratulated at the 1999 NHL All-Star game, the last time the event was in Tampa Bay. [DIRK SHADD   |   Times file]
  3. How the 2018 NHL All-Star Game reflects Jeff Vinik's vision for Tampa

    Lightning Strikes

    TAMPA — There were several reasons the NHL announced Monday that Tampa will host the 2018 All-Star Game on Jan. 28.

    This was the  logo for the 1999 NHL All-Star game played Sunday, Jan 24, 1999 at the Ice Palace in Tampa Bay. (AP Photo)
  4. Photo gallery: Nation pays respects to America's war dead on Memorial Day

    Human Interest

    At Memorial Day ceremonies in Tampa Bay area and around the country, Americans paid tribute to the men and women who gave their lives in service to their country.

    Eight-year-old Piper St. Jean, of Tampa, uses a brush to clean the grave of her grandfather, Henry St. Jean, who served with the United States Air Force during the Korean and Vietnam wars. at Curlew Hills Memory Gardens on Monday moments after the conclusion of their 31st annual Memorial Day Service on Monday (5/23/17) in Palm Harbor. The event featured guest speakers, live choral performances by the Palm Harbor United Methodist Church choir and live music by Bones South, an area trombone ensemble with rhythm section. On Saturday local Boy Scout and Girl Scout troops placed flags on veterans???‚??„? graves prior to the event. This is an annual tradition of Curlew Hills' Memorial Day services and helps the Scout troops achieve merit badges. The event is free and the public is invited to attend.
  5. Protest sparks Texas lawmaker threats of gun violence


    AUSTIN, Texas — Hundreds of protesters opposing Texas' tough new anti-"sanctuary cities" law launched a raucous demonstration from the public gallery in the Texas House on Monday, briefly halting work and prompting lawmakers on the floor below to scuffle — and even threaten gun violence — as tense …