Preparing for and Avoiding Bee and Wasp Stings

Like most people, I have a healthy respect for bees.  Most of them work hard, pollinating fruit and vegetable crops and making honey.  We love seeing them buzz around from blossom to blossom and then returning to their hives laden with pollen.  And we try to avoid antagonizing them or causing any distress whatsoever.  People who have been stung by bees know it hurts, and the rest of us have enough faith on their words to believe them.

At forty-four years old, I was a brand new beekeeper when I got my first ever bee sting.  A bee somehow got tangled up in the hair on the top of my head.  I tried to free her, without being able to see because I was up in the garden, far away from the house.  Eventually, she became frustrated and chose pain and death.  Pain for me and death for her.  And that's because, as most are aware, when a bee stings, she loses her stinger (honey bees are the only insects to lose their stingers and die).  She may escape and fly a little distance, but death is imminent.  That's the way it is.  However, when that sting happens, the bee sends out pheromones in the process.  That pheromone is a banana-like scent telling other bees in the vicinity that an attack is underway and beckoning all to join in the fight as noble kamikazes.

So a victim may experience multiple stings, but they are from different bees.  And this is why it is critical to teach children, and adults, to leave the area where they were stung immediately. 

For most of us, bee and wasp stings are merely an annoyance and the pain resolves without complications.  For three percent of the population, however, even a single bee sting is life-threatening, and nearly one hundred people die from these stings in the US each year.  Individuals with a known allergy to bee stings should carry an Epi-pen at all times when outdoors.

Unfortunately, these life-threatening anaphylactic reactions aren't always known.  The first bee sting a person has rarely causes an anaphylactic response.  It's a subsequent sting that becomes problematic.  Anaphylactic reactions usually develop within the first hour of a sting.  If someone is suspected to be developing an anaphylactic response, there are a few options if there is no Epi-pen nor medical facilities immediately available.  The first choice is Benadryl, liquid or chewables if they're available, as these get into the bloodstream faster.  Other options are H2 blockers like ranitidine (Zantac) or famotidine (Pepcid).  Oral steroids like prednisone may also help.  The patient will probably need intramuscular injections of epinephrine, antihistamines, and steroids in the hospital. 

Here are some tips from the Centers for Disease Control to reduce the risk of stings:

• Wear light-colored clothing
• Avoid perfume, cologne, scented toiletries, especially anything banana-scented
• Wear clean clothes and bathe daily (Sweat makes bees mad--can't say that I blame them.)
• Cover as much skin as possible
• Avoid flowering plants
• Don't swat at flying insects

When a person is stung by a bee, the first thing to do is to leave the area immediately.  Once a safe distance from the site of the attack, remove the stinger as quickly as possible.  Using a fingernail to scrape it out is actually the preferred method.  Tweezers may actually squeeze any venom remaining in the stinger into the patient.  Also, the longer the stinger remains in the body, the greater the chances for a worse reaction.   Next, wash the area surrounding the sting thoroughly with soap and water.  Ice packs and lidocaine or benzocaine anesthetic ointments will reduce swelling and provide topical relief.

Several hours after the sting it is common to develop a local hypersensitivity reaction.  This is not an infection and the goal is to provide symptomatic relief. 

In addition to the cold packs and anesthetic ointments used right after a sting, any of the following remedies may be used: 

• Benadryl.  An oral medication will offer the best relief, but is not for children under the age of six without first consulting a doctor.  Benadryl cream or spray may be used in children over the age of two years.
• Acetaminophen or ibuprofen for pain.
• Antibiotic ointment to prevent infection.
• Essential oils--lavender, helichrysum, tea tree, peppermint, 1-2 drops on the site, 3 times per day.
• Baking soda paste.
• Activated charcoal paste.

A physician may also treat a severe local reaction with oral steroids like prednisone if available.  Individuals who have a severe reaction, even anaphylaxis, with bee stings and who wish to be better prepared, may consider working with an allergist to reduce their sensitivity.

Wasp stings are similar to bee stings, but at the same time, entirely different.  Unlike bees, wasps do not die when they sting.  Because they have smooth stingers rather than barbed stingers like bees, they can continue to sting away as long as they wish.  Bee venom is acidic; wasp venom is alkaline.  The theory behind a baking soda paste is that the base neutralizes the acid of a bee sting to provide relief.  Based on that, a baking soda paste would not work with a wasp sting. 


For further reading:
https://www.cdc.gov/niosh/topics/insects/beeswasphornets.html
Joseph Alton, The Survival Medicine Handbook, pp 331-332.
Cynthia Koelker, Armageddon Medicine, pp 205-206, 299-301.   

22 april 2020