Field Guide to Venomous and Medically Important Invertebrates ...

Other, extremely rare, responses to hymenopteran stings known to occur include serum sickness,
acute inflammation of the kidneys, and a neurological condition called Guillain-Barré syndrome.
Stings in the mouth or throat also may require immediate medical assistance due to swelling that
can close the airway. Multiple stings in a short period of time may cause systemic symptoms
such as nausea, malaise and fever. Typically, it takes 500 or more honeybee stings to kill an
adult human by the toxic effects of the venom alone.
A patient's reaction to a hymenopteran sting determines the treatment required, if any.
Emergency health personnel should attempt to determine degree of reaction based on both
patient history and a physical examination. People having previously experienced anaphylaxis
from hymenopteran stings, should always carry an Epi-Pen, or similar instrument.
Commercially available kits include antihistamine tablets and syringes preloaded with
epinephrine. Sensitive individuals should also consider wearing a Medic-Alert tag to alert
medical personnel of their allergy in case they lose consciousness. Venom immunotherapy for
sensitive individuals will reduce but not eliminate the risk of anaphylactic reactions. Delayed
reactions to Hymenoptera envenomation are uncommon but usually present as large local
swellings or, rarely, systemic syndromes. The cause of delayed reactions is unclear and may not
always involve immunologic mechanisms. Topical corticosteroids and analgesics and systemic
antihistamines can be used to treat most hymenopteran stings, but anaphylaxis is a medical
emergency requiring immediate medical intervention.
Individuals can practice a number of precautions to avoid stinging hymenopterans. For example,
when outdoors avoid wearing brightly colored floral-pattern clothes, and do not go barefoot in
fields where bees and wasps may be feeding at ground level. To the extent possible and