Bee Sting

Four different types of reactions can occur to bee stings. The first and most common is an ordinary local inflammatory reaction at the site of the sting. Redness, warmth, pain, and swelling occur around the sting, rarely exceeding two or three inches. These usually cause problems only if they occur in an especially sensitive site, such as near the eye.

Occasionally, local reactions are larger, involving, for instance, a whole limb, but are essentially of the same nature as a smaller local reaction and are not life-threatening.

A "delayed" reaction is one which occurs four or more hours, sometimes several days, after the sting and may involve a variety of symptoms including joint pain, rash, and fever. These are due to overreaction by the immune system to the sting,

Sometimes, in response to a large number of bee stings, a toxic reaction can occur, characterized by nausea and vomiting and sometimes fever and pain. This is a direct effect of the bee venom and does not involve the immune system.

The fourth and most serious reaction fortunately occurs rarely, but can, in allergic individuals, cause death from a single sting. This reaction, called anaphylaxis, involves rapid swelling, wheezing, shortness of breath, and circulatory collapse. It is a medical emergency and must be treated immediately with epinephrine.

Bee stings can occur any time and place that bees are active. In general, bees are active when the temperature is above freezing. Bees are most often found in wooded areas in the spring, summer, and fall but may also live in more settled areas. Bees and wasps like to build their nests around trees and other brush but may also do so on the eaves of houses.

If you know that bees, wasps, or their nests are in an area, try to avoid them. Avoid actions that agitate or irritate a group of bees or wasps in or around their nests.

Most people feel a bee sting and often even see the bees or wasps that sting them.

For local reactions, ice compresses can help relieve the swelling and pain. Over-the-counter medicines such as ibuprofen or acetaminophen can also help. In the case of an anaphylactic reaction, epinephrine needs to be given as a shot. Those who know they are allergic to bee stings may need to carry a dose of epinephrine when they participate in outdoor activities where bees may be present.

Toxic reactions can be managed by treating the symptoms, and generally improve on their own. Delayed-type reactions can benefit from anti-inflammatory medications.

Epinephrine is a very powerful drug and can cause a change in the regular beat of the heart, called arrhythmias. This drug can also result in a decreased blood flow and can raise blood pressure. If epinephrine is needed for an anaphylactic reaction, the affected person should seek emergency care as soon as possible after the bee sting.

In most people, the swelling and redness at the injury site will resolve within a week. There may be times when the site becomes itchy, but the person should try to avoid scratching. No unusual side effects should occur after this.