FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

EPINEPHRINE COULD SAVE SON'S LIFE IF HE'S STUNG BY A BEE AGAIN

Question: I was working in my back yard and got stung by a wasp on the back of my hand. I didn't have a serious reaction, but I'm concerned about my son who has had to go to the hospital because of a bee sting reaction. Do you have any suggestions that can help prevent bee stings?

Answer: About 20 percent of the population has antibodies against bee venom. This means that their immune system is already prepared to put up a furious fight if they are stung by a bee again. For about one percent of the population, the reaction is so intense that a bee sting can cause a serious -- sometimes fatal -- allergic reaction. In these people, a sting may result in major swelling, difficulty in breathing, and even life-threatening shock. In fact, about 50 people die each year in the U.S. because of reactions to bee stings. Fortunately, however, in most people bee stings do not present a major medical problem. They produce a small amount of redness and swelling at the sting site with some associated itching or discomfort. Usually, these annoying but mild reactions clear up by themselves in a matter of hours or perhaps as long as a day. I assume that you had a mild reaction like this.

Bee sting reactions are like many conditions in that the first step in treatment is avoidance of the sting in the first place. So, here are some things you can do to minimize the chances of being stung. First of all, avoid wearing flashy clothing and shiny jewelry that attract bees and other flying insects. Also, don't use perfumes and scented soaps and lotions when you are going outdoors. One very obvious precaution is to avoid going barefoot or wearing open-toed shoes when walking in grass or in the woods.

When you picnic, make sure to seal all food in plastic or other suitable containers until it's needed. This will reduce the number of bees that seek to join your meal. When you are finished eating, dispose of food waste either by burying it or resealing it until you get home. This will remove the incentive for bees and wasps to visit the picnic area and, thereby, make your next visit more pleasant.

If the bees come to your picnic or come around you when you are working in your yard, don't aggravate them. Don't try to chase them away or frantically shake and swat at them if they land on you. Hold still and wait for them to fly off you, or blow at them -- but don't swat! I know this is hard to do, but it will probably keep you from getting stung. Conversely, if several bees sting you, run as far away from the scene as quickly as you can. This is because stinging releases a chemical into the air that attracts other bees and tells them that one of their colleagues needs help in defending against an invader. That's you! Avoiding additional stings is important, because the more stings you receive, the greater the chance that you'll develop a severe reaction.

In spite of your efforts to avoid getting stung, you may still have that undesired encounter with one of these stinging pests. If you or somebody you're with is stung by a bee and begins to have a reaction that is more than redness and discomfort at the site of the sting, get to an emergency room right away. Time is of the essence because, unless a drug like epinephrine is administered promptly, the person's symptoms can quickly get worse.

I recommend that anyone who has previously had a serious reaction to bee stings, like your son, keep the drug epinephrine on hand because a shot of this medicine can reverse the life-threatening effects of what doctors call an "anaphylactic reaction" to a bee sting. It will help open the breathing passageways and keep the blood pressure up to a near normal level. This is a prescription medicine, so ask your doctor if you should have epinephrine in your first aid kit and if your son should carry an injectable dose with him when he's away from the house.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.