By Pediatric Alliance — Allergy, Asthma and Immunology Division



Most of us develop redness and swelling at the site of an insect bite. Yet people who are allergic to stinging insect venom are at risk for a much more serious reaction. This life-threatening reaction is called anaphylaxis (an-a-fi-LAK-sis).

Dr. Sergei Belenky of the Division of Allergy, Asthma and Immunology of Pediatric Alliance states, “Understanding differences in symptoms between a normal reaction and an allergic reaction can bring peace of mind. It is also important to have an accurate diagnosis so you can manage your condition and be prepared for an emergency.”

An allergic reaction occurs when the immune system overreacts to an allergen. In stinging insect allergy, the allergen is venom from a sting. Most serious reactions are caused by five types of insects:

•    Yellow jackets are black with yellow markings, found in various climates. Their nests are usually located underground, but sometimes found in the walls of buildings, cracks in masonry or in woodpiles.
•    Honeybees have round, fuzzy bodies with dark brown and yellow markings. They can be found in honeycombs in trees, old tires or other partially protected sites.
•    Paper wasps are slender with black, brown, red and yellow markings. They live in a circular comb under eaves, behind shutters or in shrubs and woodpiles.
•    Hornets are black or brown with white, orange or yellow markings. Their nests are gray or brown and are usually found in trees.
•    Fire ants are reddish-brown ants living in large mounds, mostly in warmer climates. They are not found in our geographic area but are found in southern states. They attack with little warning, inserting highly concentrated toxins that cause burning and pain.



Most people develop pain, redness, and swelling at the site of an insect sting. This is a normal reaction that takes place in the area of the sting. A serious allergic reaction occurs when the immune system gets involved and overreacts to the venom, causing symptoms in more than one part of the body such as:

•    Swelling of the face, throat or tongue

•    Difficulty breathing

•    Dizziness

•    Stomach cramps

•    Nausea or diarrhea

•    Itchiness and hives over large areas of the body

This severe allergic reaction is called anaphylaxis.


Insect stings can cause serious symptoms that are not allergic. A toxic reaction occurs when the insect venom acts like a poison in the body. A toxic reaction can cause symptoms similar to those of an allergic reaction, including nausea, fever, swelling at the site of the sting, fainting, seizures, shock, and even death. A toxic reaction can happen after only one sting, but it usually takes many stings from insects.

Serum sickness is an unusual reaction to a foreign substance in the body that can cause symptoms hours or days after the sting. Symptoms include fever, joint pain, other flu-like symptoms, and sometimes hives.



If you think you might be allergic to stinging insects, an accurate diagnosis is essential. An allergist/immunologist has specialized training and skills in determining the cause of your symptoms. Your allergist will conduct a thorough health history followed by allergy testing to determine what, if any, allergens put you at risk for serious reactions to stinging insects.


Treatment & Management

According to Dr. Deborah Gentile of the Division of Allergy, Asthma and Immunology of Pediatric Alliance, “Avoiding contact with stinging insects is the key to successfully managing this allergy.” These steps can help:

•    Insects are most likely to sting if their homes are disturbed, so have hives and nests around your home destroyed. Because this activity can be dangerous, you should hire a trained exterminator.
•    If you spot stinging insects, remain calm and quiet, and slowly move away.
•    Avoid brightly colored clothing and perfume when outdoors. Many stinging insects are searching for food and could confuse you with a flower.
•    Be careful outdoors when cooking, eating or drinking sweet beverages like soda or juice. Cover food and drinks to keep insects out.
•    Wear closed-toe shoes outdoors and avoid going barefoot to steer clear of stepping on a stinging insect.
•    Avoid loose-fitting garments that can trap insects between material and skin.


If you have an anaphylactic reaction, inject epinephrine immediately and call 911.
 After a serious reaction to an insect sting, make an appointment with an allergist/immunologist. With proper testing, your allergist can diagnose your condition and determine the best form of treatment.

Immunotherapy (allergy shots) may be effective long-term treatment for stinging insect allergy. Your allergist will give you shots containing small doses of your allergen, allowing your body to build a natural immunity to the trigger.


*** Dr. Belenky and Dr. Gentile are available to help diagnose and manage your child’s asthma and allergies in concert with you and your primary care physician. Appointments can be scheduled by calling their office at 412-348-6868.


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