Insect Sting allergies | Stinging insect allergy

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The insects most commonly associated with triggering severe allergic reactions belong to the Hymenoptera order. Members include bees, wasps, yellow jackets, hornets, and ants, including the fire ant, an increasingly common, harmful pest that is spreading throughout the United States, where it is now the leading cause of insect stings.

Although you can take steps to avoid insect stings, you should also know what to do if someone is stung.

A Growing Threat

It is believed that fire ants entered the United States via steamships bringing agricultural products from South America to Mobile, Alabama, in the 1930s. Once in the United States, northern frosts and western deserts proved effective barriers to widespread fire ant migration for many years. However, recent warm, wet weather conditions, including the El Nio weather system of 1998, seem to have helped the ants advance north and west. They now live in more than 260 million acres and pose a serious health risk to humans, wildlife, and domesticated animals.1

Reactions to fire ant stings range from localized skin itching and swelling with pussy formations, to severe, life-threatening anaphylaxis.

Hymenoptera Members7

Fire Ants  Appearance: Usually 1/4" long; bright reddish-brown in color, can be dark brown to black  Nest: Mounds up to 18" high, 3' wide above ground, with underground tunnels  Range: As far north as Nevada in the West and Washington, DC, in the East  Behavior: Very aggressive territorial behaviors; attack in swarms with little warning or provocation  Stings: Can sting up to 7 or 8 times; causes burning, itching, pustules    Honey Bees  Appearance: 1/2" long; rounded, hairy, dark brown body with bright yellow markings  Nest: Hives in beekeepers' boxes, bushes, trees, building niches  Range: Worldwide  Behavior: Not terribly aggressive; sting only when challenged directly  Stings: Can sting only once, then lose stinger and die    Africanized Honey Bees  Appearance: 1/2" long; rounded, hairy, dark brown body with bright yellow markings like the honeybee  Nest: Honeybee hives, or any partially protected site (e.g., old farm machinery, fences, house exteriors)  Range: Spreading from the Southwest to more populated areas  Behavior: Very aggressive, temperamental, easily provoked and fiercely protective of territories up to a half-mile radius  Stings: Can sting only once, like the honeybee, but attack in swarms    Yellow Jackets  Appearance: 1/2- to 3/4" long; black with yellow markings  Nest: Papery nests in the ground or in wall crevices  Range: Worldwide  Behavior: Versatile and persistent pests. Not as easily provoked as fire ants or killer bees, but highly aggressiveparticularly as weather cools in the late summer or early fall  Stings: Can use stinger more than once    Hornets  Appearance: Up to 1" long; black or brown with hints of yellow, white or orange  Nest: Brown or gray football-shaped hives of a papery substance high above ground level  Range: Throughout North America  Behavior: Extremely protective of their nest; more aggressive than honeybees but not as feisty as the fire ant or killer bee  Stings: May sting repeatedly without losing stinger    Wasps  Appearance: Elongated bodies up to 1" long; black, brown or red with yellow markings  Nest: Exteriors of buildings, woodpiles and shrubs  Range: Throughout North America  Behavior: Aggressive, but not as easily provoked as fire ants or killer bees  Stings: Can sting more than once    * All insect coloring and size is highly variable, and one cannot rely upon visual identification for testing and treatment.

Avoiding Stings

The best way to avoid stings is to minimize contact with stinging insects. Simple steps that people can take to avoid attracting and provoking stinging insects when outdoors include:

Refraining from wearing brightly colored clothing or sweet-smelling cosmetics  Keeping food and garbage covered  Wearing shoes to guard against stepping on insects  Keeping arms and legs covered during activities (such as gardening, hiking) that may expose you to stinging insects  Refraining from swatting or crushing insects  Steering clear of areas where insects have nested  Stinging insects attack when their nests are in jeopardy; people who find nests, hives, or fire ant mounds on their property may wish to consult a professional pest control expert to determine whether eradication of the nest or insects themselves is appropriate.

What to Do if Someone Is Stung

When someone is stung you should:

Remove any stingers  Check for signs of an allergic reaction  Treat allergic reactions immediately  Remove any stingers  Stingers left behind by bees should be removed immediately to minimize the amount of insect venom the sting delivers. It is important to remove the stinger in a sweeping motionas with the edge of a credit cardinstead of using tweezers to pull it out. A sweeping motion is less likely to break the stinger or push remaining venom from the stinger into the sting site (which can happen if you squeeze the stinger or try to pull it out).

Check for signs of an allergic reaction  A normal response to an insect sting is swelling, pain, and redness around the site of the sting or bite. Typically, washing the sting site with soap and water, and then applying ice to reduce the swelling is sufficient to treat a local reaction. However, physicians may prescribe antihistamines or corticosteroids to minimize discomfort if swelling is pronounced or if the location of the sting makes it especially uncomfortable.

When a person is allergic to an insect sting, the reaction is typically much more widespread and may include anaphylactic symptoms such as:

Itching and hives  Swelling of the throat or tongue  Difficulty breathing  Dizziness  Severe headache  Stomach cramps  Diarrhea  Nausea  A sharp drop in blood pressure  Loss of consciousness  Treat allergic reactions immediately  If an allergic individual is stung, emergency medical treatment should be sought at once. If the allergic patient has injectable epinephrine such as the EpiPen or EpiPen Jr auto-injector at hand, it should also be administered immediately to reverse the potentially deadly symptoms of anaphylaxis. Prompt administration of epinephrine is important because even seemingly mild allergic reactions can escalate to deadly anaphylaxis in minutes.2

Side effects of epinephrine may include palpitations, tachycardia (an abnormally fast heartbeat), sweating, nausea and vomiting, and respiratory difficulty. Cardiac arrhythmias may follow administration of epinephrine. Patients should ask their physician about the circumstances under which this life-saving medication should be used.

Many physicians also recommend that antihistamines such as diphenhydramine be administered to lessen the symptoms of an allergic reaction, but antihistamines should only be taken in addition to epinephrine for the treatment of anaphylaxis and should not be considered a substitute for it. Only epinephrine can halt the potentially deadly effects of anaphylaxis.

Even when epinephrine is used, severely allergic people experiencing anaphylaxis may need emergency respiratory or cardiac care, or even resuscitation if they stop breathing. In any case, when an allergic person is stung, he or she will need professional care to determine whether additional epinephrine, steroids, antihistamines, or other treatments are required. Follow-up diagnosis and care by medical professionals after self-administration of epinephrine for insect stings may be critical to recovery.

Delayed or secondary reactions do occur, and patients should remain under medical supervision for at least 4 hours after an episode of anaphylaxis.3 As many as 25% of people who experience an anaphylactic reaction will have a recurrence up to 48 hours after the initial reaction and will require further medical treatment, including additional epinephrine.4-6 Therefore, it is essential that anyone who experiences anaphylaxis is equipped with enough self-injectable epinephrine to treat additional episodes if necessary, whether they are secondary reactions or result from future exposures to anaphylactic triggers.  For more information please visit : http://www.epipen.com 

Epi Pen is writer for emergency treatment of allergic reactions and medications, anaphylaxis, anaphylaxis allergies, anaphylaxis reaction, anaphylaxis reactions symptoms and treatments. EpiPen Auto-Injector http://www.epipen.com/

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Food allergies | Anaphylaxis allergy causes, symptoms & treatment

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Food allergy is the most common cause of anaphylaxis outside of the hospital.1,2 Experts estimate that from 2% to 2.5% of the general population, or 5.4 million to 7 million Americans have food allergies.3 About three million of these are believed to be allergic to peanuts or tree nuts alone,3 yet there are other common food culprits.

The symptoms of food allergies resemble those of food intolerance and so it is important to consult a doctor to be diagnosed correctly. Once diagnosed, you can learn about ways to prevent and treat your food allergy.

Definition

Food allergies are an increasingly common cause of anaphylaxis that result in about 125 deaths each year in the United States.4 Some allergists believe this perceived rise in incidence may be attributed to increased exposure to certain foods, such as peanuts, before children's immune systems are mature enough to handle them.5,6

Having a food allergy, as with any other severe allergy, means that a person's immune system reacts to a protein, in this case a food protein, as a threatening foreign substance and primes the body's defenses against it. Each time the person comes in contact with this protein, his or her immune system launches an attack by releasing histamines and other powerful chemicals. The release of these chemicals trigger symptoms of an allergic reaction, which can range from hives to deadly anaphylaxis.

Histamine is a chemical released by cells of the immune system called mast cells. It is largely responsible for producing the symptoms associated with allergic reactions.

Common Culprits

There are eight types of foods that are accountable for 90% of all food-allergic reactions.7 The foods that most commonly cause anaphylaxis (called allergenic foods) are:

Peanuts  Tree nuts (walnuts, pecans, etc.)  Shellfish  Fish  Milk  Soy  Wheat  Eggs  Sulfites added to foods can also set off anaphylactic reactions, as well as exercising, within a few hours of eating for a small number of people who do not otherwise experience food-related anaphylaxis.

Children, who have immature immune systems compared with adults, are most susceptible to a broad array of food allergies. People have been known to outgrow allergies to milk, soy, and eggs after childhood. However, peanuts, tree nuts, and shellfish tend to be lifelong food triggers.5,8,9 In fact, reactions to these foods may become more serious over time. When sensitivity exists, the intensity of a given anaphylactic attack is unpredictable because it depends on the amount of allergen contained in the food eaten and the individual's degree of hypersensitivity to the allergen.8 Also, if someone already has another immune problem, he or she may be at increased risk for a strong reaction to the food to which they are allergic. For example, patients who have asthma or atopic dermatitis, as well as food allergies, are at increased risk for severe anaphylaxis.1,2,10,11

Asthma is a condition in which the airways narrow due to an allergic hypersensitivity.

   Atopic dermatitis is a chronic condition resulting in itchy inflammation of the skin that is associated with allergy sufferers.

Symptoms

Symptoms of food allergies can range from mildly irritating to life threatening. The most common symptoms of food allergies are:

Hives  Vomiting  Diarrhea  Abdominal cramping  Other symptoms typical of anaphylaxis generally include:

Swelling of the throat, lips, or tongue  Difficulty breathing or swallowing  Metallic taste or itching in the mouth  Generalized flushing, itching, or redness of the skin (hives)  Nausea  Increased heart rate  Plunging blood pressure (and accompanying paleness)  Sudden feeling of weakness  Anxiety or an overwhelming sense of doom  Collapse  Loss of consciousness  For some people with food allergies, just a taste or even a touch of the foods to which they are allergic can result in any of these symptoms and can set off a chain reaction that takes only minutes to culminate in full-blown anaphylaxis: swelling of the airways, loss of blood pressure, loss of consciousness, shock, and even death.12 This can happen with their first known exposure to a food. There have even been rare cases documented in which inhalation exposure to a food has triggered an anaphylactic reaction.13 The more rapidly symptoms present themselves; the more likely the reaction is to be severe.13

Intolerance Versus Allergy

Food allergy and intolerance are often mistaken for one another. While they may share similar symptoms, including diarrhea and vomiting, food allergy is an immune system response while food intolerance occurs when another system of the body (usually the digestive tract) reacts adversely to a food.

For example, one of the most common food intolerances arises in response to lactose, the sugar in milk. Lactose intolerance occurs when a person lacks an enzyme needed to digest this sugar, and the body reacts with gas, bloating, diarrhea, and abdominal pain when milk products containing lactose are consumed. When these symptoms occur as a result of intolerance rather than allergy, they do not indicate an anaphylactic reaction. However, anyone who has such symptoms should seek proper medical care to get a diagnosis and counseling in order to determine what dietary and medical measures are needed.

Diagnosis

A person who has experienced even mild allergic reactions to food should seek a professional diagnosis by a board-certified allergist (see Find an Allergist to locate an allergist near you). To make a proper diagnosis, the allergist will record a complete history of the symptoms, which foods were eaten, how much of the food was eaten, and how soon afterward the symptoms began. The doctor may also decide to perform a skin prick test, RAST (blood test), or oral food challenge to confirm the diagnosis.

A skin prick test may be used to identify allergens. This test involves injecting tiny amounts of diluted food solutions into the skin. If the person is allergic to the particular food sample injected, then the skin will react within 15 to 20 minutesusually with a hive-like swelling surrounded by redness.

RAST, or radioallergosorbent test, directly measures antibodies specific to allergens in the blood.

Prevention and Treatment

In most cases, there is no cure for food allergies. Therefore, it is essential that people with food allergies protect themselves by carefully avoiding the foods that trigger their reactions, and by being prepared to treat anaphylactic reactions that occur immediately with epinephrine in combination with emergency medical care.

Avoidance  Avoidance of foods that trigger allergic reactions is critical and more challenging than one might expect. While steering clear of a food in its isolated form may not be so difficult, people with allergies, or the parents of children with food allergies, must know to check product labels for alternate names of food ingredients that may contain their allergens. People who have food allergies must also try to avoid foods that may contain hidden ingredients or that may have been prepared using equipment contaminated by an allergenic food.

Since it is often difficult to avoid hidden foodsand because it is often difficult for children to resist sharing foodsit's important that an allergic person's family, friends, and teachers know about, and understand, the ramifications of food allergy, so they can aid in the prevention of anaphylaxis and be ready to assist should an emergency arise.

Epinephrine  Exposure to allergenic foods is sometimes unavoidable, so people with food allergies need to be prepared to treat allergic reactions. The treatment of choice for severe allergic reactions to food, which can swiftly lead to anaphylaxis, is an immediate injection of epinephrine followed by emergency medical attention.14 Many physicians also recommend taking antihistamines such as diphenhydramine to relieve the symptoms of allergic reactions, but antihistamines are not a substitute for epinephrine. Only epinephrine can stop the potentially deadly effects of anaphylaxis.

A 1992 study of children and adolescents with food allergy demonstrates how important it is for people with food allergies to carry epinephrine at all times.10 According to the study, 10 out of 13 fatal and near-fatal anaphylactic reactions to food occurred in public places, and none of the adolescents and children who died had epinephrine with them. All of the adolescents and children who survived received epinephrine before or within 5 minutes of developing severe symptoms.10 Other studies agree with these findings.11 Thus, all individuals with food allergies should carry self-injectable epinephrine, such as the EpiPen or EpiPen Jr auto-injector, with them at all times.

Since immediate administration of epinephrine can be the difference between life and death, parents of children with life-threatening food allergies should alert their child's school of the particular allergen, and make sure their child's teachers and caregivers have an epinephrine auto-injector on hand and know how to administer it.

Side effects of epinephrine may include palpitations, tachycardia (an abnormally fast heartbeat), sweating, nausea and vomiting, and respiratory difficulty. Cardiac arrhythmias may follow administration of epinephrine. Therefore, patients should ask their doctors about the circumstances under which this life-saving medication should be used.

You and your child should also ask your physicians whether antihistamines should be carried in addition to epinephrine. Wearing a medical identification bracelet describing your allergies and susceptibility to anaphylaxis can help ensure prompt, proper treatment during an emergency.

Emergency medical care  Even after administering epinephrine, emergency medical treatment should be sought at once because severely allergic people experiencing anaphylaxis may need emergency respiratory or cardiac care, or even need to be resuscitated if they stop breathing altogether. More commonly, these patients will need professional care to determine whether additional epinephrine, steroids, antihistamines, or other treatments are required. In either case, follow-up diagnosis and care by medical professionals after administration of epinephrine is critical to recovery. Delayed or secondary reactions do occur, and patients should remain under medical supervision for at least 4 hours after an episode of anaphylaxis.  For more information please visit : http://www.epipen.com

Epi Pen is writer for emergency treatment of allergic reactions and medications, anaphylaxis, anaphylaxis allergies, anaphylaxis reaction, anaphylaxis reactions symptoms and treatments. EpiPen Auto-Injector http://www.epipen.com/

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Insect allergies | Insect allergy causes, symptoms & treatment

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Insect venom allergies are common , especially allergies to members of the Hymenoptera order of insects .

While a normal response to an insect sting may consist of reddening and some pain, an anaphylactic response is much more serious and can involve changes in breathing and loss of consciousness.

Usually once you have experienced an allergic response you are likely to experience a subsequent response when exposed to the insect culprit, but the severity of the response can vary. If you, or someone you know, has an insect venom allergy then you should learn how to prevent and treat insect stings.

You may also be interested to learn more about insect sting allergies , including information on common insect culprits and what to do if someone is stung.

Incidence

It is estimated that 0.5% to 5% of the population of the United States, or as many as 13 million people, have insect venom allergies.1,2 Many of these venom-sensitive individuals are at risk for life-threatening anaphylactic reactions. An estimated 40 to 100 deaths due to anaphylaxis caused by insect venom are reported each year, half of which are attributed to fire ants , an increasingly common pest that is spreading throughout the United States. from the south.2-5

Common Culprits

The insects most commonly associated with triggering severe allergic reactions belong to the Hymenoptera order of insects. This order is comprised of:

Bees  Wasps  Yellow jackets  Hornets  Ants, especially the fire ant  You may wish to learn more about stinging insects , including how to recognize and avoid them and what to do if you are stung.

Normal Response Versus Anaphylaxis

A normal response to an insect sting results in swelling, pain, and redness around the site of the sting or bite. When a person is allergic to an insect sting, he or she is susceptible to the effects of anaphylaxis, which can include:

Itching and hives over much of the body  Swelling in the throat or tongue  Difficulty breathing or swallowing  Dizziness, severe headache  Stomach cramps, nausea, or diarrhea  Rapid fall in blood pressure  Shock and loss of consciousness  It is important to remember that these symptoms can progress to deadly anaphylaxis in 1 to 2 minutes,6 so treatment should be administered immediately.

Severity of Subsequent Allergic Reactions

In general, people who have experienced an allergic reaction from an insect sting have approximately a 30% to 60% chance of experiencing a similar or worse reaction the next time they are stung.7 An individual's chance of experiencing subsequent life-threatening allergic reactions varies, depending on factors such as:

Patient age8  Health8  Amount of venom to which a person is exposed when stung8  Severity of the initial reaction8  It has been shown, for example, that severe initial reactions increase the likelihood of future anaphylactic responses.

On the other hand, some people who have experienced allergic reactions to insect stings will see the severity of their reactions decrease over time or even cease spontaneously.9

Protection, Prevention, and Treatment

As with other anaphylactics, the primary method of protection is a two-step process: avoiding contact with what causes reactions and being prepared to treat anaphylactic emergencies by carrying self-injectable epinephrine and receiving prompt medical attention.

Unlike people susceptible to anaphylaxis triggered by food , latex , or medication allergies, people allergic to insect venom have the option of undergoing immunotherapy , a preventive course of treatment that provides long-term protection against insect sting allergies.

Avoidance  Avoidance is a key element in guarding against severe allergic reactions to insect stings. Simple steps that people can take to avoid attracting or provoking stinging insects when outdoors include:

Avoiding brightly colored clothing or sweet-smelling cosmetics and shampoos  Keeping food and garbage covered  Wearing shoes to guard against stepping on insects  Keeping arms and legs covered during activities (such as gardening or hiking) that may expose you to stinging insects  Refraining from swatting or crushing insects  Steering clear of areas where insects have nested  Immunotherapy

If you or your child suffers from severe allergic reactions to insect stings then you should discuss the option of receiving venom immunotherapy (VIT) from your doctor, preferably a board-certified allergist.

During VIT, patients undergo a series of injections that exposes them to minute amounts of pure venom. The dosage is slightly increased over the course of the therapy, helping the patient build a tolerance to the venom proteins that trigger allergic reactions. VIT is 97% successful in preventing future allergic reactions to insect stings and is usually completed after 3 to 5 years of regular injections.10,11

Even after patients receive VIT, however, they may be advised to carry self-injectable epinephrine because not all patients will remain tolerant to insect venom for life.12 Moreover, VIT itself poses a 6% risk of anaphylaxis due to the venom used in the therapy. Patients should make sure that the physician who administers their VIT regimen is properly trained in immunotherapy and keeps epinephrine and other resuscitative medications and equipment needed to treat anaphylaxis on hand.

You can find a board-certified allergist by using our handy Find an Allergist feature.

 Emergency Treatment

Because not all stings can be avoided, the American Academy of Allergy, Asthma and Immunology recommends that people allergic to insect stings be prepared to administer injectable epinephrine to themselves immediately if they are stung.13 People with insect sting allergies should carry a self-injectable form of epinephrine, such as the EpiPen or EpiPen Jr auto-injector, with them at all times. Epinephrine (also known as adrenaline) works rapidly to reverse the symptoms of anaphylaxis by relaxing smooth muscle tissue in the lungs, speeding up the heart rate, combating hives and welts on the skin, and by reducing the swelling of the mouth, throat, and face.

Side effects of epinephrine may include palpitations, tachycardia (an abnormally fast heartbeat), sweating, nausea and vomiting, and respiratory difficulty. Cardiac arrhythmias may follow administration of epinephrine. Patients should ask their physician about the circumstances under which this life-saving medication should be used.

Many physicians also recommend taking antihistamines such as diphenhydramine to relieve the symptoms of allergic reactions. However, antihistamines are not substitute for epinephrine, and only epinephrine can stop the potentially deadly effects of anaphylaxis.

Even after administering epinephrine, emergency medical treatment should be sought at once because severely allergic people experiencing anaphylaxis may need emergency respiratory or cardiac care, or even to be resuscitated if they stop breathing altogether. More commonly, these patients will need professional care to determine whether additional epinephrine, steroids, antihistamines, or other treatments are required.

Either way, follow-up diagnosis and care by medical professionals after self-administration of epinephrine for insect stings are critical to recovery.

Delayed or secondary reactions do occur, and patients should remain under medical supervision for at least 4 hours after an episode of anaphylaxis.14

Finally, because stinging insects are difficult to avoid completely, patients who have been treated for an anaphylactic reaction should protect themselves against further episodes by requesting a prescription for self-injectable epinephrine from the emergency room physician and carrying the epinephrine with them at all times, particularly when outdoors.

Patients should also ask their physicians whether antihistamines should be carried in addition to epinephrine.

Wearing a medical identification bracelet describing your allergies and susceptibility to anaphylaxis can help ensure prompt, proper treatment during an emergency.  For more information please visit : http://www.epipen.com

Epi Pen is writer for emergency treatment of allergic reactions and medications, anaphylaxis, anaphylaxis allergies, anaphylaxis reaction, anaphylaxis reactions symptoms and treatments. EpiPen Auto-Injector http://www.epipen.com/

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