Insect bite allergy - causes, symptoms, treatment

Insect bites mean danger to some people with allergies

In an insect sting allergy sufferers react with an allergic hypersensitivity to the poison of certain insects. Mostly, wasps and bees are the culprits. An insect bite can cause a life-threatening anaphylactic shock in these allergy sufferers. Here are the most important things in brief:

• definitionIn an insect sting allergy, triggered by components of the insect venom, an overreaction takes place in the immune system that affects the entire body. The reaction to the poison depends on the severity of the allergy.
• symptoms: Depending on the severity, an insect bite can cause discomfort such as itching and swelling, dizziness, nausea and vomiting, as well as cramps, shortness of breath and fainting. In the worst case, there are even life-threatening situations with rapid drops in blood pressure, collapse and unconsciousness.
• trigger: Stings of bees and wasps most often trigger allergic reactions. Bites of bumblebees and hornets are also possible triggers, but are much rarer. Even mosquito bites can cause allergic reactions, which are less threatening.
• causes: The immune system of those affected reacts excessively to the sting and forms antibodies against the allergens contained in the insect venom, which can affect the entire cardiovascular system.
• risk groups: Frequently, the immune system becomes sensitized from one to the next. Thus, people who are increasingly stung, the risk group, so for example beekeepers, gardeners, firefighters and fruit growers.
• therapy: The so-called hyposensitization is the only effective causative treatment against insect sting allergies. In addition, sufferers should carry an emergency kit when staying outdoors.

contents

• Insect bites mean danger to some people with allergies
• Different types of allergies
• causes
• Trigger for an insect sting allergy
• Symptoms of insect sting allergy
• diagnosis
• Medication
• prevention
• Hyposensitization in insect sting allergy
• Emergency measures for an insect bite
• Emergency remedies from Naturopathy
• Additional information

Different types of allergies

The allergies are four different types known. The type to which the insect sting allergy is also assigned is the type I, the immediate type, in which the body responds within seconds to minutes by means of a particularly strong formation of immunoglobulins of the IgE type. Other types of allergy are the type II or cytotoxic type with a reaction time of hours or days, the type III or immune cell type in which the organism reacts to the antigen within six to eight hours and the type IV, also referred to as late type , which is characterized by symptoms of allergy in the period of one to three days.

As important as honeybees are to nature, they are so dangerous to insect allergies. (Image: Alekss / fotolia.com)

causes

The insect sting allergy is based on a predisposition that can lead to an allergic reaction in the course of life. In contact with the allergen, here the poison of an insect, the body produces large quantities of immunoglobulins of the type IgE. These remain attached to the surface of mast cells (blood cells that belong to the leukocytes). If the person has contact with an insecticide a second time, the body starts a so-called antigen-antibody reaction, whereupon the mast cells immediately release histamine and other ingredients.

Allergic reactions are evident in no time

Within seconds or minutes, the allergic symptoms appear. This is usually anaphylaxis in the case of an insect sting allergy. After initial itching, redness and swelling of the puncture site, additional symptoms are added that are no longer localized, but can spread more and more throughout the body. These are edema of the face and upper body, shortness of breath and onset redness, especially of the face (flush). Released histamine, which has a vasodilator effect, lowers blood pressure. Also abdominal and abdominal spasms may arise.

Anaphylactic shock

Anaphylaxis can, in extreme cases, result in a life-threatening anaphylactic shock. This goes hand in hand with loss of consciousness, pulse acceleration and drop in blood pressure, until in the end cardiovascular failure and respiratory arrest can occur.

Trigger for an insect sting allergy

The main triggers for an insect sting allergy are the venom of the honeybee and the wasp. Although bumblebees and hornets are large, scary insects, they are less likely to be stinged by these species. Wasps are more aggressive when it comes to sticking. As a rule, these do not lose their sting, as is the case with the bee. Furthermore, mosquito bites can cause allergic reactions. Although these are very unpleasant, but not as dangerous as the immune response to bee and wasp venom.

Bee and wasp stings are the most common cause of allergic reactions in people with insect sting allergy. (Image: mirkograul / fotolia.com)

Symptoms of insect sting allergy

In the symptoms of insect sting allergy local reactions are distinguished from general reactions. Local reactions include redness, itching, itchy rash and swelling at the injection site. This can increase and last for several days. General reactions do not occur in the vicinity of the sting, but can affect the whole body. Slight manifestations are facial flushing, nausea, dizziness and difficulty breathing. The more pronounced general symptoms include persistent, massive nausea and vomiting and palpitations. An insect sting allergy can in the worst case lead to life-threatening situations with shortness of breath, rapid drop in blood pressure, collapse, unconsciousness to cardiac arrest.

diagnosis

In order to diagnose an insect sting allergy, a detailed history is needed. In the process, those affected are questioned in detail about the nature and course of the trick. A subsequent allergy test, in which minute amounts of bees and wasp venom are introduced into the skin with the help of a lancet, can substantiate the suspicion of an insect sting allergy. Usually followed by a blood test, in which the number of immunoglobulins of type E is determined.

Medication

The drug treatment of an insect sting allergy is not a causal, but a pure symptom treatment. However, this is extremely important in order to get the allergic reactions in an acute case as quickly as possible and to counteract anaphylactic shock can. The drugs used include antihistamines, glucocorticoids and mast cell stabilizers.

The influence of histamine

Histamine is a substance that the body produces itself. In the event of allergen contact, histamine is released from the mast cells, which leads to the most diverse and unpleasant symptoms of allergic rash. Leaning of the vascular musculature, which is manifested by a drop in blood pressure, increased vascular permeability, which causes swelling, both locally and throughout the body, and impairment of the intestinal mucosa, which can lead to diarrhea. All of these are symptoms triggered by the released histamine.

Swelling as a result of an allergic reaction caused by a bee sting. (Image: SENTELLO / fotolia.com)

antihistamine

This is where the use of an antihistamine attacks. This does not affect the release and the breakdown of the substance, but blocks the receptors in the body where histamine attacks. In contrast, mast cell stabilizers interfere with the mechanism of histamine release by stabilizing the cell walls of the mast cells. Glucocorticoids, which are also used in the treatment of insect sting allergy, have an anti-inflammatory effect, which is very important for allergic symptoms.

adrenaline

Since histamine is not the sole responsible substance in an insect bite, other antagonists such as alpha or beta sympathomimetics are also used. In anaphylactic shock, the most important remedy is adrenaline. This works widening the bronchi and increasing blood pressure. A ready-to-use emergency syringe containing adrenaline, called an autoinjector, is part of every emergency kit that people with an insect sting allergy should always have at hand, as it is lifesaving in an emergency.

prevention

The avoidance strategy is of course the best way to get around an allergic reaction. Of course, this is not always possible. These measures can help to protect against insect bites:

• dress: Those affected should protect themselves with appropriate clothing and always wear shoes when they are in the garden.
• Eating outdoors: When eating ice cream, cakes and the like, extreme caution is advised.
• Fruits and flowers: The picking of fruit or flowers should be reserved for those who have no insect sting allergy.
• Perfume: Perfumed cosmetics should be avoided as much as possible, as the insects love and can be attracted by fragrances.
• insect Screens: At night protects an insect screen in front of the window.
• motorcycle: To protect against insect bites, it is best to wear tight-fitting clothing and to keep the visor of the helmet closed at all times.

emergency kit

Affected persons should always carry the emergency kit with them. It is also important to inform friends and acquaintances of the allergy, so that they can immediately recognize the emergency situation and act accordingly. The use of the emergency kit does not save the alarm of the emergency doctor.

A carried emergency kit can save lives in case of doubt. (Image: elena3567 / fotolia.com)

Hyposensitization in insect sting allergy

Since an insect bite in life can never be ruled out, a causal treatment in the form of a specific immunotherapy is recommended. In a hyposensitization, the organism is confronted with continuously increasing doses of the insect venom, in the form of an injection. As a result, the immune system slowly gets used to the poison.

Stationary implementation

This treatment is not completely safe. The beginning of the therapy is therefore carried out stationary, in order to be able to act immediately in an overreaction. The basic treatment usually takes five to ten days. It starts with a very low dose of the insect venom and then gently, in the smallest steps, increased.

High chances of success

Thereafter, the therapy can be performed on an outpatient basis, but always under medical supervision. Thus, patients must spend at least half an hour in the office after each injection, so that a possible rapid intervention of the physician is possible. The complete hyposensitization lasts between three and five years. This therapy provides 95% certainty and can be done from the age of five.

Emergency measures for an insect bite

The subsequent measures should be followed when an emergency situation occurs. Those affected should also educate friends, relatives and colleagues about this so that they can react properly in the event of an emergency if the affected person is no longer able to do so. These measures include:

• keep Calm: This is extremely important in order to successfully complete the next steps. A panic attack would only worsen the situation drastically.
• emergency doctor: Call an emergency doctor immediately.
• emergency kitIn an existing emergency kit containing both an antihistamine and a glucocorticoid plus adrenaline, it should be used immediately before the doctor arrives. Adrenaline should be used first as soon as the first symptoms appear. Thereafter, the other two drugs are administered. Each affected person should be instructed in their use before the first use of his emergency kit.
• Cool the injection site: In addition, the puncture site should be cooled. For a swallowed insect, sucking ice cubes is recommended, but only as long as the person is conscious.

Emergency remedies from Naturopathy

Under no circumstances should the emergency kit and the emergency doctor be dispensed with in case of an insect sting allergy. However, homeopathy has three remedies ready for use in this emergency. The homeopathic remedy Apis helps with both wasp and bee stings. Vespa, on the other hand, is only used for wasp stings. Normally the application is oral. However, the agent can be dissolved in some water and thus the injection site are supplied. The general, sudden onset of emergency requires Aconitum. These funds, as well as the emergency kit, should always be carried.

Additional information

• Home remedies against wasps: distribute wasps with these measures.
• Some wasp stings can also be life-threatening for non-allergy sufferers: Even for non-allergy sufferers, there is a risk if they are stung in the mouth or neck area.
• Quick help against wasp and bee stings in children: What to consider when children are stung by wasps or bees.
• Insect poison allergy is underestimated by many: Expert reports on treatments for an insect sting allergy.
• Bee and wasp stings can be deadly: Bavarian State Minister of Health Melanie Huml advises caution in wasp and bee stings.
• How to protect yourself from wasps: Expert tips for the prevention of wasp stings.

(sw, vb; updated March 26, 2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)