Severe allergic reaction to insect bites can be deadly

Dear Dr. Camardi:

When I brought Dad to you after that bite he got in the garden, I thought nothing of it. He’s 76 and he’s been getting bit by something all his life, why should this be any different?

Whatever you gave him worked, so we didn’t go to the allergist like you recommended .

The good thing was I got the EpiPen. The bad thing was I didn’t do what you said and learn how to use it.

About a month later, he was visiting us and something bit him again and he started to turn blue. I didn’t know what to do, but my son’s girlfriend has allergies and something told me she knew what to do.

By that time the fire department was there . I told them that she gave him the shot, and they said “good job” and Dad started to look better.

They said Dad was in shock, but he would come out of it. And he did. They all said that it was a good thing that we gave him that shot …and to think I wasn’t going to get it!

Thanks so much to you and your student that day for all you did.

— Roanoke

A year rarely goes by that I don’t see at least one serious insect sting allergic reaction.

Allergies are the reaction of our immune system to particles in the environment that our bodies think are threats to us. Our immune systems give us signs and symptoms that some people think are our body’s way of telling us to get out of the environment in which the particles exist.

So by sneezing, tearing, coughing, sniffing, wheezing etc., we are being made so uncomfortable that we discontinue being in contact with it.

Studies show that as many as one person in five has some form of allergies.

When it comes to insect stings, experts estimate that some 2 million of us are allergic to insect venom like your dad is and that alone is responsible for an estimated 500,000 emergency room visits per year. Sometimes these attacks can result in death with an average yearly mortality of some 50 patients per year.

When a stinging insect like a bee attacks, its stinger tears away part of its abdomen and continues to empty its venom into the victim.

If you are stung, you should scrape the stinger off (pulling it off squeezes more venom into you).

As in your dad’s case, a patient who has an allergic reaction to an insect bite has about a 50/50 chance of having a worse reaction if they are stung again. That’s why we referred you to an allergist .

A lot of people will say that they have been tending to gardens and lawns all their lives and have been bitten numerous times without any problem. However, the variable in the geriatric patient is their medication list .

These medications have an effect on how the immune system responds to stings. That’s why we spent so much time on getting the medication list up to date.

Always keep handy that list of tips we gave you so as to avoid insect bites: Don’t walk barefoot on the grass , avoid wearing bright-colored clothes as the colors can be similar to flowers, and keep food and soft drink cans covered. Also sweet-smelling hair sprays and deodorants will attract the insects as many of them have plant extracts in their formula.

At this point you must avail yourself of the referral I gave you: Your dad could die if he is stung again. The type of overreaction to a sting that can cause death is called “anaphylaxis,” which comes from the Greek words for “against protection” meaning our bodies’ defenses have been triggered to overreact to the wound instead of protecting us .

Symptoms of a severe insect sting allergic reaction can range from hives, itchiness, swelling in areas other than the sting site, difficulty breathing, a sharp drop in blood pressure, hoarse voice or swelling of the tongue, dizziness, unconsciousness and cardiac arrest. Reactions such as these require immediate medical attention. That was why you saw me look at your dad’s other organ systems besides the bite site.

Keep in mind that these insects tend to act only when threatened so with some simple precautions and good sense, most bites can be avoided.

Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging and an assistant professor of medicine of the Virginia Tech Carilion School of Medicine. His column runs monthly in Extra.

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