Insect venom allergies are quite common, as it is estimated that 0.5 to 5% of the population of the United States are affected. In Florida, the majority of stinging insects are bees, wasps, yellow jackets, hornets and the unforgettable fire ant, which can all pack a big punch. 

A patient's reaction to an insect sting determines whether further treatment is required.   Sometimes, symptoms can take as long as 30 minutes to appear.  There are two types of reactions:  local and generalized. 

Local reactions occur around the sting area or on the entire affected limb and may produce swelling, irritation, warmth, and pain after the sting. There may also be associated nausea or vomiting.

More dangerously, generalized reactions can produce shortness of breath, wheezing, diffuse hives, airway swelling, increased heart rate, loss of consciousness, and even death.  These types of life threatening allergic reactions progress rapidly and require immediate medical treatment of epinephrine, antihistamines and corticosteroids.

People who have had past experiences with a generalized allergic reaction to an insect sting have a 60% chance of a similar or worse reaction if stung again.  To prevent generalized insect sting reactions, venom immunotherapy (VIT) involves injections of the particular venom to stimulate the immune system and to reduce the severity of the allergic reaction.  VIT has proven to be 97% successful in preventing future allergic reactions to and its course is usually complete after 3 to 5 years of injections.

However, even after patients receive VIT, they may be advised to continue to carry self-injectable epinephrine (Epi-Pen) because not all patients will maintain their immunity to insect venom for life.

If you have been stung by an insect, immediately scrape the stinger out with a blunt-edged object, such as an index card or credit card, without squeezing it. Avoid directly pulling the stinger out as this can burst the venom sac and release more venom.  Afterwards, wash the area with soap and water, apply a cold compress or ice pack for 10 to 20 minutes, and take Tylenol to ease the pain or Benadryl for the itch.