Wasp and Bee Stings in Children

Symptoms

Whilst insect stings can cause unpleasant reactions around the site of the sting, most will be minor and will subside naturally. A severe local reaction may cause swelling with increasing pain over a period of hours, and in some cases, the entire limb that has been stung may swell up. Whilst not serious in itself, if swelling is near the face or neck it should be watched carefully in case it causes difficulty breathing.

A few people may have a serious allergic reaction to bee or wasp stings, leading to anaphylaxis. If a child has been stung and suffers breathing difficulties, a tight chest, a hoarse voice or a swollen tongue, these indicate a serious allergic reaction which may lead to anaphylaxis. Other signs of anaphylaxis are abdominal cramps, nausea, feelings of weakness or fear, dizziness and unconsciousness. Sometimes, people may develop hives and swelling over a part of their body distant to where the sting has occurred; while this is not anaphylaxis, this indicates a mild systemic reaction. In older children and adults (but not young children), such a reaction is considered to be a risk factor for a future severe reaction.

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Disease

It is difficult to know how many insect stings occur since these are most often minor and do not need medical attention. A very small number of adults (less than half a percent) may have an anaphylactic reaction to a bee or wasp sting. In children, that number is even smaller, although it is still worth being watchful if your child already has another allergy.

Bees are not aggressive and will generally only sting when they feel threatened. However, the sting is barbed and remains in the flesh after stinging, meaning that a bee can only sting once. However, the sting can continue to pump venom into the body, so must be removed carefully without squeezing the venom sac.

Wasps are aggressive and have smooth stingers, and so can sting more than once.

Bees and wasps have different venoms and so an allergic reaction to one does not mean that a child is automatically allergic to another since these are different allergens. Hornets, however, do have a similar venom to wasps, so there may be some relationship between the allergic reactions to the stings of these two insects.

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Diagnosis

It can be difficult to predict if a child will suffer an allergic reaction when next stung since this is not always the case.

The history of a child’s reactions to insect stings is useful in assessing whether they are allergic. Skin prick tests and blood tests are not 100% reliable for insect sting allergy, so sometimes it can be necessary to perform a special skin test (called an intradermal injection) to determine true allergy.

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Treatment

For mild reactions using anti-histamines, either in a skin cream on the affected area or orally as a syrup or tablet, can be useful in relieving the allergic symptoms or general discomfort.

Encouraging a child to suck on an ice cube or iced lolly may help to reduce swelling around the mouth and throat if this is a concern.

For moderate symptoms, an inhaler may be recommended or anti-histamines or steroids may be given by injection. In the case of anaphylaxis, an immediate dose of adrenaline will be necessary.

Immunotherapy can be offered as a form of desensitisation to the insect venom, but is only usually available in specialised centres.

Avoidance measures are the most sensible course of action, but this can be difficult due to the difficulty in spotting the insects.

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Self Help

• Avoidance measures are the most sensible course of action, but this can be difficult due to the difficulty in spotting the insects
• It is important that your child is told to keep away from stinging insects that can cause an allergic reaction, but it is equally important that they do not panic when a bee or wasp comes near them. They should be encouraged to stay calm and gently brush the insect away if it lands on them
• As your child gets older discourage them from wearing highly scented sprays as these can attract wasps
• If eating or drinking when wasps are prevalent then make sure your child stays inside at this time
• In the UK insect stings from bees, wasps and hornets, can cause allergies but, when travelling abroad, be aware of the other stinging insects that can pose a hazard, i.e. fire ants and yellow jackets
• Be aware that insect repellents do not work against stinging insects
• Wasps and bees are most common during the summer and early autumn, and if going out, encourage your child to cover their skin with clothing as much as possible. If not covered always take an item of clothing that they can use to cover their skin if they find that the insects become a nuisance
• Discourage your child from wearing open toe sandals or walking barefoot outside
• Bright colours attract insects as if to flowers, so you could consider encouraging your child to wear dark or pastel colours
• Do not let your child drink from open cans of drink that have been left outside as wasps are attracted into them and cannot be seen