- Bee sting
Name = PAGENAME
ICD9 = ICD9|989.5
A bee sting strictly means a sting from a
bee( honey bee, bumblebee, sweat beeetc). In the vernacular it can mean a sting of a bee, wasp, hornet, or yellowjacket. Some people may even call the bite of a horseflya bee sting. The stings of most of these species can be quite painful, and are therefore an object of dread for many humans.
It is important to differentiate a bee sting from an
insect bite. It is also important to recognize that the venom or toxinof stinging insects is quite different. Therefore, the body's reaction to a bee sting may differ significantly from one speciesto another.
The most aggressive stinging insects are vespid wasps (including
bald-faced hornets and other yellowjackets) but not hornets in general (e.g., the European hornetis gentle). All of these insects aggressively defend their nests, although they have not developed a sting targeted at mammalslike the honey bees.
In people who are allergic to bee stings, a sting may trigger a dangerous
anaphylacticreaction that is potentially deadly. Honey bee stings release pheromones that prompt other nearby bees to attack.
Honey bee stings
A honey bee that is away from the hive foraging for
nectaror pollenwill rarely sting, except when stepped on or roughly handled. Honey bees will actively seek out and sting when they perceive the hive to be threatened, often being alerted to this by the release of attack pheromones (below).
Although it is widely believed that a worker
honey beecan sting only once, this is a partial misconception: although the sting is in fact barbed so that it lodges in the victim's skin, tearing loose from the bee's abdomenand leading to its death in minutes, this only happens if the victim is a mammal(or bird). The bee's sting evolved originally for inter-bee combat between members of different hives, and the barbs evolved later as an anti-mammal defense: a barbed sting can still penetrate the chitinous plates of another bee's exoskeletonand retract safely. Honey bees are the only Hymenopterawith a strongly barbed sting, though yellowjackets and some other wasps have small barbs.
The sting's injection of
apitoxininto the victim is accompanied by the release of alarm pheromones, a process which is accelerated if the bee is fatally injured. Release of alarm pheromones near a hive or swarmmay attract other bees to the location, where they will likewise exhibit defensive behaviors until there is no longer a threat, typically because the victim has either fled or been killed.(Note: A true swarm is not hostile - it has deserted its hive and has no comb or young to defend). These pheromones do not dissipate or wash off quickly, and if their target enters water, bees will resume their attack as soon as it leaves the water.
The larger drone bees do not have stings. In worker bees, the sting is a modified
ovipositor. The queen beehas a smooth sting and can, if need be, sting skin-bearing creatures multiple times, but the queen does not leave the hive under normal conditions. Her sting is not for defense of the hive; she only uses it for dispatching rival queens, ideally before they can finish pupating. Queen breeders who handle multiple queens and have the queen odor on their hands are sometimes stung by a queen.
The main component of bee venom responsible for pain in
vertebrates is the toxin melittin; histamineand other biogenic amines may also contribute to pain and itching.cite book | author= Meier J, White J. | title = Clinical toxicology of animal venoms and poisons | year = 1995 | publisher = CRC Press, Inc | id = ISBN 0-8493-4489-1] In one of the medical uses of honey beeproducts, apitherapy, bee venom has been used to treat arthritisand other painful conditions. [ Phillip Terc"Report about a Peculiar Connection Between the Bee stings and Rheumatism", 1888.]
The sting consists of three parts - a stylus and two barbed slides (or lancets), one on either side of the stylus. The bee does not push the sting in but it is drawn in by the barbed slides. The slides move alternately up and down the stylus so when the barb of one slide has caught and retracts it pulls the stylus and the other barbed slide into the wound. When the other barb has caught it also retracts up the stylus pulling the sting further in. This process is repeated until the sting is fully in and even continues after the sting and its mechanism is detached from the bee's abdomen.
The first step in treatment following a bee sting is removal of the sting itself. The sting should be removed as fast as possible without regard to method: studies have shown the amount of venom delivered does not differ if the sting is pinched or scraped off and even a delay of a few seconds leads to more venom being injected.cite journal |author=Visscher P, Vetter R, Camazine S |title=Removing bee stings. |journal=Lancet |volume=348 |issue=9023 |pages=301–2 |year=1996 |pmid=8709689 |doi=10.1016/S0140-6736(96)01367-0] Once the sting is removed, pain and swelling should be reduced with a cold compress.cite journal |author=Balit C, Isbister G, Buckley N |title=Randomized controlled trial of topical aspirin in the treatment of bee and wasp stings |journal=J. Toxicol. Clin. Toxicol. |volume=41 |issue=6 |pages=801–8 |year=2003 |pmid=14677790 |doi=10.1081/CLT-120025345]
Many traditional remedies have been suggested for bee stings including damp pastes of tobacco, salt,
baking soda, meat tenderizer, toothpaste, clay, garlic, urine, onions, aspirinor even application of coppercoins.cite web |last=Glaser |first=David |title=Are wasp and bee stings alkali or acid and does neutralising their pH them give sting relief? |work= |publisher=www.insectstings.co.uk |date= |url=http://www.insectstings.co.uk/sting-acid-or-alkali.shtml |accessdate=2007-05-03] [ [http://pubs.caes.uga.edu/caespubs/pubcd/c782-w.html Beverly Sparks, "Stinging and Biting Pests of People"] Extension Entomologist of the University of Georgia College of Agricultural & Environmental Sciences Cooperative Extension Service.]
Bee venom is acidic and these interventions are often recommended to neutralize the venom; however, neutralizing a sting is unlikely to be effective as the venom is injected under the skin and deep into the tissues, where a topically applied alkali is unable to reach, so neutralization is unlikely to occur. In any case, the amount of venom injected is typically very small (between 5 and 50 micrograms of fluid) and placing large amounts of alkali near the sting site is unlikely to produce a perfectly neutral pH to stop the pain. Many people do claim benefit from these home remedies but it is doubtful they have any real physical effect on how much a sting hurts or continues hurting, the effect is probably related to rubbing the area or the mind perceiving benefit. Furthermore, none of these interventions have been proven to be effective in scientific studies and a randomized trial of aspirin paste and topical ice packs showed that aspirin was not effective in reducing the duration of swelling or pain in bee and wasp stings, and significantly increased the duration of redness. The study concluded that ice alone is better treatment for bee and wasp stings than aspirin.
The sting may be painful for a few hours. Swelling and itching may persist for a week. The area should not be scratched as it will only increase the itching and swelling. If a reaction persists for over a week or covers an area greater than 3 or 4 inches, medical attention should be sought. Doctors often recommend a
tetanus immunization. For about 2 percent of people, anaphylactic shock from certain proteins in the venom can be life-threatening and requires emergency treatment by a physician. [ [http://maarec.cas.psu.edu/bkCD/HBBiology/insect_sting.htm Thor Lehnert, "Hymenopterous Insect Stings"] "Beekeeping in the United States" - USDA - Agricultural HandBook Number 335.] If the victim is allergic to bee stings, the victim must be treated to prevent shock. People known to be highly allergic may carry around epinephrinein the form of a self-injectable Epipenfor the treatment of an anaphylactic shock.
For patients who experience severe or life threatening reactions to insect stings, researchers at Johns Hopkins have developed a series of allergy injections composed of increasing concentrations of naturally occurring venom which provide excellent and usually life-long protections against future insect stings. [cite journal |last=Resiman |first=R |title=Insect Stings |journal=New England Journal of Medicine |volume=26 |year=1994 |month=Aug |pages=523–7 |doi=10.1056/NEJM199408253310808 |pmid=8041420 ]
Bee venom therapy
Characteristics of common wasps and bees
Schmidt Sting Pain Index
* [http://library.thinkquest.org/C007974/2_4hon.htm Thinkquest, Poisonous plants and animals] accessed June 2006
* [http://plantphys.info/Plants_Human/bees/bees.html The Biology of the Honey bee, Apis Mellifera] accessed June 2006
* [http://www.mic-d.com/gallery/darkfield/honeybeestinger.html Darkfield image gallery: Honey bee stinger] accessed June 2006
* [http://bees.ucr.edu/stings.html Removing Bee Stings - Vischer Vetter Camazine] accessed January 2007
* [http://www.wvu.edu/~agexten/wildlife/bees.htm Helpful medical information "About Bee and Wasp Stings"] West Virginia University
* [http://www.webmd.com/content/Article/96/103760.htm Bee Venom May Take the Sting Out of Arthritis] (WebMD, 4 November 2004)
* [http://www.virtualmedicalcentre.com/diseases.asp?did=761 Prognosis for bees stings]
* [http://www.apitox.us Bee boxes & bee tweezers for apitherapy]
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