Each week, OMRF Chief Medical Officer Dr. Judith James opens “Adam’s Journal” to answer a medical question from Adam Cohen, OMRF’s senior vice president & general counsel.
Adam’s Journal
My wife had what she describes as a “bad” reaction to a bee sting as a second grader. To her knowledge, Mary has never again been stung, but she’s since lived in fear of bees.
What are the chances she still needs to worry about bee-ing stung? Is there anything she can do to test for an allergy?
Dr. James Prescribes
When bees sting, they inject a venom that’s mostly water. This allows easy dispersal of the venom, especially if they sting in moist tissue, which we have lots of. For example, our skin and muscles are both mostly water.
While the water allows the venom to spread, it’s the remaining ingredients that cause problems for our bodies. The biggest culprit – and source of pain – is a protein called melittin, which causes blood vessels at the site of the sting to burst and the blood vessels to expand.
There are also other components of venom that make trouble for us, including proteins that cause pain and inflammation, irritate nerve cells, and spread the reactions to surrounding tissues. Finally, histamines in the venom cause tiny capillaries to leak fluid and fuel the itching that also comes with stings.
Faced with a cocktail of toxins, our bodies do exactly what you might expect: The immune system launches a counterattack to neutralize them. But in a small percentage of people, that counterstrike is too strong, leading to a reaction that can involve hives, extreme pain, severe swelling, dizziness and difficulty breathing. In severe cases, this reaction – called anaphylaxis – can be life-threatening.
A 2004 study from Johns Hopkins University found that, unless they’d received allergy treatments for bee stings, a significant percentage of those who’d had severe reactions to bee stings as children also reported having severe reactions to stings as adults.
It sounds as if Mary has never had allergy treatment for bee stings. So, if she had a strong reaction to one as a child, there is a significant chance her body might respond similarly today.
To find out if this is the case, she could undergo allergy testing. The most common method involves a skin prick with a small amount of bee venom. Allergists can also test blood samples for certain antibodies to insect venom.
For anyone found to be severely allergic, an allergist is likely to prescribe an epinephrine autoinjector like an EpiPen, which can prevent anaphylaxis if administered immediately following a bee sting. And over time, a course of allergy shots can reduce or eliminate bee-sting allergies.
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Dr. Judith James is OMRF’s executive vice president & chief medical officer, and Adam Cohen is OMRF’s senior vice president & general counsel. Send your health questions to contact@omrf.org.
