Newark, N.J.--Most of us see insect bites as simply a warm weather nuisance. But insect stings and bites can also be very serious. The American College of Allergy, Asthma & Immunology (ACAAI) says most people will have a reaction to an insect bite or sting, with some reactions causing a need for immediate medical attention. The most common reaction is pain, redness, itching and swelling at the site. ACAAI recommends that you apply ice to control the swelling. Sometimes antihistamines and steroids are needed.
“There are between 50 and 100 deaths a year from anaphylaxis as a result of stinging insects,” says Timothy S. Yeh, MD, FAAP, Chairman, Department of Pediatrics at Children's Hospital of New Jersey at Newark Beth Israel Medical Center and Medical Director of the Pediatric Intensive Care. “While this figure is low compared to deaths from food allergies, many of the sting-related deaths could be prevented.”
Bees, wasps, hornets, yellow jackets, and imported fire ants can all deliver a sting. But it is the nature of the victim’s immune system and sensitivity to the insect’s venom that triggers a reaction.
It is important to know the difference between a local reaction and an allergic reaction, which is much more serious. Over two million Americans are allergic to stinging insects. Some of the signs of an allergic reaction according are:
- hives, itching, and swelling in areas other than the sting site
- tightness in the chest and difficulty in breathing
- hoarse voice or swelling of the tongue
A more dangerous reaction is anaphylaxis, which can also involve:
- dizziness or a sharp drop in blood pressure
- cardiac arrest
Anaphylaxis usually involves various parts of the body and it can be fatal. The allergic reaction can be halted by the use of epinephrine, so someone who is sensitive to insect stings may want to keep this prescription medication on hand.
If the victim exhibits any signs of allergic reaction or anaphylaxis shortly after a bug bite, call 911 immediately.
Insects and other arthropods can also carry serious disease.
Mosquitoes can transmit West Nile virus (WNV) and other diseases that can lead to encephalitis, which is an inflammation of the brain. Infection with WNV can be asymptomatic (no symptoms) or can lead to West Nile fever or severe West Nile disease.
Symptoms include fever, headache, tiredness, and body aches, occasionally with a skin rash (on the trunk) and swollen lymph glands. While the illness can be as short as a few days, even healthy people have reported being sick for several weeks. The symptoms of severe disease include headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, and paralysis.
Ticks can transmit Lyme disease and Rocky Mountain spotted fever (RMSF). Lyme disease affects the skin, causing a reddish rash often associated with flu-like symptoms. Later, it can produce abnormalities in the joints, heart, and nervous system. RMSF gets its name from the rash it causes — small red spots on the wrists, ankles, palms, and soles. The infection can cause fever, chills, muscle aches, vomiting, and nausea. Although RMSF is most common in the southeastern states (Virginia, Georgia, the Carolinas), it also occurs in other states.
With a spider bite, victims should be concerned when a local reaction worsens for more than 24 hours. Look for redness spreading from the bite, drainage, increase in pain or numbness or a discoloration around the bite like a halo. Anaphylaxis is also a concern.
Black widow spiders have a toxin that affects muscle contraction and nerve function. Severe brown recluse spider bites can also cause some symptoms over the entire body (systemic reaction). Look for sweating, chills, headache, body aches, stomach cramps, leg cramps, rapid pulse or exhaustion.
For this reason, it is a good idea for everyone to avoid unnecessary exposure to insects and ticks by taking some simple precautions, which are supplied by Newark BethMedical Center:
- Avoid sweet fragrances, which tend to attract insects, such as perfumes, colognes and hair sprays.
- Don't let standing water remain on your property.
- Wear long-sleeved shirts and long pants when possible, tucking pants into boots or socks when hiking.
- Using insect repellent (bug spray) with 30%-50% DEET. Picaridin, available in 7% and 15% concentrations, needs more frequent application. The American Academy of Pediatrics indicates that DEET is safe to use on children 2 months of age or older. Other sources suggest DEET use on children 2 years or older. There is less information available on how effective picaridin is at protecting against all of the types of mosquitoes that transmit malaria.
- If you must be outdoors in areas where Lyme disease or other tick-borne illnesses are a serious risk, inspect yourself and family members for the ticks. Also, be aware of rashes that might develop. One of the first signs of Lyme disease may be a red circular rash (bull’s eye) at the site.
Date: July 22, 2008
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