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Dr. Lee Perry

Q: My kids love being outdoors. How can I tell the difference between an allergic reaction and a normal reaction to an insect sting?

A: The most common stinging insect allergies come from fire ants, honeybees, wasps, hornets and yellow jackets. Most of the time, these insects trigger local reactions that are very painful and itchy but not particularly concerning from a medical standpoint.

On the other hand, some people may experience systemic symptoms after being stung, including shortness of breath, coughing, wheezing, lip swelling, hives, nausea and vomiting. In extreme circumstances, a combination of these symptoms can occur, a condition known as anaphylaxis, which is life-threatening.

Children and adults who have had symptoms of this severity should be evaluated for venom allergy, because there is about a 60 percent chance that future stings can cause more severe reactions. This evaluation should include both skin tests and blood tests.

If the tests are positive, allergic individuals should be prescribed a device that injects adrenaline (EpiPen or AUVI-Q), which should be carried at all times. Venom immunotherapy (venom shots) is also an option for a patient with a life-threatening allergy. Venom shots can reduce the risk of life-threatening reactions to insects to less than 5 percent.

— Dr. Lee Perry, Chattanooga Allergy Clinic; member, Chattanooga-Hamilton County Medical Society

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