It was a bright morning in late spring, and the dew was drying rapidly on the crumpled cedar chips underfoot. I was helping to supervise a little band of preschoolers at my local elementary school. The rambunctious group was racing over wooden ramps, through plastic tunnels and down and around slick plastic slides and wearing oversized smiles. Until a sharp, shrill siren-y scream pierced the idyllic scene. All the fun suddenly stopped cold.
A pair of shiny, fat insects buzzed angrily around a small boy’s ears. I didn’t quite know what to do, or even what kind of insects these were; they were all black, and not stripe-y, but they buzzed like bees. So we tried to shoo them away, and eventually brought the kids back into the classroom a few minutes early, just to be safe.
Stinging insects are a seemingly ubiquitous warm-weather presence, and on the whole they are beneficial to us, pollinating crops and eliminating pests. But they can also be a nuisance, interrupting playtime with their noisy scare tactics or with painful, but harmless, stings and bites. At worst, they can be downright dangerous, causing life threatening allergic reactions in a few children and even serious injury in non-allergic kids who are stung by large amounts of the critters all at once. It’s thus a good idea to be able to learn about some of the more common stinging insects, including how to avoid getting stung, and what to do if you are.
According to Amy Albam, senior horticulturist at the Rockland County Cornell Cooperative Extension in Stony Point, N. Y., common varieties of bees and wasps that buzz around us in warm weather include honeybees, bumblebees, cicada killers, carpenter bees, and yellow jackets (see box for descriptions).
Some types of ants can sting too, but for the most part they are not a health nuisance in our area, she says.
Generally, then, female wasps and bees are the stingers, using the sharpened ends of the part of their body that lays eggs. And the stings involve not just puncturing skin, but also depositing venom into the body.
It’s the venom that causes most of the pain, as well as any allergic reactions. According to a paper about stinging insects from the University of California, Davis’ Integrated Pest Management Program, the venom hurts because of an ingredient called melittin, which stimulates pain receptors in the skin. "The body responds to stings by liberating fluid from the blood to flush venom components from the area," it says. "This causes redness and swelling at the sting site."
It’s very rare, but if someone gets multiple stings, it is possible to die from the poisons in the venom itself, even if the victim did not have an allergy to the venom. A lethal dose from a honeybee, for example, is about 8.6 stings per pound of person stung, according to this same University of California, Davis, paper. That means a 50-pound child could die from 430 stings, whereas a 150-pound adult would find about 1,290 stings lethal. Even if the venom doesn’t get you immediately, a person who has had multiple stings is at risk of kidney failure hours or days later. So absolutely have your child checked out by a doctor immediately if she gets attacked by a hoard of stingers!
Somewhat more common than multiple sting incidents, are life threatening allergic reactions to the venom, with about 40 deaths per year in this country. And while the ranks of the stinging venom-allergic are actually quite small – about 3 percent of the population has a serious allergy to insect venom – the stakes are obviously huge.
Judi Levine, a salesperson for The Parent Paper with two grown children, says she’ll never forget the day her 1-year-old baby sister had an allergic reaction to a bee sting. Which is amazing, because it was 50 years ago this summer and Levine was only 6 years old! But the horror of the event has stayed with her. In Technicolor.
"We were at Darlington Country Club," Levine recalls, "and she was running in the grass, barefoot, wearing just a diaper. All of a sudden, she collapsed. I remember my mother screaming, panic stricken. There was a big to-do. The lifeguards came running.
"My sister had stopped breathing, she was out cold. They found a bee stuck in the bottom of her foot. She had stepped on a bee. I guess it was what is called anaphylaxic shock. But the lifeguards were great. They had oxygen, and they brought her back."
When you’re allergic to an insect sting, the culprit involves the body’s response to the proteins in the venom, according to Dr. MaLourdes de Asis, an allergist at Allergy & Asthma Consultants of Rockland & Bergen, with offices in West Nyack and Westwood (Allergyasthmasource.com). Different types of bees and wasps have slightly different venoms, but all are comprised of similar proteins. Some people might be allergic to just one type of wasp or bee venom, while others have reactions to a number of different insects.
What happens, according to Dr. de Asis, is that the first time someone is stung, the body forms antibodies to the proteins from the venom, which "start floating around in your blood stream and in your cells."
You can’t have an allergic reaction at this point, but you could the next – or any subsequent – time you’re stung. After the first sting, your immune system releases the antibodies it designed in the past whenever it comes across the venom protein again. And then, in people with allergic reactions, immune cells peg these antibodies as dangerous, and try to fight them by releasing a substance called histamine.
"Depending on how allergic you are and how much of the protein you’re exposed to, the histamine can cause a serious reaction in your body," explains de Asis. "You can develop hives all over your body. You can develop swelling in your throat or in your face. You can drop your blood pressure. You can start wheezing and have trouble breathing."
Levine’s sister undoubtedly survived because the lifeguards responded so quickly. A swift dose of epinephrine can generally stop the allergic reaction and save the person’s life. In this case, the oxygen was enough to revive the baby.
One tricky thing is deciding whether or not a person is actually having an allergic reaction, because the timing can vary from incident to incident. Sometimes, it’s quick and the person just drops, like Levine’s sister. In that case, you need to get help within minutes. Other times, it can take a lot longer – up to six hours, according to the doctor – for the reaction to progress to where it’s life threatening.
She thus recommends that if your child has any reaction to a sting besides a little swelling and pain near the wound site, you should err on the side of safety and bring him to the Emergency Room. Once there, he’ll probably receive an injection of epinephrine or at least some Benadryl to stop the reaction.
Upon leaving the emergency room, a child should be given an epinephrine auto-injector to use in a possible future allergic reaction, and also be advised to make an appointment with an allergist. At the allergist’s office, you’ll probably take some skin tests to confirm the allergy, and then discuss the advisability of allergy shots, which are also known as allergy desensitization or immunotherapy.
Allergy shots have been around for a long time. Indeed, Levine’s sister started a successful course of allergy shots a half century ago. While today, Virginia Citrano’s son is engaged in the exact same type of therapy.
Citrano, the editor of myveronanj.com and mother of two boys, explains that her youngest was stung by a wasp at the Verona pool in 2006 when he was 6, and then again the following year. Both times, he had some serious swelling, so she took him to a local allergist, Dr. Arthur Frost, who diagnosed a major allergy to wasps and bees and started the boy on the immunotherapy shots.
With immunotherapy, you’re injected with a minute amount of the venom protein, and then a gradually increasing amount is injected on a weekly and then monthly basis over a series of years, until your body gets used to the protein and stops reacting to it.
The good news is that it’s 95 percent effective, so that the allergy stays at bay for life. On the other hand, it’s both time consuming and can add up to be rather expensive, even if you have insurance (Citrano’s medical insurance pays half the cost, but she’s still up for about $38 a pop).
"It was once a week, in the beginning, and then they gradually tapered it back, so now we’re on once a month," Citrano says. "It’s been four years. He’ll be tested again at the end of the summer and depending on how he reacts, he may be able to go off the program entirely."
But even if you’re not allergic, and there’s only one insect involved, it’s important to make sure that you receive proper first aide treatment after a sting.
"Most people get large swellings in the area where they’re stung, and it’s very uncomfortable," says de Asis. "Sometimes it gets very large, and it becomes a concern because it might get infected, or you may need to go on steroids to make it get better."
Make sure you wash the infected area with soap and water, and then apply ice, ice water, or cold compresses, advises Jane Siebert, a certified school nurse with the Robert Treat Academy Charter School in Newark. And if you’re at home or have supplies on hand, you might want to apply a soothing paste of baking soda and water. If your child’s discomfort is intense or continues for a long time, you could also give him some Tylenol, she says.
Honeybees, in particular, leave a barbed stinger behind in a jagged wound. And, not only is that nasty for the insect, who dies without its stinger, but it can increase the amount of venom a child receives.
"What the (detached) stinger does is continue to pump venom into your body after your stung," explains de Asis. "So you’re going to get a bigger dose of the venom in the body." Which means that getting a honeybee stinger out promptly is essential.
According to Siebert, it’s not too difficult to remove a stinger. But you have to be careful not to apply too much pressure, which might break a bit off and inject the venom further into the body. "You want to take your hand or a piece of cardboard and gently flick or brush it out," she says. "Don’t pinch or use tweezers."
Overall, however, bees seem to be relatively docile, compared to wasps, says Albam. "Bees usually leave you alone. But if you get too close to a nest, or if you startle them they might sting," she says. The best and first defense against these insects should generally be avoidance and common sense.
"I teach my son to be smart," notes Citrano. "I make a point of not having him wear brightly-colored clothing (which, along with perfume or any other sweet scent, attracts these insects) during wasp season. And I tell him to look around on the ground to see if there is any noticeable activity of ground wasps ... But I don’t want him to feel that he has to be locked into a bubble."
Albam adds that you should wear shoes outside, move slowly so you don’t startle these insects, and be careful when picnicking. Keep sugary drinks in open or clear containers (the better to see if you’re sharing your beverage), she says. And don’t forget to look inside a sandwich before taking a bite.
If you do find a hive or nest near where the kids play, and you suspect an allergy, it’s probably a good idea to get rid of it. If it’s inside the walls of your house, consult with a professional, advises Albam. But if the nest is easily accessible and there’s no escape route for the critters, you can try it yourself using the least toxic wasp and bee insecticide available (check the IPM guidelines.org for specifics). Wait until the cool of the evening, and then spray inside the hole.
Honeybee hives, in particular, are valuable. So you might try to contact a local beekeeper to see if they’d be willing to come and take over an inconvenient (but freestanding) honeybee hive, says Albam. (Try to make sure these are actually honeybees, as that’s the only hive beekeepers will take! For beekeeper contacts, call: 845-429-7085 http://rocklandcce.org in Rockland County; or check www.njbeekeepers.org in New Jersey).
Know your stinger
How do you tell wasps from bees? According to Albam, bees are usually fuzzy, don’t have much of a waist, live in a variety of hives or nests, and have somewhat muted colorations. Whereas wasps are smoother, often have a pinched-in mid-section, live in papery nests, and are generally more brightly colored than bees, with bands of yellow or white contrasting sharply with black or brown or other darker hues. One thing I was surprised to learn from Albam, is that yellow jackets and hornets are actually wasps. A hornet, it turns out, is just another word for wasp!
Honeybees are the best known of the bees. Nearly everybody on the planet is keeping their fingers crossed that the honeybee population rebounds from the recent die-off in what is known as colony collapse disorder. Bees are crucial to our food supply as efficient pollinators of many crops (not to mention honey makers, yum!). Nearly a third of the country’s honeybees disappeared in 2007, for example, according to honeybee specialist Eric Mussen.
Bumblebees are big fat black and gold insects that buzz around. They do make honey, but not in as big quantities as do honeybees, and they often nest in the ground in relatively small hives (compared to honeybees).
Cicada killers are those massive long buzzers that live in distinct holes in the ground, that kind of look like giant ant hills. They may look scary, but in general they’re not aggressive, insists Albam. And they help control the cicada population.
"You probably have to step on one to get stung. They have holes in the ground and capture cicadas as provisions for their young. So their whole focus is on taking cicadas into the nest."
Carpenter bees are probably the critters that were buzzing around the preschoolers I was supervising. They’re often dark in color, bore holes in wood to make their nests, and would thus be likely buzzing around a wooden play structure like the one at the school. While they can cause serious damage in thinner wooden structures, they feed on nectar just like honeybees, and are thus important pollinators of plants with larger flowers.
Yellow jackets are sometimes called picnic wasps, because they feast on sugary drinks or any other human food they run across. As scavengers of human food, then, they have a lot of interactions with people and can even be aggressive when trying to get a feed.
