After a bee sting, the skin swells badly and turns red, and a little later you experience shortness of breath and dizziness. No, this reaction is not normal. A life-threatening bee venom allergy is present.
What is bee venom allergy?
Bee venom allergy is a type of allergy. An allergy manifests itself in an overreaction of the body against substances that are actually harmless. Many people get itching or local swelling after an insect sting. This is nothing special. In the case of bee venom allergy, however, these symptoms are much more acute and threatening. They occur within the first minutes or even seconds after the sting and can be life-threatening. Around five percent of the population suffers from bee venom allergy in Germany.
Causes
The causes of bee venom allergy are not easy to pinpoint. After all, researchers do not yet know why an allergy develops in the first place. Suspicions involve excessive cleanliness, damaging environmental factors, stress, and a poor diet high in protein and sugar. To suffer from bee venom allergy, there must have been at least one bee sting in the past. Only then is the increased sensitization to the bee venom present. Accordingly, the only thing that can be done is to try to avoid bee stings in order not to suffer from bee venom allergy.
Symptoms, complaints and signs
Mild redness, as well as swelling and itching, is a completely normal reaction to a bee sting and is seen in almost every victim. In people who are allergic to bee venom, these reactions occur many more violently. In the case of bee venom allergy, there are often very pronounced skin changes at the sting site. The skin or even adjacent joints swell up strongly, redness forms, which is accompanied by intense itching, which often occurs all over the body. Watery and reddened eyes, which itch intensely and are associated with runny nose, are also a typical symptom of a bee venom allergy. Some sufferers also experience abdominal pain accompanied by nausea and vomiting. In addition, there is often swelling of the face and throat in conjunction with difficulty swallowing and speaking. However, these accompanying symptoms usually subside after about a day. In contrast, allergic reactions that affect the circulation or breathing can be dangerous. The first signs are anxiety, a general feeling of weakness, acute breathing difficulties, palpitations and unconsciousness. These symptoms also often precede anaphylactic shock, in which cardiovascular arrest is imminent. Here, relevant symptoms must be responded to immediately and the emergency physician must be notified.
Diagnosis and course
If a bee venom allergy is present, there is a danger to life with each subsequent sting. Symptoms are likely to worsen each time. If perhaps only extreme swelling occurred at the sting site at first (grade 0), the next sting may already cause nausea and severe itching. In grade 3, shortness of breath and dizziness may also occur. In the worst case (grade 4), the affected person collapses in anaphylactic shock. In such a moment, there is a very high risk of death! Sometimes one of the stages is skipped and a life-threatening state of shock occurs immediately at the first sting. Since nobody knows in advance if and when this could happen, a bee venom allergy belongs consistently in medical hands. The allergist will use a blood test to find out what degree of severity the bee venom allergy already has.
Complications
Various complications can occur with bee venom allergy. If affected persons are stung by a bee, the typical skin rash with redness and itching occurs first. Depending on the severity of the allergy, this can be followed by swelling of the neck and face as well as severe difficulty swallowing and speaking. Further complications are runny nose, watery and itchy eyes, and shortness of breath with danger of suffocation. As the disease progresses, abdominal cramps often occur, which may be associated with nausea and vomiting. The swelling can cut off the blood supply and, depending on the location of the sting, lead to paralysis and movement disorders. In the case of an existing bee venom allergy, a sting can also trigger heart palpitations and feelings of weakness, which in turn lead to anxiety and panic. If not treated, circulatory collapse occurs, accompanied by unconsciousness.If left untreated, bee venom allergy can lead to the death of the affected person. Secondary complications can occur if the bee sting becomes infected or there is a fall and further injury as a result of unconsciousness. Complications can occur during treatment if the affected person does not have an emergency kit on hand or if acute treatment is given improperly or too late in the field.
When should you go to the doctor?
If bee venom allergy has already been established, a doctor should definitely be consulted in the event of a bee sting. If certain symptoms appear after the sting, especially nausea, dizziness and shortness of breath, the emergency doctor must be called immediately. In this case, there is a risk of circulatory shock, which can be fatal. People who do not know whether they are allergic to bee venom should closely monitor themselves or their child after a sting. Burning pain and swelling of the sting site immediately after the sting are normal. However, after removing the stinger and cooling the puncture site with ice cubes or a cold washcloth, there should be a rapid improvement. If this is not the case, there is a suspicion that a person is allergic to bee venom. This suspicion should definitely be clarified by a doctor, since the next sting can be life-threatening in the case of an allergy. In any case, a visit to the doctor is necessary if the affected person still feels severe pain several hours after the sting and the swelling increases instead of decreasing. In case of shortness of breath or first signs of shock, the emergency physician must be called immediately.
Treatment and therapy
Bee venom allergy should by no means be left untreated. First and foremost, any further sting should be avoided. This avoidance is easier than for a pollen allergy. After all, most bees do not belong to an aggressive variety and also sting only when they feel threatened. If a bee venom allergy is confirmed, the affected person must carry emergency medication around the clock. This includes a breathing spray as well as an adrenaline shot. The treatment of bee venom allergy always belongs in experienced hands. Currently, hyposensitization is the only way to treat bee venom allergy. In this procedure, the patient is injected under the skin with slowly increasing doses of the allergy-causing bee venom. Since this procedure can be very dangerous in the case of a bee venom allergy, the therapy is only carried out under medical supervision within a clinic stay of several days. Even after this, a bee venom allergy is not cured. In 90 percent of those treated, an excessively strong reaction no longer occurs after a new sting. Unfortunately, this does not last long. For this reason, it is necessary to check annually whether the protection is still working. If not, the hyposensitization must be repeated. In addition to hyposensitization, bee stings should be avoided at all costs. Taboo in a bee venom allergy are therefore barefoot walking, strongly scented perfumes and excited movements near bees.
Outlook and prognosis
Bee venom allergy always requires treatment because it can be life-threatening for those affected. At first, only mild swelling may show up after a bee sting, but the very next one can cause severe itching and nausea. As the symptoms increase each time, shortness of breath and dizziness can follow, and in the worst case, anaphylactic shock. However, since there is no certainty that the reactions will increase slowly, a bee venom allergy must definitely be treated by a doctor; even the first sting can be life-threatening. Only by means of a blood test at the doctor’s can be estimated how the body reacts to the bee venom. If a bee venom allergy has already been diagnosed by a doctor, it is important for those affected to carry an emergency kit with them. In severe cases, hyposensitization is necessary, which is carried out as part of inpatient treatment under supervision. In about 90% of cases, the reaction to another bee sting is more moderate, but the allergy cannot be cured. The experience of experts shows that the protection lasts only for a limited time and should therefore be reviewed annually. To minimize the risk, barefoot walking, intense perfume or panic reactions are taboo when bees are around.
Prevention
It does not seem possible to protect oneself from bee venom allergy.Researchers still know too little about the development of an allergy for this. As a general rule, a person allergic to bee venom should always carry their medication with them in case of an emergency. This includes a cortisone spray (in case respiratory distress occurs) and a syringe kit. In the event of a sting, the bee venom allergy sufferer must immediately and promptly inject the medication into his or her thigh. If he is no longer able to do so, someone else must do so. For this reason, family, friends and co-workers should be made aware of the bee venom allergy and how to properly administer the injection.
This is what you can do yourself
People with bee venom allergy should avoid bee stings whenever possible. Suitable clothing and appropriate footwear can reliably prevent stings and thus contact with bee venom. Special insect sprays and similar products also help to prevent stings in the first place. Allergy sufferers should also not wear bright jewelry and avoid meadows with many bees. When in contact with bees, a sting can be reliably avoided by calm behavior. In case of emergency, allergy sufferers should always carry a first aid kit with a pre-filled adrenaline syringe, antihistamine, cortisone preparations and cooling spray. Should a sting occur despite all precautions, the necessary measures can be taken immediately. However, the stinger and bee must be removed beforehand. The bee should not be squeezed in the process, otherwise additional venom may be released. Accompanying the first aid, an emergency doctor must be consulted. If there are signs of circulatory problems, immediate emergency medical assistance is required. If fainting occurs, further life-saving measures may have to be taken. The emergency medical services should then be informed immediately of the allergy and the circumstances surrounding the sting to ensure prompt treatment.
