Insect bites (ictus, (Latin ictus stroke; thesaurus synonyms: Bee sting; Bite by arthropod; Bite by venomous insect; Bite by centipede; Paralysis by tick bite; Sting by arthropod; Sting by venomous insect; Toxic effect of venomous insect bite; Toxic effect of venomous insect sting; Poisoning by arthropod bite; Poisoning by arthropod sting; Poisoning by venomous insect; Wasp sting; ICD-10-GM T63. 4: Poison of other anthropods) can cause unpleasant, more often even dangerous symptoms in humans. They are caused by the salivary secretion of the insect or by its venomous sting.
Allergic symptoms can be distinguished from toxic ones. Local reactions can also be distinguished from systemic reactions (general reactions).
In up to 75% of the population, an allergically triggered wheal (immediate type reaction) occurs after an insect bite (mostly mosquito Culicidae). In up to 50 % a papule (reaction of the late type) occurs.
Stings of honey bees (Apis mellifera) and certain wrinkled wasps (Vespula vulgaris, Vespula germanica) are among the most frequent triggers of clinically relevant reactions (in Central Europe). Bites from field wasps, bumblebees, hornets, ants, mosquitoes, or horseflies usually result in a much milder reaction.
The prevalence (frequency of illness) for local allergic symptoms is up to 26% (in Germany). Anaphylactic reactions (IgE-mediated reaction; immediate type allergy/anaphylaxis to honey bee/ wasp venom) occur in up to 3.5% of stung adult patients and in 0.4-0.8% of children. Allergens are species-specific, but cross-reactions are possible! The most common triggers for severe anaphylactic reactions in adults are wasp stings (in Germany). Very rare are such reactions to bites of ants and mosquitoes. An anaphylactic reaction can occur very quickly. Allergic reactions occur 10 minutes to 5 hours after the sting, but in most cases within the first hour.
Course and prognosis: The venom of wasps and bees (hymenopteran venoms) causes pain and, later, pruritus (itching). Swelling is also one of the typical symptoms. In about 2.4-26.4% of patients, due to insect venom allergy, there are increased local reactions in the area of the sting site with a diameter of more than 10 cm. It may last for several days.
The venom of wasps, bees, bumblebees and hornets is not life-threatening. To achieve such an effect, several hundred stings would be required.
Nevertheless, sting reactions can be lethal (fatal) in the worst case. The reason for this is the anaphylactic (systemic) reaction of the body. In adults, insect stings are the most common triggers of severe anaphylaxis (strongest allergic reaction); in children, they are the second most common cause after food.In Germany, about 20 people, almost exclusively adults, die each year from the sting of a bee, wasp or even hornet. Two-thirds of those are male.
