Anaphylactic Shock

Anaphylactic Shock article - Masterfile

Stings from bees, yellow jackets, hornets, wasps, and fire ants are a common occurrence during the summer months (and year-round in warm climates). For most people the reaction to a sting is harmless (albeit potentially painful).

However, some people—about 3 percent of the population—are so sensitive to the venom that even one sting can provoke their immune system to overreact drastically. This is known as anaphylactic shock (from the Greek ana, meaning excessive, and phylaxis, meaning protection). About 50 Americans die each year as a result of being stung by bees, wasps, or hornets. No other venomous animal, even snakes, kills that many. And this figure may be too low: experts suggest that an unknown number of deaths attributed to heart failure may actually be caused by stings.

Signs of Insect Bites and Stings

The venom of stinging insects contains toxins that produce fierce burning and swelling at the site of the sting. Reactions can also include redness and sometimes welts and itching in the area around the sting.

Allergic Reactions

The cause of more severe allergic reactions to stings is not well understood. Anyone who has experienced any symptoms of anaphylactic shock or any systemic reactions after being stung should know that reactions usually become increasingly severe with successive stings. Life-threatening reactions most often occur in people over the age of 30.

These reactions include rapid swelling of the lips, tongue, throat, and eyes; nausea and vomiting; irregular heartbeat; difficulty breathing; loss of consciousness. (Multiple stings can also produce the same symptoms.)

Immediate Care for Insect Stings

In most people the pain and swelling from a single sting disappears after a few hours. If you are allergic, however, you should seek medical help, even if the reaction appears to be mild. Multiple stings can also produce a toxic reaction that requires immediate treatment.

For pain and swelling at the site of the sting, the following measures can help. (If you’re hypersensitive to stings, you should have an emergency kit containing adrenaline (epinephrine) whenever you’re outdoors, as noted in the box at right. Also consider desensitization shots, especially if you spend a good deal of time outdoors in areas populated by bees.)

  • Start with soap and water. The best way to treat a sting is to wash it with soap and water. Applying an ice pack or flushing with cold water can also help relieve pain and reduce swelling.
  • Try tenderizer. You may also obtain some relief by applying calamine lotion or a paste made by mixing baking soda or unseasoned meat tenderizer and water. (The tenderizer contains papain, an enzyme that breaks down toxins in the venom.) Aspirin or another over-the-counter anti-inflammatory drug such as ibuprofen can also help alleviate pain.
  • Remove bee stingers at once. Conventional wisdom says that pulling a stinger from the skin with tweezers or fingers is a bad idea because it tends to inject more venom. Thus, standard advice has been to scrape the protruding venom sac away with a sharp blade and then remove the stinger (and to leave the stinger in until you can do this). However, in a study published in the The Lancet, bee stings swelled less and hurt less when the stinger was removed immediately by whatever method—including pinching the stinger. (Beekeepers have known this for centuries, it seems.) If you are among the small percentage of people subject to anaphylactic shock, removing the stinger quickly can help save your life.
  • If you’re near a hive, retreat. As it stings, a honeybee releases a chemical that identifies you and draws other bees. So if you’ve been stung close to a hive, hurry to a safe place.

Prevention Tips

You can avoid being stung by taking a few preventive measures:

  • Dress for protection. Wear shoes and socks outdoors; don’t go barefoot. When gardening, wear a long-sleeved shirt, long pants, and gloves. Bees can mistake you for flowers, so avoid brightly colored clothes and floral prints.
  • Spray yourself. There are dozens of products with DEET (N, N-deiethyltoluamide), which works well and has an excellent safety record when used according to directions. For ordinary purposes, don’t use a product on your skin that has more than a 30 percent concentration. It helps to apply insect repellent on exposed skin (but not on broken skin or over cuts) and also on trouser and sleeve cuffs, and on shirt fronts. Avoid wearing sweetly scented perfumes, soaps, or lotions.
  • Be cautious about eating outside. Bees are particularly attracted to sweet, drippy foods like ice cream or watermelon.
  • Don’t try to fight. If an insect is annoying you, don’t swat it—either walk away or, if attacked by a swarm, lie down and cover your head.

When to Seek Medical Help

If you experience any of the symptoms of anaphylactic shock, you must go to the nearest emergency room or doctor immediately. This is also true if you experience severe symptoms due to multiple stings. You should also see a doctor immediately if you know you are allergic to stings, even if your reaction to a sting is mild.

Fortunately, there are effective short-term and long-term treatments for those who are highly allergic to bee stings. Once you are found to be allergic, your doctor can prescribe an emergency kit to deal with serious reactions to a sting. Long-term treatment involves going to an allergist for regular shots of a serum made from insect venom. This may gradually desensitize you until a sting poses little serious harm.

For More Information

  • American Academy of Dermatology

Publication Review By: the Editorial Staff at

Published: 11 Aug 2010

Last Modified: 21 Oct 2014