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Treatment of bumblebee stings and allergies

1. Bumblebee and honeybee stings

Only bumblebee workers and queens have a sting, as with honeybees and wasps. So males cannot sting. The sting is During a sting, some venom is injected into the body though the sting. With humans, this generates a short severe pain that fades away. Occasionally (approx. 1%) allergic reactions develop against the injected venom. The sting of a bumblebee has no barbs. Hence the bumblebee worker or queen can withdraw her sting, and is able to sting again. The sting of a honeybee does have barbs. When a honeybee tries to withdraw its sting, it tears off its
2. How to prevent bumblebee stings?
First of all, it is important to be CALM when working with the bumblebees. Prevent sudden currents of air (breath) into the colony. Also, be aware that bumblebees become alerted by smells as coming from transpiration, alcoholics, perfumes, soap, aftershave and so on. Moreover, rings, bracelets and watches may cause aggressive behaviour. (specially due to the scent of oxydated material between skin and the rings etc.) So also here applies: it’s better to prevent than to cure!
3. Stung? Reactions and treatments
3.1. Non-allergic, local reaction

Usually a bumblebee sting leads to a non-allergic, local reaction: a swelling at the site of the sting, being red and itchy, but lasting only for a couple of hours. This can occur directly after the sting, but more generally it starts after some hours. The itching may last for some hours or even days. In some cases the local reaction may spread somewhat more; in that case it usually lasts longer (up to a couple of days). This is still a local, non-allergic reaction.
3.1.1. Treatment of a local (non-allergic) reaction
Usually medical treatment is not necessary. Some measures can be taken to minimise the local reaction, specially in the case one got stung at an extra sensitive place (f.i. near the eyes). Then it is advised to take two tablets of aspirin (together with milk or water) immediately after the sting (prevents swelling) and to put cold compresses on the site. There are ointments available that ease itching (Azaron). In the rare case of a sting in the pharynx, breathing might be hindered. Clinical observation is advisable and corticosteroids (f.i. Prednisolone) should be administered intravenously.
3.2. Allergic or general reaction
In some cases (approx. 1%) repeated stings may lead to an allergic reaction, also called general, systemic or
anaphylactic reaction. This might happen at the second or third sting. It is not possible to have allergic reactions after
the first sting, because there are no antibodies present yet. Allergic reactions usually become evident within 15 minutes after the sting. Allergic reactions are classified in 4 grades, in order of increasing severity: Grade 1 – reactions on the skin (swellings, redness, site becomes itchy) over the whole body
Grade 2 – grade 1 plus intestinal problems (vomiting, diarrhoea)
Grade 3 – grade 1 and/or 2 plus bronchial obstruction
Grade 4 – grade 1 and/or 2 and/or 3 plus heart palpitations, anaphylactic shock

3.2.1. Treatment of allergic reactions
In this case of vomiting but certainly with symptoms of grade 3 or 4, the victim should be brought immediately to the
hospital for observation and treatment! In case of a grade 1 reaction, one could decide to wait, but be aware that the
reaction still can shift to a higher grade after some time. Where allergic reactions are involved, administration of an anti-histamine (f.i. clemastine / Tavegil) is useful. The anti- histamine reduces the swelling caused by the histamine in the poison. If some time has already passed since the victim was stung, or if the reaction is already in progress, it is also useful to combat possible secondary symptoms resulting from the reaction by administering corticosteroids (e.g. Prednisolone). In the case of reactions constituting a great threat to life (grade 3 and 4), or if there is no reaction to clemastine, it may
be necessary to administer adrenaline. Adrenaline stimulates the heart, narrows blood vessels and widens bronchia.
3.2.2. Information for doctors
Below a description of medication for a severe anaphylactic attack (grade 3/4) following a bumblebee sting. (Source: Dr.
H. de Groot, department of Allergology, Erasmus Medical Centre Rotterdam). One or more of the medicines can be administered in the indicated order, until symptoms disappear and stay away. Medication
Sequence
Children
2 mg = 2 ml intravenously or intramuscular
3.2.3. Living with bumblebee allergy
After having shown an allergic reaction to bumblebee venom, especially after grade 1 and grade 2 reactions, there is a good chance that next stings will not cause an allergic reaction. To test for this (in the hospital) artificial bumblebee venom can be used. The artificial venom can also be used for treatment of allergic persons (hyposensitisation). This is meant to make the human body insensitive for bumblebee venom. Persons who, after serious allergic reactions, do not undergo hyposensitisation treatment should carry Epipen, an epinephrine (adrenaline) auto-injector as long as they stay in contact with bumblebees.
3.2.4. Toxic reactions
Toxic reactions only occur when stung very often (e.g. tens of stings at one incidence). Generally symptoms like
abnormalities in the vascular and nervous systems may then occur. Supporting measures should be taken in the hospital,
3.2.5. Hyperventilation
Besides a severe allergic reaction (grade 4) also hyperventilation may cause unconsciousness. Of course also in this
case it is necessary to alarm immediately.
3.2.6. Increased risk
Persons that use certain medicines (beta-blockers) and pregnant women are at increased risk when allergic reactions

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