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About Bee & Wasp Venom Allergies

Being stung by a bee or wasp often results in painful swelling at the sting site, which is generally not dangerous for most people. However, those with an allergy to bee or wasp venom may experience a systemic reaction, meaning it affects the whole body, and can lead to anaphylaxis.

Anaphylaxis (pronounced anna-fill-axis) is a serious and often sudden allergic reaction, requiring emergency treatment. The fear of being stung, especially for those at risk of anaphylaxis, can be daunting. But rest assured, there are measures you can take to minimise this risk.

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Who is at risk?

You are more at risk of serious allergic reactions to insect stings if you have frequent or multiple stings. For example, beekeepers, gardeners or refuse collectors have a higher risk of having a serious reaction to a sting. In addition, people with a rare condition called mastocytosis are more at risk of having serious sting reactions.

People with allergies like hay fever or food allergies aren’t more likely to have a severe allergic reaction to an insect sting.

If you are allergic to insect stings, you can still enjoy the great outdoors by seeking medical advice, carrying prescribed medication at all times, and taking precautions to avoid getting stung.

6 ways to avoid being stung if you have an allergy

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What are the symptoms of anaphylaxis?

The most serious form of allergic reaction is called anaphylaxis. Most healthcare professionals consider an allergic reaction to be anaphylaxis when it involves difficulty in breathing or affects the heart rhythm or blood pressure. Any one or more of the following symptoms may be present – these are often referred to as the ABC symptoms.

AIRWAY

Swelling in the throat, tongue or upper airways (tightening of the throat, hoarse voice, difficulty swallowing).

BREATHING

Sudden onset wheezing, breathing difficulty, noisy breathing.

CIRCULATION

Dizziness, feeling faint, sudden sleepiness, tiredness, confusion, pale clammy skin, loss of consciousness.

In extreme cases, there could be a dramatic fall in blood pressure. The person may become weak and floppy and may have a sense of something terrible happening. Any of the ABC symptoms may lead to collapse and unconsciousness and, on rare occasions, can be fatal.

Other symptoms

Other symptoms that might be present include:

  • A raised red rash (known as hives or urticaria) anywhere on the body
  • A tingling or itchy feeling in the mouth
  • Swelling of lips, face or eyes
  • Stomach pain or vomiting

These symptoms can also happen on their own. If you don’t have any ABC symptoms, the reaction is likely to be less serious and may not be classified as anaphylaxis. However, it’s important to monitor closely in case ABC symptoms develop.

Allergies to Bee & Wasp Stings on YouTube

Watch our podcast to learn more about allergies to bee and wasp stings, including symptoms, treatment, and prevention with Dr Andrew Whyte. Dr. Andrew Whyte works at the Department of Allergy and Immunology at Derriford Hospital, where he provides care to patients with immunodeficiency and allergies from across the South West Peninsula.

Find out what to do in an emergency

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Getting a diagnosis

If you have previously experienced symptoms away from the site of the sting – such as those listed above – you should see your GP and ask for a referral to an allergy clinic. Your GP can locate an allergy clinic by visiting the website of the British Society for Allergy and Clinical Immunology (BSACI).

Individuals who experience significant swelling (more than 10 centimeters) at the sting site, which typically increases within 24 to 48 hours, are likely to have similar reactions if stung again. These individuals also have a slightly higher risk of experiencing a systemic reaction in the future.

It is advisable for anyone who has experienced such a large local reaction to consult their GP. While most individuals may not require a referral to an allergy clinic, those at an increased risk of future stings (such as beekeepers) may benefit from a referral to an allergy specialist.

Getting treatment

A small allergic reaction at the site of the sting, however painful, will usually respond to antihistamine medicine and the use of a cold compress. However, anaphylaxis requires an urgent injection of adrenaline. If you are at risk of anaphylaxis, you should be prescribed your own pre-loaded adrenaline auto-injectors (AAIs):

  • We recommend that you carry two AAIs with you at all times and know how and when to use them.
  • As soon as anaphylaxis is suspected you should lie flat with your legs raised and use an adrenaline auto-injector without delay.
  • 999 must be dialled immediately after an adrenaline injection is given, as symptoms could return after a short period of time, and more than one injection may be needed.
  • The emergency service operator must be told the person is suffering from anaphylaxis (pronounced anna-fill-axis).
  • A second AAI should be given after 5 minutes if symptoms do not improve.

Immunotherapy treatment

Your GP or allergy specialist may decide you are a suitable candidate for immunotherapy, also known as desensitisation. Venom immunotherapy (VIT) involves a series of injections of insect venom. The injections start at very low doses and gradually increase over an agreed period of time until a safe level of venom is reached, typically 100 micrograms. This dosage is approximately the amount that someone with multiple stings may encounter.

Research has shown that VIT is very effective for people who are allergic to bees and wasps. VIT is effective in about 80% of people who have the treatment for bee venom allergy. For wasp stings, it works in up to 95% of people having treatment. This means that most people who complete a course of VIT will be much less likely to have a serious allergic reaction if they are stung again.

This treatment is available at several specialist centres in the UK, but your need for this treatment must be assessed at an allergy clinic.

Immunotherapy has two phases: the “initial” (or up-dosing) phase and the “maintenance” phase:

  • The initial phase lasts approximately 8 to 12 weeks, during which the starting dose is increased slowly to achieve the required maintenance levels.
  • Following this, you may need monthly injections for up to three years, although treatment schedules may vary between centres.
  • Anyone receiving immunotherapy has to remain in the allergy clinic for a period of time after the treatment in case they suffer an allergic reaction. The risk of a serious reaction is low, and most patients successfully complete the course.

View our new Venom Immunotherapy Factsheet for more information

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Are you concerned you may have a wasp or bee sting allergy?

If you’re worried that you may be allergic to the stings of bees and wasps, consider taking the following actions:

Talk to your GP

Explain to your doctor why you are worried, including any symptoms you've encountered from bee or wasp stings. They can provide guidance and, if necessary, arrange referrals to allergy clinics for testing and specialised treatments.

Risk avoidance

Minimise the risk of bee and wasp stings by avoiding things that attract them, like sweet food, bright clothing, and certain fragrances present in hairsprays and cosmetics.

Adrenaline auto-injectors (AAI)

Anyone prescribed adrenaline auto-injectors must carry two AAIs on them at all times.

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Types of insects

It’s important to determine which species of wasp or bee is causing the allergic reaction, as each has its own venom. While some individuals may be allergic to both bees & wasps, most people react to only one. In the UK, wasps and honeybees are the primary culprits for systemic allergic reactions, however bumblebees and hornets are also a risk. In other regions of the world, various insects like bees, wasps, and ants can trigger allergies. Allergy tests can help identify the specific insect you’re allergic to, but they can’t predict the severity of future reactions.

Remember that swatting bees or wasps could cause them to release pheromones that attract more!

  • Bees

    The bee leaves its stinger (with venom sac attached) in the skin. Because it takes a few minutes for all the venom to be injected, quick removal of the stinger is important. Avoid squeezing the venom sac as this will only inject more venom into the skin. The sac should be flicked upwards with one quick scrape of the fingernail or a credit card. This will reduce but not eliminate the risk of a serious reaction.

    Beekeepers should take special care. They must always wear protective clothing when collecting swarms or honey. Any beekeeper who is at risk of anaphylaxis to bee venom should seek medical advice on how to safely continue beekeeping.

    Bees only sting if they accidentally collide with you or if their hive is disturbed. Remember to stand back from hives and not directly in front of them. Bees usually follow a similar flight path back to the hive’s entrance. By standing back and observing, you can understand where this flight path is so you can try to avoid getting in the way. Popular places for bees to nest include compost bins and holes in the ground.

  • Wasps

    Contrary to popular belief, wasps do pollinate flowers and can act as excellent pest controllers for gardens, consuming insects that damage plants. However, as summer ends, they can become more aggressive due to the dwindling sugary food supply, leading them to hunt for other sources of sugar. In late summer, they may consume fermented fruits, causing them to become “drunk wasps” that act erratically and sting indiscriminately.

    To deter wasps, consider hanging a decoy nest, as wasps avoid areas they perceive as already occupied. Placing a jar of sweet jam in a secluded area of your garden can also divert them from bothering you and your family.

    During autumn and winter, dormant “sleepy” wasps may be found motionless, which can make accidental encounters more likely. Queen wasps hibernate during this time and may seek shelter in bedding, curtains, gloves, boots, or among stacks of plant pots in greenhouses.

    Unlike bees, wasps can sting multiple times, as their stinger remains intact after each sting.

  • Hornets

    Hornets in the UK are larger than standard wasps, typically brown or orange in colour, and often have a louder buzzing sound. Despite their intimidating appearance, they are generally less aggressive than wasps. However, their stings can be particularly painful due to the larger volume of venom they inject into the skin.

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