Overview

Many Texans are stung by insects every year. Most people will experience pain, redness, itching, and mild swelling at the site of the insect sting, a normal response. In contrast, people who are allergic to insect stings will develop much more severe symptoms that can be life-threatening or rarely even fatal.

What is a Stinging Insect Allergy?

People develop an allergy to a stinging insect by their immune system reacting to the foreign insect venom. After a normal sting, they can develop the allergic antibody called IgE. The next time they are stung by the same type of insect, they may develop an allergic reaction, caused by their immune system over-reacting to the insect venom.

Which Stinging Insects Cause Allergic Reactions in Texas?

The majority of allergic reactions to stinging insects are caused by five types of insects:

  • Fire ants
  • Yellow jackets
  • Honeybees
  • Paper wasps
  • Hornets

In Texas, fire ants are the most common cause of insect sting allergic reactions. Fire ants are reddish brown to black stinging insects. They are very aggressive and can attack with little warning. Fire ant mounds are typically raised (depending on soil type) and will swarm upon disturbing the mound.

What are the Symptoms of Stinging Insect Allergy?

As indicated above, most everyone who is stung by one of the above insects will develop a local reaction to the sting, which is normal. Fire ant stings cause a unique reaction in that a sterile pustule develops at the site of the sting. These pustules are sterile and should be left alone but can easily get infected by scratching. Pustules from fire ant stings are not an allergic reaction. Allergic reactions to stings are divided into large local and generalized (systemic) allergic reactions.

  • Large local reactions: These reactions involve more extensive redness and swelling that extends from the original site of the insect sting. For example, if one is stung on the hand, a large local reaction could involve swelling of the entire arm. Large local reactions typically progress over several hours.
  •  Generalized (systemic) reactions: These reactions cause symptoms that are distant from the original sting site and often occur within minutes of the sting. Symptoms may include itching or hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea and in severe cases, loss of consciousness and shock. The involvement of many body organs from an allergic reaction is termed anaphylaxis (see anaphylaxis page).

How do I know if I have Stinging Insect Allergy and what can be done?

If you think you are allergic to a stinging insect, you should see an allergist/immunologist who can perform the appropriate testing to determine if you are indeed allergic to a stinging insect, and if so, which one(s) you are allergic to. Your allergist/immunologist can determine if venom immunotherapy (allergy shots) would be indicated. Venom immunotherapy is highly effective at preventing future sting reactions in 97% of treated patients. Depending on the type of allergic reaction, your allergist/immunologist may also recommend self-injectable epinephrine for treatment of generalized or systemic reactions.

The Texas Allergy, Asthma and Immunology Society (TAAIS) is a group of more than 220 board-certified Allergists/Immunologists in Texas.

An Allergist/Immunologist is a physician, usually an Internist or Pediatrician, who has had special training and experience in the field of Allergy and Immunology and who is considered to be an expert in the diagnosis and management of immune system disorders such as asthma, allergic rhinitis (hay fever), eczema, urticaria (hives), drug reactions, food allergies, immune deficiencies, and all general aspects of anaphylaxis.

A Board Certified Allergist/Immunologist is a physician who has passed the certifying examination of the American Board of Allergy and Immunology. A list of Board Certified Allergists can be found here. Those with “ABAI” under Board Certification are Board Certified Allergists/Immunologist.