Wasps, bees, horseflies and jellyfish: what to do in the event of a sting or bite?

By Cristiano Antonino On Jul 7, 2022

With the arrival of summer, it can happen to be stung by a wasp or bee, to be bitten by a horsefly or viper, to come across the tentacles of a jellyfish or to step on a weevil. What to do for proper and immediate relief?

Wasp, hornet, bee and bumblebee stings

The reaction to the sting of hymenoptera, i.e. wasps, hornets, bees and bumblebees, is very subjective as it depends on the individual person’s immune response.

When we are stung by these insects, they inject a certain amount of venom with their sting that our organism recognises as foreign and tries, so to speak, to fight it off.

Depending on individual sensitivity, the symptoms may differ, ranging from normal local manifestations (skin reaction) to involvement of the whole organism (systemic reaction).

This explains why in some people a wasp sting causes only a little pain and mild discomfort at the sting site that passes within a few hours; while in others, the same sting can cause more severe reactions that in some cases can even lead to death.

HYMENOPTERA AND VENOM

Hymenoptera use their sting to defend themselves.

When they sting us they cause pain both through mechanical action and (above all) through the presence of irritants and stimulants in the venom that stimulate the pain nerve fibres.

The amount of venom injected by a wasp is not always the same, depending on whether it has already stung someone else or some insect/animal before stinging us: if so, its venom vesicle contains little venom.

The hornet, on the other hand, injects up to three times as much venom as the common wasp, which is why it causes more pain and can lead to a more severe reaction.

Bees rarely sting and if they do, it is because they feel threatened.

After the sting, the serrated stinger remains ‘stuck’ in the skin and continues to contract, injecting venom.

The bee trying to fly away dies as its abdomen tears.

This is a ‘sacrifice’ to defend the hive: when it dies, in fact, a pheromone called ‘alarm pheromone’ is released to warn other bees of imminent danger.

For this reason, when you are stung by a bee it is important to move away quickly from the place where you are and be careful not to be attacked by the swarm if you are in the vicinity of a hive.

What to do in the event of a hymenoptera sting?

1) Remain calm: first of all, it is important not to panic, and in the case of a child being stung, parents must not create agitation in the little one.

2) Watch out for the sting: one must look at the sting site to ensure that there is no sting.

Wasps, hornets and bumblebees have a smooth sting and it rarely remains in the skin, while that of the bee is serrated and when it stings it remains ‘stuck’ in the skin together with the venom vesicle (a white sac containing the venom) which continues to contract and inject venom: it is important to remove the sting quickly with the edge of the nail without crushing the vesicle with your fingers to avoid releasing more venom.

3) Observe the symptoms: there may be different local or systemic reactions depending on the extent and symptoms for which a targeted therapeutic intervention is planned.

Let’s look at the individual situations in detail.

Local reaction

-> Limited

In most cases the hymenoptera sting causes a reaction around the sting characterised by pain, swelling and redness that usually subsides within a few hours.

What to do? In such cases, it may be helpful to put ice on it to reduce the swelling and a cortisone ointment to treat the inflammation (redness, pain, swelling). If in doubt, consult your doctor or pharmacist.

-> Extended

It may happen that within a few tens of minutes or hours the skin reaction extends beyond 10 cm from the puncture site: for example, if you are stung on a hand the swelling and redness reaches up to the elbow, but no other symptoms appear (e.g. dizziness, breathing problems, diffuse urticaria – see Systemic Reaction).

The extensive local reaction usually resolves within a few days to a week.

What to do? As with the limited local reaction, it is useful to put ice on it immediately to reduce swelling and to take cortisone and antihistamine by mouth to treat the associated inflammation and itching, and then contact your GP or pharmacist.

Systemic reaction

-> Diffuse urticaria

If, within 15-30 minutes after the sting, redness appears all over the body and is accompanied by mosquito-bite-like pomphi (diffuse urticaria), it means that the reaction is systemic, i.e. it involves the whole organism, even if it only affects the skin/mucosal apparatus.

What to do? In the absence of other symptoms (see Anaphylactic reaction) it is a reaction of low severity for which, however, it is necessary to go to the emergency room for a check-up and for the prescription of an appropriate cortisone and antihistamine therapy.

-> Anaphylactic reaction

An anaphylactic reaction occurs when, in addition to the skin, other systems such as the cardiovascular, respiratory and gastrointestinal systems are involved.

At least two of the four target systems of anaphylaxis must be involved, but all four can also be involved at the same time.

Some symptoms are as follows:

– dizziness, low blood pressure, feeling faint (involvement of the cardiovascular system);

– acute intense rhinitis (sneezing, cold, watery and swollen eyes), asthma, difficulty breathing, feeling of swelling in the throat (involvement of the respiratory system);

– intense abdominal cramps, nausea, vomiting (involvement of the gastrointestinal system).

What to do in case of a sting?

An anaphylactic reaction usually appears 5 to 20 minutes after the sting.

You should go quickly to the nearest emergency room.

-> Anaphylactic shock

The most serious situation of an anaphylactic reaction is anaphylactic shock where all four systems are involved with marked hypotension (drop in blood pressure) causing loss of consciousness.

One must go immediately to the nearest emergency room as adrenaline has to be administered in such cases.

To cope with emergencies, there is adrenalin for self-injection, a life-saving drug that you should always carry with you, especially if you have had allergic reactions to hymenoptera stings.

This treatment is the first approach to an anaphylactic reaction from hymenoptera venom, in addition to cortisone and antihistamines.

It is advisable to go to the nearest emergency room and in the event of a severe drop in blood pressure to lie down on the back seat with your legs elevated.

How to prevent a stinging insect bite

Avoid wearing too bright colours and perfumes or deodorants with too strong a fragrance so as not to attract insects
Wear long-sleeved shirts, trousers, shoes and a hat to minimise skin exposure
Use insect repellent sprays on exposed skin
Use insect repellent products when outdoors (garden, terrace…)
Do not leave drinks, sweets or food in the open air. Avoid leaving open drinks cans that have not been completely consumed.
Check for insects before sitting, lying down or otherwise staying in an outdoor place
Avoid walking in areas where there are insect colonies (e.g. orchards, beehives, flowering meadows…)
Wear gloves if you pick fruit, even if it has fallen to the ground.
Do not under any circumstances attempt to crush wasps or bees. It increases the risk of being stung and attracting the swarm.
Do not use your arms to ward off hymenoptera and do not make rapid movements. If you find yourself in an area where there are bees or wasps, walk slowly and move away so as not to annoy the insects.

Horsefly bite

The horsefly is similar to a large fly does not sting but bites to suck the blood needed to produce eggs.

As with mosquitoes, these are female horseflies.

Their bite is very painful due to the particular conformation of their mouth that tears the skin.

The mandibles of these insects, in fact, resemble, so to speak, small sharp scythes: initially they are joined together, as they bite they open outwards to let out more blood.

Horseflies and mosquitoes, and so all hematophagous (blood-sucking) insects, inject substances with anticoagulant action during the bite to keep the blood fluid.

Their saliva contains hymenoptera-like irritants that are responsible for the local skin reaction characterised by redness and the formation of a pompho at the site of the bite.

Although it is a rare reaction, in more sensitive people the bite of horseflies (and mosquitoes) can cause allergy.

– What to do in the event of a horsefly bite?

A horsefly bite leads to a small wound that bleeds.

It is good to wash and disinfect the part carefully.

Put ice on it to counteract the swelling and cortisone ointment to reduce the inflammatory effects (redness, pain and swelling) triggered by the irritants injected during the bite.

Within a few days the situation returns to normal, but it is important to check that the wound does not become infected.

Should the swelling spread, you can contact your doctor or pharmacist.

Although rare, should other symptoms appear, such as widespread hives, dizziness or difficulty breathing, you should go to the emergency room.

Viper bite

Vipers rarely bite, they only do so when annoyed.

Usually having a stick to beat them with is enough to make them flee, as they are very sensitive to ground vibrations.

– What to do?

If you are bitten, it is important not to panic, but to go to the nearest emergency room.

If you are bitten in the arm or leg, it is important to move the limb as little as possible to slow the spread of venom into the bloodstream, and to remove rings or bracelets to prevent them from swelling.

There are many snakes, and it is very useful for rescuers to know whether it is a viper or another snake in order to administer the most appropriate therapy (e.g. anti-venom serum).

If you can and are not a snake expert, it is good to take a photograph.

Do not incise the wound and do not attempt to suck out the venom.

Jellyfish and anemones

Jellyfish and anemones are close relatives.

At the end of their tentacles they have stinging cells which release their venom when touched.

On the skin, the sensation felt is a strong burning sensation.

To put it bluntly, the reaction is similar to the one you might get from putting acid on your skin.

Depending on the type of jellyfish or anemone and the amount of tentacles one comes into contact with and which remain attached, the affected skin area may show a slight reddening or blisters and even second-degree burns.

– What to do?

Get out of the water immediately.

It is important to remove any bits of tentacles within a few minutes using a soft cloth moistened with sea water or salt water.

Do not use your fingers as they will also get burnt.

Do not rinse with fresh water because the different osmotic pressure would cause the vesicles containing the venom to burst and make the situation worse.

Use the edge of a credit card or the back of a knife blade to gently ‘swipe’ the area to remove all the vesicles present, which are often not easily visible.

The toxins contained in the poison are thermolabile, i.e. they work well at low temperatures (such as that of the sea), but are inhibited at higher ones.

To counteract the action of the poison and get more relief, once the area has been examined and cleaned, warm (not boiling) salt water can be used to

sponge from above by sprinkling water over the affected area without touching it with hands, sponges, cloths to avoid further irritating the injured part;
soak the affected part in warm salty water if possible.

After treating the area in this way for about ten minutes, allow it to dry.

Consult your doctor or pharmacist to assess the treatment required depending on the type and extent of the injury (cortisone ointment, healing dressing, oral antihistamine).

Rarely do these toxins cause allergies, generally the lesions are caustic to the skin.

If you experience different symptoms such as diffuse urticaria, extensive swelling, dizziness, loss of consciousness go to the nearest emergency room.

Do not use ice as it would worsen the situation as cooling the area facilitates the action of toxins on the skin. Also avoid using urine or ammonia are not effective methods.

Spider fish

Spiderfish or tracine are a fish that hides under the sand.

On their backs they have a dorsal fin composed of several spines, normally closed, which is snapped open when they feel in danger.

It can happen that one inadvertently puts a foot on it when entering the water. The sting is very painful because of the toxins contained in the venom.

Often the pain felt is so severe that you cannot move your whole leg, you feel dizzy, nausea and vomit.