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#BrownEMHealthTip from Whit Fisher, MD - Autumn is coming, and so are stings from angry creatures

Autumn is coming, and so are stings from angry creatures. Here are a few things to watch for as we transition between seasons:

• As the end of summer nears, many social wasp species such as yellowjackets become more aggressive. Patients often come to us stating “I was bitten by a bee,” but usually they have been stung by a wasp. Wasps are predators that feed on other insects. Honeybees and bumblebees are nectar-feeders that can sting (not bite), but are usually more docile.

• Social wasp colonies can get quite large. They may be in roofs, shrubs, tree branches, or overhangs. Be careful when doing ‘end of summer maintenance,’ such as re-roofing, pruning trees and bushes, and cleaning out under porches.

• Most stings will be itchy, red, and painful with some associated swelling. These symptoms alone do not mean you are allergic to wasp stings, which are often treated with over-the-counter antihistamine medications.

• Severe allergic reactions are called ‘anaphylactic.’ This type of reaction may involve trouble breathing, wheezing, low blood pressure, abdominal pain or vomiting, trouble swallowing, voice changes, hives, and swelling of body parts away from the sting site. These symptoms usually begin shortly after a wasp or bee sting, but sometimes can appear many hours later. You should call 911 immediately if you develop these symptoms.

• If you have been prescribed an epinephrine autoinjector for anaphylactic reactions, keep it NEARBY (car, handbag, toolbelt). It can’t do you any good if you leave it at home and you get stung miles away. Use it FIRST, and THEN call 911 for help! Epinephrine takes several minutes to begin working, and for rapid allergic reactions, those minutes are critical time you don’t want to lose.

• Some caterpillars can sting as well. These often have conspicuous coloration meant to warn possible predators, but they can be attractive to children. If you or your child is stung, try to take a picture of the caterpillar with your cell phone and show it to your medical providers.

• Wasps and bees are attracted to sweets such as sodas, ice cream, and lollipops. Be careful and make sure you are not putting a stinging insect in your mouth along with a late summer delight.



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