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Bites and Stings Poisoning

Bites and stings poisoning or hypersensitivity response (allergic reaction) to insect and reptile venoms.

Though numerous insects sting and spiders and snakes bite, most are not poisonous (harmful beyond local discomfort at the site of the sting or bite). Rapid first resonse efforts can often reduce the severity of the resulting injury from poisonous stings and bites.

Hymenoptera stings

The most common stings come from wasps, hornets, yellow jackets, honey bees, and fire ants, collectively known as the Hymenoptera order.


For the two million Americans who are allergic to the venom of these insects, the sting is far more significant than irritation or discomfort. Severe hypersensitivity response can cause swelling of the throat that blocks the airway; anaphylactic shock is a life-threatening circumstance.

First response for Hymenoptera stings:

1. Gently scrape the stinger out of the wound with the edge of an object such as a credit card. Do not grasp the stinger with tweezers or fingernails as this squeezes the venom sack and forces more venom into the wound.
2. Apply ice until the area is numb.
3. Make a paste of baking soda and water and liberally spread it over the area of the sting (Alternately, apply a small amount of hydrocortisone cream or diphenhydramine cream.)
4. Seek further evaluation and treatment from a health-care provider when pain persists or worsens, or when the person stung has a hypersensitivity response (allergic reaction).

Poisonous spider bites and scorpion stings

There are only two types of poisonous spiders in North America, the widows (of which the black widow is the most notorious species) and the brown recluse. There is one species of poisonous scorpion, Centruroides sculpturatus, found in the
southwestern United States (particularly Arizona) and northern Mexico.

The venom of a widow spider is a neurotoxin that produces pain and swelling at the site of the bite and systemic effects that may include generalized discomfort or pain, muscle cramp, and muscle spasm. It may also elevate blood Pressure (hypertension).

scorpion

Many people do not notice the bite of the brown recluse spider for up to a week, when the toxin begins to cause tissue necrosis (death) at the site of the bite. The sting of the C. sculpturatus scorpion is also a neurotoxin; pain is immediate and later systemic response is common. Though unpleasant, these bites and stings are seldom fatal.

First response for poisonous scorpion stings and spider bites:

1. Apply ice to the bite.
2. Minimize movement of the bitten area; splint if possible.
3. Seek immediate medical care at a hospital emergency department. Antivenin is available for widow spider and C. sculpturatus scorpion bites.

Poisonous snake bites

There are four types of poisonous snakes in North America, the bites of which are all capable of causing death. Antivenin is available for each type. Bites from poisonous snakes require urgent medical treatment at a hospital emergency department.

First response for snake bite:

1. Loosely splint or otherwise immobilize the area of the bite, and keep it lower than the heart.
2. Keep the bitten person calm and still.
3. If it will be longer than 30 minutes before the bitten person can get to a hospital, wrap a bandage (or improvise with a scarf or other item of clothing) firmly but not tightly three to four inches above the bite, between the bite and the heart.

The tightness of the wrap should be such that the responder’s finger can fit under it. After placing such a bandage, do not remove it for any reason. Doing so will release a surge of venom into the person’s blood circulation.

Stings from stingrays, jellyfish, and sea urchins

jellyfish

Numerous species common in the oceans in the coastal United States can deliver a significant sting. Stingrays and sea urchins sting with spines coated in venom.

The spines may break off under the skin, continuing to release venom. They also present very high risk for bacterial infection. Heat inactivates the venom and vinegar dissolves the spines.

First response for stingray and sea urchin stings:

1. Soak the area of the sting in water as hot as the person stung can tolerate for at least 30 minutes.
2. After the hot water soak, place gauze pads soaked in vinegar over the sting area.
3. Repeat these measures until symptoms improve or the stung person reaches a hospital for further treatment.

Jellyfish and related creatures such as sea anemones and Portuguese man-o-war have clusters of long tentacles covered with stinging cells.

First response for these stings:

1. Flush the area of the sting with seawater.
2. Place gauze pads soaked in vinegar over the sting area for at least 30 minutes.
3. Use gloved hands or tweezers to remove tentacles.
4. Repeat steps 2 and 3 until all tentacles are gone and pain subsides.
5. Seek treatment at a hospital emergency department.

Bee sting

Venom immunotherapy is the process of injecting venom to treat various conditions. The most common form of venom immunization is bee venom therapy (BVT), with honeybee venom or stingers used to treat conditions.

BVT is one form of apitherapy, which is the therapeutic use of products made by honeybees. Other products used in apitherapy include bee pollen and royal jelly.

Origins

Apitherapy is thousands of years old. In ancient Egypt, venom from bee stings was used to treat arthritis. Hippocrates, the Greek physician known as the “father of medicine,” used bee stings for treatments several centuries before the birth of Christ. Descriptions of apitherapy are found in 2,000-year-old Chinese writings, the Bible, and the Koran.


Bee venom therapy has remained part of folk medicine throughout the centuries. The modern study of apitherapy is said to have started in 1888, with Austrian physician Phillip Terc’s research titled “Report about a Peculiar Connection between the Beestings and Rheumatism.”

Benefits

Although a bee sting is painful for most people, the sting can be fatal to some. Approximately 15% of the population is allergic to the sting of such insects as bees and wasps. Allergic reactions range from mild to life-threatening.

In mainstream allopathic medicine, honeybee venom is used to treat people who are allergic to bee stings. A small amount of venom is injected during desensitization treatments to help patients develop a tolerance to stings.

Honeybee venom immunotherapy is used to treat many other conditions in alternative medicine. BVT is regarded as an effective treatment for arthritis, asthma.

Bee venom is also said to relieve premenstrual syndrome (PMS) and conditions related to menopause. However, BVT is most commonly used as an anti-inflammatory remedy for arthritis and MS. Advocates maintain that it will provide relief for rheumatoid arthritis when injected into the joints.

Bee venom is also used to lessen the pain and swelling of osteoarthritis as well as such inflammations and injuries as tendinitis and bursitis. Furthermore, people diagnosed with MS say that BVT significantly reduces symptoms that include muscle spasms and tiredness.

Description

Bee venom therapy involves the injection of venom by a needle, insertion of the stinger, or stinging by live bees. While a licensed physician must give injections, other treatments can be done by a bee venom therapist, a beekeeper, the patient, or a friend or relative.

The cost and length of treatment depends on the condition, as well as when and where a person is treated. If a physician provides the treatment, the doctor’s appointment may be covered by health insurance. Rates for other therapies are set by beekeepers and bee venom therapists. Information about these providers can be found through organizations such as the American Apitherapy Society.

The society’s resources include an extensive web site with information about BVT. Apitherapy resources include books and videos about home treatment. Live bees can be ordered by mail; one business in June 2000 charged $50 for four boxes, each containing about 60 bees.

When live bees are utilized, tweezers are used to remove one bee from a container such as a box, jar, or hive. The bee is held over the area to be treated until it stings the patient. The stinger is removed after three to five minutes.

Patients receive an average of two to five stings per session. The number of stings and the number of sessions varies with the condition treated. Tendinitis might require two to three stings per session for two to five sessions. Arthritis is sometimes treated with several stings per session at two to three weekly sessions.

MS may take months to treat. While BVT advocates say MS patients are more energetic after several sessions, they maintain that treatment should be done two to three times weekly for six months.

Preparations

Before beginning venom immunotherapy, a person should be tested for allergies. If a relative or friend plans to help with the therapy, that person should be tested too. Bee venom may cause a severe allergic reaction called anaphylaxis.

The symptoms of anaphylaxis include shock, respiratory distress, and in some cases, death. Even if tests indicate that a person isn’t allergic to bee stings, it is important to obtain an emergency bee-sting allergy kit before beginning treatment.

Precautions

People should check with their doctor or practitioner before beginning bee venom immunotherapy. The therapy is not recommended for pregnant women, diabetics, people with heart conditions, tuberculosis, or infections.

An allergy test is a must before starting bee venom therapy. A person who is allergic to bee stings should not start venom treatment. In some cases, scarring and infections have resulted when the stinger was left in too long.

Side effects

If there is an allergic reaction to bee venom therapy, emergency treatment should be started. Such symptoms as minor itching and swelling, however, are not causes for alarm. They are signs of the healing process.

Research and general acceptance

During the late 1990s, researchers in countries including the United States, France, and Russia began researching the effect of bee venom immunotherapy on humans. Before that, research with such animals as mice indicated that venom could be beneficial for treating inflammatory conditions.

Anecdotal reports by people with MS indicated that venom immunotherapy is effective. Those supporting the study of this therapy include the Multiple Sclerosis Association of America and the American Apitherapy Society. As of June 2000, it remains to be seen whether bee venom immunotherapy is effective.

Training and certification

Although a doctor can administer bee venom therapy, no specific training or certification is required to perform the therapy. Training in handling bees is recommended. Organizations such as the American Apitherapy Society can provide information about training and therapy providers.