Excerpted from the Summer 2006/2007 issue of Allergy Today. For more articles like this, subscribe to Allergy Today, click here.

Legend has it that Pharaoh Menes, stung by a wasp in Ancient Egypt, was the first recorded death caused by a stinging insect. However, researchers have recently debunked this as myth, pointing out that Menes was in actual fact several different pharaohs rolled into one. The researchers found his name was not mentioned until over 1000 years after his alleged death. Despite this good news for Menes, summer can be a worrying time if you are allergic to insect stings. Inga Stünzner reports.

sting in the tail

Clayton Smith is something of a landscape surveyor. Not in the road works sense, but in the sense that he is always on high alert in summer and is aware of every insect around him.

This interest in insects started when he was three years old and experienced his first severe reaction to a wasp sting. “The detail’s a bit vague because I was so young when it happened, but this is what my parents have told me,” the 25-year-old from Auckland says.

“I lived in a small country town outside of Dargeville, and when I got stung by a wasp my Mum and Dad noticed straightaway that I was swelling.

“It was a 25-minute drive to the nearest doctor, so they threw me into the car and drove at top speed. By the time we got there, my head was twice its normal size and my throat had swelled to the same size as my head. I stopped breathing as soon as we reached the doctor and someone gave me mouth-to-mouth resuscitation while another person gave me an injection of adrenaline. The swelling went down. Apparently it was very scary.”

Clayton now wears a MedicAlert bracelet and carries a self-injecting adrenaline EpiPen wherever he goes. Although he hasn’t been stung since, due to vigilant avoidance strategies and his constant surveillance for buzzing insects when outdoors, there can be some anxious moments.

“As soon as I see a wasp, I freak out. All I can think of is how can I get away from it fast enough! I’m on highest alert over summer, when they are more active.”
Clayton is one of about 40,000 New Zealanders who are allergic to insect stings. Although there have been no prevalence studies here, overseas data suggests that about 1 per cent of the population is allergic to stings. The main culprits are bees, wasps and paper wasps.

The reaction

The usual response to an insect sting is redness, pain, and itching at the sting site that soon disappears. Another reaction is a large local reaction. This swelling is larger than five centimetres in diameter and persists for longer than 24 hours. Swelling usually increases over several hours, may last days and may sometimes affect an entire limb. If you have this type of reaction and are stung on the throat, you should take treatment (usually steroids and antihistamines) and seek medical help.

The third response is a systemic, or generalised, allergic reaction, which varies greatly in severity. It may be relatively mild and show only cutaneous (skin) symptoms, such as itching, hives and swelling, or it may be more severe, with potentially life-threatening symptoms such as swelling in the throat, respiratory problems (bronchospasm) and a drop in blood pressure (hypotension). Patients with hypotension feel light-headed, have darkening or tunnel vision, and often lose consciousness. Patients with severe reactions often have a sense of impending doom and feel that they might die.