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Allergy or just scary looking?

You don’t have to keep bees for long—no more than fifteen minutes or so—before you start hearing the allergy stories. It seems that one out of every two people you meet is either deathly allergic to bee stings or has a (choose all that apply) sibling, spouse, partner, parent, aunt, uncle, cousin, or child who is. Certainly all your neighbors are allergic, as are the neighbor’s kids, guests, gardeners, housekeepers, and family pets.

Oddly, the statistics don’t bear this out. According to Web MD, about 2 million of the 314 million Americans are allergic to some kind of insect sting. The “stinging insect” category is a lot bigger than just honey bees and includes other bees, wasps, hornets, and fire ants. The venom of each is different, so allergy to one doesn’t necessarily mean allergy to another. Two million out of 314 million is about 0.64 percent—way less than 1 in 100.

This seemed low to me, so I examined a number of other references. The very highest estimate I found for severe reaction (Mayo clinic) was 3 percent, a number which also comprised all stinging insects. That larger figure still doesn’t come close to the number of people who claim severe allergy.

I think the discrepancy occurs because of the medical definition of “allergic” compared to the sometimes scary reactions we see on our skin. Various sites list the following symptoms for a bee sting allergy (an anaphylactic reaction):

  • Difficulty breathing
  • Hives that appear as a red, itchy rash and spread to areas beyond the sting
  • Swelling of the throat and tongue
  • Wheezing or difficulty swallowing
  • Restlessness and anxiety
  • Rapid pulse
  • Dizziness or a sharp drop in blood pressure
  • Nausea, vomiting or diarrhea
  • Loss of consciousness

When I get stung on my hands or ankles, the irritation disappears after a few minutes. If I get stung on the face, however, my face swells up, turns bright red, burns, and my eyes swell shut. By the second day I usually have two black eyes that make me look like I lost more than one serious fist fight.

But my type of reaction is considered normal, not allergic. Most people who see me in this state say something like, “I didn’t know you are allergic to bees!” When I protest that I’m not, they give me that sympathetic, “You poor thing” kind of look, like I’ve completely lost my mind. I think these spectacular reactions fuel the belief in widespread allergy. If you look that bad, something must be seriously wrong with you, right?

Even though I think that most people who say they are allergic are not, I would never try to convince anyone of that. After all, there are those who are definitely allergic and I have no way of knowing which ones they are. I wouldn’t want to be wrong.

Still, I hear the stories often enough to be jaded. I usually ignore the latest horror story about “my mother’s cousin Fred” or any other victim of the day. I just remind them that bees are unpredictable and suggest they stay as far from the hives as possible. This is best for everyone . . . then I can go sit on a beehive and write in peace.

Rusty
HoneyBeeSuite

Comments

Mark Luterra
Reply

I’ve read quite a bit of allergy literature since having a reaction myself (full body rash, not life-threatening thankfully), and have often come across a figure that 10% of beekeepers experience allergy at some point in their lives. That might seem too high, but then I personally know four local beekeepers (myself included) who have had an allergic reaction and have gone through desensitization. I would guess I know about 40 beekeepers total, so that would seem to confirm the 10% estimate albeit with a small sample size.

One of the things I gleaned from the allergy literature is that beekeepers who are stung very frequently (daily to weekly) almost never develop allergy. Since completing desensitization myself I have been following that philosophy with weekly stings. In addition to keeping the allergy away, I have noticed a marked decrease in my local reactions over time.

While I do think the risk of allergy is overstated among the general public, and I support attempts such as yours to allay that fear, I also think that accurate information about allergy risk should be presented to beekeepers. With that in mind I will share a two-article series written by an beekeeper MD that does a good job of summarizing what is currently known about the mechanism, occurrence, and treatment of bee allergy.

[Editor’s Note: As of 06/18/17 the links were removed because they no longer worked.]

Rusty
Reply

Thanks for the info, Mark. I will read the articles.

Holly
Reply

Darn, I wish I would’ve seen this when posted in 2013. I am just about finished with my desensitization therapy and am happy to declare success. My mentor showed me how to administer in-the-field therapy with a live bee sting, and I only had a local reaction. Now I am trying to determine how often is often enough for in-the-field maintenance. I think I would have enjoyed reading the article series.

Tricia Lockhart
Reply

I am part of a volunteer apiary project at a house owned by the National Trust (a charity that looks after heritage buildings for the people of the UK). Our NT contact is definitely allergic to wasp stings – he’s had the full rush to hospital at death’s door scenario. So he is wary of our bees but still a great support. For example he volunteers to trim the apiary or help cut down tree overhang. Do you have any knowledge that links wasp sting allergy to bee sting allergy?

Another great post, of course. All so true.

Rusty
Reply

Tricia,

All I know is that sometimes a person is allergic to both, sometimes not. He should definitely carry an epi-pen while he is working around bees. Someone else should be nearby as well.

Tim Eisele
Reply

The chapter on beesting allergies in “The Hive and the Honey Bee” is pretty good reading. Particularly the section where they talk about the different types of allergic reactions. They distinguish between the “large local” reactions, which are like what happens to you with facial sting, are very common and are not life-threatening, and the “systemic” reactions which happen all over the body, are much more rare, and sometimes are life-threatening.

Rusty
Reply

Thanks, Tim. I will review that.

Rusty
Reply

Greg,

Thank you. Yes, I’ve seen the articles and started a post about electromagnetism. It sometimes takes me awhile to decide how to present complex stuff, so this additional article will help.

Tiff Wilhelm
Reply

Great post! My family was insistant that I get an epi-pen “just in case” because I have those scary looking reactions to bee stings. I have reminded them all that this is not an allergy. As I understand it there are three reactions to stings: minor local, major local and allergic. And the allergic category has the symptoms you stated above. What a culture of fear we live in.

And you are right! I can go sit and watch my girls without fear since everyone else will be staying clear.

Alia
Reply

I think confusing the issue is the fact that your face (hand, etc) swelling up is a local allergic response, with histamine and everything, but it’s not the same allergic response as the full body anaphylactic shock one. The immune system is complex!

Rusty
Reply

Good point, and you are right. It is complex.

Julie Lauletta
Reply

Yeah, I’m a proponent of taking it back towards the way it used to be, a beehive at every homestead. I was afraid I would have negative reactions when I installed my garden hive, but only one neighbor expressed concern and he admitted that he should carry an epi at all times. I’m reading the Thinking Beekeeper by Christy Hemenway and it’s making me regret not sticking to my guns and installing a top bar as I originally intended and was discouraged from by beekeepers in our Indiana Beekeeper’s Association.

Rusty
Reply

Julie,

As a general rule, beekeeper’s associations discourage top-bar hives. I have no idea why they are so adamant, except they’ve used Langstroths forever and anon, which doesn’t really seem like a viable reason. I have both types and each has advantages and disadvantages. For me personally, it’s easier to keep my bees alive in the top bar. The people most against them are the people who never used one.

Julie Lauletta
Reply

Thanks for the response Rusty, I’ll be able to do a real side by side comparison because we’re going to have two hives this year, one Langstroth and one top bar. Adamant is a pretty apt description, while I was at bee school and started talking over lunch about our plans to install a top bar, one of the older more experienced beekeeps came out of his chair to shake his finger in my face and tell me, “I’m sick of all these people starting their trendy top bar hives. They won’t winter over in a top bar, all you’ll do is kill your bees!” His passion was almost a little scary, but I just tucked the plans away for an extra year.

Glen Buschmann
Reply

If you have not done so, look up the Schmidt Sting Pain Index, a ranking of the intensity of discomfort brought on by different bee and wasp stings. Those who have studied stings have found that sting pain and sting toxicity are different, that some stings hurt intensely but the venom itself is not particularly poisonous (i.e. pain receptor stimulus vs systemic reaction) and vice versa.

Mark Luterra
Reply

One of my best friends here in Corvallis started keeping bees this year. Her first sting caused a minimal reaction at first, but the next day large painful fluid-filled blisters developed at the site. She called me on the way to the ER asking if it sounded like an allergic reaction – which it didn’t really, but it didn’t sound normal either. Turns out it was a staph infection, either injected with the sting or else present on her skin and given entry by the puncture. It cleared up quickly with antibiotics.

So in addition to “normal” and allergic reactions, there is the rare category of sting-triggered infections.

Rusty
Reply

Mark,

That is fascinating! I’ve never heard of that but it sounds completely plausible. Thanks for passing it on.

Granny Roberta
Reply

The links in the first comment sound fascinating, but alas they’re dead now.

I’m one of those beekeepers on desensitization treatment. I don’t know that I was allergic to bees before what I call The Bear Event—which you might just as well call The-New-Beekeeper-Runs-Out-To-Put-Hive-Back-Together-Without-Lighting-Smoker-Or-Quite-Grasping-How-The-Three-Zippers-of-Her-Beesuit-Are-Supposed-to-Overlap Event.

Apparently 40+ bee stings at once can cause an allergy. The ER staff was lovely, but failed to recommend desensitization. They only recommended EpiPen. I have an EpiPen now but I’ve never used it. The epinephrine they gave me in the ambulance was horrible. How is it possible to be semi-conscious from plummeting blood pressure and so wired that every light and sound is painful, all at the same time?

It took me a couple of subsequent incidents of fainting (not that I would admit to fainting, but it’s very inconvenient in the beeyard) after single stings to find myself an allergist. He tested me for various wasp/hornet/bee allergies, and found I was only allergic to honey bees. For all those people who claim to be allergic but probably aren’t, if you were REALLY allergic your allergist would have told you what EXACTLY you were allergic to.

In my opinion, the treatment has been completely successful. I get stung now with no noticeable systemic effects, just local burn/red/itch. My allergist thinks the treatment is not yet complete, and because I am fortunate to have pretty good health insurance, I continue it.

Rusty
Reply

Granny,

You are brave to continue beekeeping after an ordeal like that. Still, I admire the fact you recognize that different insects have different venom, and one cannot assume that allergy to one is allergy to all. I have to admit I take a cynical approach to people who are “allergic to everything.” I’m sure some folks are allergic to many things, but not in the numbers that write to this website. The CDC statistics don’t come close to the number claiming life-threatening bee allergy.

Also, thanks for the heads up on the bad links. I removed them.

Granny Roberta
Reply

Arguments could be made for “stupid”, “crazy”, “stubborn” as better word choices than “brave” in that opening sentence there!

Rusty
Reply

Granny Roberta,

I’ve had these various words used on me, too. Once upon a time I was a competitive roller skater. After a bad accident that left me with multiple compound fractures in one leg, my bones were pieced together with metal parts (which are still in there somewhere). Five weeks later, I was skating again. One year later I won a national title. “Quit” is a four-letter word.

Holly
Reply

Roberta, I found the articles! The author allowed me post them to my blog here. I think you’ll be particularly interested in Part 2, in which Dr. Marterre writes about “massive envenomation.” I would venture to say you suffered a “toxic reaction” to the 40+ stings, and that could be why the ER staff did not think desensitization was is order. I am sorry that you developed a sensitivity to honey bee sting but really encouraged to read of your success! I, like you, feel that my desensitization is complete but continue to receive injections (unfortunately to all 5 venoms).

Granny Roberta
Reply

Thanks, Holly. That was a very interesting pair of articles.

Anna
Reply

As usual, Rusty, your website saves the day. I got stung yesterday working my hives (got me right through the glove) and had full body hives, facial swelling reaction. Maybe not full anaphylactic, but the EMTs gave me Epi just to be safe. I was heartbroken to think that my beekeeping days might be over. Thanks to the posts – especially Granny Roberta – I have hope to keep it going.

Rusty
Reply

Anna,

Whoa! That is scary in any case.

Holly
Reply

Anna, you definitely had a systemic reaction! Anaphylaxis can be mild, moderate to severe.
Rusty, I tracked down the two-article series mentioned in the first comment, and the author gave me permission to post them to my blog.

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