Anaphylaxis and Bee Sting Allergies

Beekeeping - Basics
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Continuing the discussion from Todays lesson: What not to do & what a normal bee sting reaction looks like:

I had for many years an allergy to mushrooms that is what people who are severely allergic to bee stings experience.

Firstly I suggest that as a responsible bee keeper you obtain from your doctor and keep handy an Epi Pen.

The likelihood of someone who is allergic to bees, but doesn’t know it, being stung by one of your bees may be low, but it exists. Administration of epinephrine via an epi pen can reduce what is easily a life threatening situation into a manageable medical emergency.

I also believe keeping a standard antihistamine such as Benedryl close at hand is a good preventative measure. It can reduce the normal reaction to a sting and help with a more sever reaction as well. Cheap insurance.

Far better to have the pen and never need it than visaversa.

If you or someone else is stung by the bees the symptoms that can indicate a serious reaction beginning are a collection of reactions.

Among them;
a sudden dry itchy feeling in the mouth
a sense of sinuses being clogged and breathing becoming an effort
hot and cold flushes over the body
goosebumps
swallowing feeling weird
a shocky feeling; feeling lightheaded, heart pounding, pins and needles in extremities. nausea, faintness
random itchiness, not just at the site of the sting

If any of these symptoms begin to appear call 911.

There is no way to tell for someone having their first reaction to a bee sting how rapidly it may progress or to what stage. Better safe than sorry.

In a remote area, in the absence of an epipen, I would administer antihistamines orally and topically and proceed to the nearest medical facility. An emergency room is best, but a firehouse with paramedics will be able to administer the shot as well.

The odds of any one of us having a problem with an Anaphylatic reaction is small, but it exists and is worth preparing for.

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@sara Doctors where I live will not just hand out an EpiPen on the off-chance that someone may need it someday. It is prescription-only. Also, an EpiPen is really expensive and only lasts a couple of years or so before expiration. Then, of course, there is the question of the bee that stung - is it your bee, a passing random bee, or what?

Benedryl is an excellent idea - many people take one before they go to see their bees and given that it makes some drowsy, helps with the whole “be calm, slow, and zenlike” state when working with the bees.

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Being a bee handler and requesting a prescription is not the same as asking for a casual hand out of prescription drugs. I know of a number of large scale (50 plus Hives) beeks who routinely carry a pen in their kit. I don’t know how common it is over all, but I feel it is worth considering. Especially for urban keepers who have less acreage to protect their bees from interactions that might result in a situation such as I have described.

The are expensive at around $100, but they last a number of years after the expiration date. I replace mine every 5 years or so.

$20 bucks a year seems like reasonable insurance. And if someone in your vicinity was stung I doubt that there would need to be much conversation around ‘whose bee’ it was that did the stinging.

Benedryl is an excellent thing to have on hand, but in the event of a serious anaphylactic shock reaction it will do nothing to keep someone alive while getting them to a medical facility that can stabilize them.

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I have no allergies to bee stings. I told my doctor that I was a beekeeper and I needed an EpiPen on hand. She wrote the prescription without hesitation. It is common sense to have one on hand as responsible insurance. NIce topic sara!

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If anyone is seriously concerned that someone will have a catastrophic allergic reaction to a bee sting that could lead to someone’s death, the most responsible thing to do is not keep bees. It’s the best insurance, too.

I think we have all wandered onto dangerous territory in this thread. Here is why.

A catastrophic reaction is very rare, about 3% of the population. It’s one of the reasons Apitherapy - where people are treated with bee venom - exits. People who know they are allergic will likely have an EpiPen with them as a sting can happen anywhere, at any time. Of course, as stated above, it’s the person who does not know they are allergic that is the potential risk.

Ultimately keeping an EpiPen depends on two things: whether or not a doctor will write a prescription that is not for you that could be administered on someone else of unknown medical condition (if you decide the humane thing to do is have one), and your own tolerance for risk.

Having an EpiPen is not necessarily going to make you any less liable should there be a lawsuit. In fact, someone could claim that you knew bees were dangerous and persisted in the behaviour anyway (with the EpiPen as proof of your knowledge).

Then there is the question of administering that EpiPen on someone else. Of course no one wants anyone to die in front of you (or anywhere else for that matter). However, people could be at serious risk from using the EpiPen incorrectly, especially if it is not a full-blown sting allergy but some other underlying condition, like high blood pressure/heart disease. Good Samaritan laws may not apply to you, but only to a person who is trained in medical use. Depending on where you are, it’s possible that the law demands you get that person’s permission in writing before administration (which in a crisis is hard to do beforehand). And, if it is administered, there are meds that can block it’s effects anyway.

For everyone mullling everything over and wanting to make informed decisions, here is a link to EpiPen patient information: http://files.epipen.gethifi.com/footer-pdfs/patient-packaging-insert-pdf/Patient-Information.pdf

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@SowthEfrikan I know where you are coming from and I can understand and feel your reservations about using drugs on unknown people.

At out Beep group each week they ask if there is anyone new and stress that if you get stung say so straight away. We are 3 miles from the nearest hospital, just as quick to rush them there.

I’m not sure what they actually do if someone gets stung but the awareness is there

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Yes it can be a big responsibility keeping bees and it is important to make sure we and anyone who comes near them are safe. Allergies can be very serious, even fatal. If you have close neighbors or family members who have allergies to bees it would be wise to not keep bees or keep them in a place away from where people go. If you are taking other people close to your beehives it is important to find out if they have an allergy to bee stings and make them aware of the risks of a sting if they do have an allergy.

While I think it is a good idea to carry an epipen (and know how to use it) if you are keeping bees and have people with allergies around. Often people with serious known allergies will carry their own epipen and understand the risks.

Epipens are relatively new and the laws are different in different countries, some countries require a subscription from a doctor. We recommend beekeepers should take a first aid course, be able to identify and deal with an anaphylactic reaction, and make an informed decision about what equipment to carry on that basis.

There is some good information on Anaphylaxis here:

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I think some of you are missing another point. Do your bees wear little micro chips or identifying jerseys? I am thinking “no”. There cannot be lawsuits as there is lacking absolute evidence of whose bee did the stinging. Bees fly 5 miles to forage. If a beek is 5 miles away from you their bees could sting if harrassed in your neck of the woods. So a little reality check is needed in this conversation.
Schools in the US keep EpiPens on hand in the office for whomever/whatever situation the admin decides it should be used in. We had a student sit on a fire ant mound. Obviously not a 15 yr old tuned into nature. Her family did not know she was severely allergic to ant bites and greatly appreciated the emergency use of the EpiPen. Parents were called first but only voice mail answered.
So who in this conversation is a licensed nurse or lawyer?

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Speaking of cars, tens of thousand get killed in those accidents - statistically some say you have a better chance of being hit by lightning than being killed by a bee.

@ gayle - that was exactly my point, btw. Except if a bee should happen to fly right out a hive and sting someone in front of witnesses. Americans are risk averse and fond of suing. It’s a factor in why people keep EpiPens.

@ dexter Actually this is more about the danger of shoving an EpiPen into someone, medically and legally. And, providing advice that could put your company at risk.

But, whatever.

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Everyone must act as they see fit, of course.

But it is perhaps worth considering that the dose of epinephrine in an epipen is not, medically speaking, a risky one.

You could inject it into almost anyone and the only reaction they would have is slightly heightened blood pressure and a bit of the jitters.

It is, basically, a dose of adrenaline. Most of us have at one time or another had a sudden scare that has resulted in a natural adrenal dump, with the resulting similar symptoms.

Should someone in the vicinity have a bad reaction to a sting it is not an ambiguous presentation of symptoms. Having experienced them myself I know.

I am a bit surprised by the degree of concern you are having and think that if the situation should arise, and someone you know and possibly care for, is suffocating in front of you, you might find that, all other things being equal, the presence of an epipen would be a valuable addition to the equation.

If you are in a situation sufficiently urban enough, that a trip to the emergency room is speedy and will answer, then the pen might be less a necessity and more a luxury.

Myself, I would rather benefit from the immediate abatement of the symptoms and sort out the possible legal out come afterwards.

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Thanks @sara for bringing up this topic. I think it is an important issue for people to be aware of. I don’t mean to sound alarmist but some awareness of the seriousness of bee sting allergies is important, I have a friend who has a serious allergy and if not treated she could die from a sting. She carries an Epipen and knows to keep her distance from beehives and wear shoes when there are lots of bees foraging on clover. Yes it can be a controversial topic and I think that every one needs to make up their own mind on what precautions to take.

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so what is a normal reaction to a sting?
I was stung yesterday on my wrist and today about 24h later my arm is still swollen to the elbow, hot to the touch and very itchy. Now I thought it was only one bee but there might have been more before I could get away and sort out the gap in my suit.
I had no other symptoms but thought this is a bit extreme

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It can vary, based on your personal sensitivity and on the particular sting.

And where the sting is.

I have had a sting in the arch of my foot stay very sore and hot and itchy for 4 or 5 days.

I got a halfhearted sting today thru my glove and all it did was give me a little blister. 4 hours later I would only notice it if I got lemon juice on it.

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Well I will monitor what it does over the next couple of day - don’t you like being your own experiment?

PS the itching is killing me :wink:

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FYI, check with your state about the legality of administering non-prescribed drugs. This is likely different for people in other countries. But personally I would never administer anything to anyone that it was not prescribed here in the US with how litigious our society is. You almost 100% open yourself up for liability if you administer an Epipen to someone whom it was not prescribed to, even if they live because of it, if it is not protected in your state.

Hell a guy who attempted suicide sued paramedic and emergency room doctors for resuscitating him after he tried to kill himself siting that the treatment was not wanted or authorized… I don’t think he won, but law suits are expensive and can destroy you financially even if you win.

Maybe you guys in other countries legal systems make more sense, but always remember here in the USA, it’s a court of LAW, not a court of JUSTICE.

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In Texas or, as far as I know all other States, you may not inject a drug into some one you don’t know. Under the "Good Samaritan Law’ you may perform up to your training level. There is also a clause that allows veterinarians to act in an emergency on a human. There are still some gray areas define a emergency though. I have taken allergy shots for years and was instructed in how to inject and how much to inject, so I could possibly get away with it “in a life threatening” emergency. We keep 1:1000 epinephrine on hand for our animals for anaphylactic shock, and my doctor way back then said it is fine to use that. It does actually come from the same production runs as the human version, “if it is made by the same company” they just label it different, and some other legal reasons. Having a veterinarian at close hand when we live in the country and have a legitimate need for keeping it is nice, because I have had some reaction to stings and it can only get worse if you are allergic to them, as my sibling is. Just for the curious out there and to save you time researching the public drug databases, “For informational purposes only” the dose for an average size adult of 1:1000 Epi is .2 cc to .25 cc along with diphenhydramine 25mg or 50mg, if they can swallow, and get them to a hospital. the Epi may be repeated if no improvement in patient over 10 minutes. Hopefully by then the ambulance will be there. This is in no way telling you to do something against the law or against your training level, it is just for letting you know what the emergency people would be doing for some one in anaphylactic shock Actual dosages can vary some :
"Administer epinephrine 1:1,000 (weight-based) (adults: 0.01 mL per kg, up to a maximum of 0.2 to 0.5 mL every 10 to 15 minutes as needed; children: 0.01 mL per kg, up to a maximum dose of 0.2 to 0.5 mL) by SC or IM route and, if necessary, repeat every 15 minutes, up to two doses).
From: http://www.aafp.org/afp/2003/1001/p1325.html

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I don’t know about places outside of the U.S., but if you ‘come across’ someone having an anaphylactic reaction and they have an Epi auto injector in their hand but are unable to effectively inject it, you may hold it to their thigh and place their hand on it so they can push it. Or you may find it in a pocket or where ever when you look for emergency contact information and medical alert information, and then hold it for them.

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I’d say it’s important for everyone (not just beekeepers) to know the signs of anaphylaxis, not just for beestings, but because people can have those reactions to virtually anything from peanut butter to grapes. If in doubt about whether you are having an anaphylactic reaction, drive for the hospital and call a family member for assistance and tell them where you are and what you are doing. If you get to feeling better, you can always turn around and go home.

I’ve never seen a epipen and hope to never see one… I don’t carry a snake bite kit either…

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Hi Michael, Would you recommend someone like myself who is a anaphylactic (i always carry my epipen and medication on myself) getting a Flowhive as there is minimal interaction with the bees during harvest time its just when you are doing brood inspections that i will be at a higher risk of being stung. As long as i suit up and carry my medication i think ill be ok.