by Chiara Bidoli
Summer and autumn are the periods most “at risk” for insect bites, especially those with stingers such as wasps, bees, hornets and bumblebees. The advice of the allergist Alessandro Fiocchi
Summer and autumn are among the periods of the year most at risk for the effects of insect bites, especially if they involve the most fragile subjects: those who are allergic and small children. In these cases, even a single sting can cause anaphylactic shock and death in allergic subjects. First of all, it is important to be able to distinguish a “normal” reaction from an “allergic” one. Many insects, especially those with stingers, inject harmful substances that can cause reactions such as redness, burning, itching, swelling and pain. If localized and limited in time, these reactions are not alarming and tend to resolve spontaneously. On the other hand, we speak of “allergy” when the reaction, which reaches its maximum peak within 48 hours, is clearly excessive, i.e.: too extensive (a large part of an arm or leg may be involved), painful, lasting (even up to 7-10 days) and associated with fever, fatigue or nausea.
What to do if you get stung
The sting must be removed immediately (within 20 seconds, otherwise the poison spreads) and ice and possibly an analgesic to calm the pain must be applied to the affected part. In case of discomfort it is possible to use an antihistamine by mouth and apply a cortisone ointment locally. If necessary, the doctor may prescribe oral anti-inflammatory therapy, based on cortisone, for 3-7 days. In the event of a suspected allergic reaction, it is essential to go to the emergency room as soon as possible and, subsequently, plan a specialist visit to the allergist. “In the case of a child, if he has never shown allergic reactions before but, following a sting, he has extensive local reactions, an antihistamine in the form of drops can be used, – explains Alessandro Fiocchi, head of Allergology of the Child Jesus From Rome. -. In this case the effect is not immediate but there is no urgency that it is. The problem is for those who are allergic, maybe we don’t know if children are, so if the sting affects the little ones, we need to carefully evaluate the symptoms ».
How to tell if you are allergic (or if your child is)
There are general symptoms and a very specific one that must alert: «The general ones are difficulty breathing, the subject who turns pale or is at risk of fainting, strong tachycardia, or dysphonia (voice descending), – continues Fiocchi -. In these cases, you need to go to the emergency room immediately. Then there is a specific symptom that can make you suspect an allergy and that requires prompt investigation by an allergist. It happens when an animal hits a specific part of the body, but the patient has reactions in other areas. As, for example, in the case in which a bite concerns a hand but the wheals appear on the face or trunk. It is a general reaction, not necessarily serious, but the diagnostic alert must be triggered because any subsequent sting or bite could not only generate effects on the epidermis but could involve vital organs ».
What to do if you are allergic
Especially those who have experienced an allergic reaction in the past must make sure they always have a drug with them that can be a real lifesaver in the event of a sting. “Many allergy sufferers believe they have to take cortisone by mouth the moment an episode occurs,” explains Fiocchi. – This drug actually works two hours apart and, for some, it may be too late. The allergic reaction, in fact, is immediate and to act immediately it is necessary to intervene with adrenaline, cortisone is not enough. Carrying it with you generates a false security effect that can delay access to the emergency room which could, however, be vital”.
Desensitizing immunotherapy
It is a life-saving therapy for all children and teenagers at high risk of anaphylactic shock or medium-high intensity allergic reactions, a sort of “vaccination” to be carried out in a highly specialized allergy centre. It consists in the subcutaneous inoculation of increasing doses of the poison of the insect to which one is allergic, starting from extremely low doses. In this way, the body gradually gets used to the poison until it reaches a tolerance threshold which prevents serious reactions in the event of an accidental sting. «Thanks to desensitizing immunotherapy it is possible to prevent anaphylactic shock and, therefore, also the deaths related to insect bites. The vaccine must be continued for at least 3 years and the effect is usually maintained for many years, but the treatment is fully effective as early as the twelfth month: if the child is stung accidentally, he no longer risks anaphylactic shock», concludes Fiocchi.
August 31, 2023 (change August 31, 2023 | 18:02)
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