Glossary
An immune-mediated hypersensitivity reaction to honey bee venom proteins (primarily phospholipase A2 and melittin) that ranges from large local reactions (extended swelling beyond the sting site) to life-threatening systemic anaphylaxis (airway constriction, blood pressure collapse, cardiovascular shock).
A normal sting reaction involves localized pain, redness, and swelling at the sting site that resolves within hours. This is not an allergy; it is a normal inflammatory response to venom. A large local reaction involves swelling extending beyond 4 inches from the sting site, sometimes encompassing an entire limb, lasting 2 to 7 days. Uncomfortable but not life-threatening. A systemic (anaphylactic) reaction involves symptoms distant from the sting: hives over the entire body, facial/throat swelling, difficulty breathing, dizziness, rapid pulse, nausea, and potentially cardiovascular collapse. This is a medical emergency requiring immediate epinephrine and 911.
For people with confirmed venom allergy, venom immunotherapy (allergy shots) is 97% effective at preventing future anaphylaxis. The treatment involves gradually increasing doses of purified bee venom injected over 3 to 5 years, retraining the immune system to tolerate venom exposure. It is one of the most effective immunotherapy protocols in all of allergy medicine.
Approximately 2 million Americans have diagnosed venom allergies. Fatal anaphylaxis from bee stings causes approximately 60 to 80 deaths per year in the U.S. The vast majority of bee stings cause only local pain and swelling that resolves within hours to days.
Many beekeeping associations recommend all beekeepers keep an epinephrine auto-injector accessible in their apiary first aid kit. Even beekeepers without known allergies can develop sensitization over time. Consult your physician about obtaining a prescription.
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