How to Avoid or Treat Bee Stings this Summer

As families spend more time outdoors during summer months, parents and other caregivers should be aware of the hazards related to bee stings, and how they can help prevent a child from being stung, a CHOC pediatric allergist says.

Bee stings can be quite common, and don’t usually lead to a serious reaction, says Dr. Wan-Yin Chan. However, there are several things parents can do to help prevent bee stings:

  • Keep food and drink containers closed when outdoors.
  • Wear shoes, socks and gloves when working outdoors.
  • Hire an exterminator to remove hives and nests around your home.
  • Avoid wearing brightly colored clothing or perfume.
  • Remain calm and walk away if you spot stinging insects.

If your child is stung by a bee, remove the stinger as soon as possible because venom can continue to be released for several seconds, says Chan. There is no special technique, but you can try flicking the stinger out as this prevents compressing the venom sac.

The most common reaction from a bee sting is a local reaction that consists of redness and swelling at the site of the sting that usually resolves within a few hours, but may last up to a day or two.

About 10 percent of people develop large local reactions, characterized by redness and swelling that increases in size over 1 to 2 days and can measure as large as 10 centimeters in diameter.  This type of reaction typically resolves over five to 10 days.

There are several ways to treat bee stings at home, says Chan. For small local reactions, try cold compresses.

For large local reactions, in addition to the cold compresses, you can elevate the limb if the sting is on an extremity.  Nonsteroidal anti-inflammatory drugs such as ibuprofen can help relieve pain, and oral antihistamines or topical steroids can help relieve itching.

Anaphylaxis, a severe and potentially life-threatening allergic reaction in response to insect stings, occurs in less than one percent of children and in three percent of adults.

Seek emergency medical attention if your child experiences any of the following symptoms of anaphylaxis:

  • Hives
  • Flushing
  • Swelling of the face, throat or tongue
  • Hoarse voice
  • Difficulty breathing
  • Shortness of breath
  • Wheezing
  • Dizziness
  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of consciousness

Also seek immediate medical attention if there are any signs of infection, which include fever, redness, swelling at the sting site, or worsening pain three to five days after the sting. For infection, your child’s pediatrician might prescribe antibiotics.

For anaphylaxis, the patient will be given at least one dose of epinephrine, also called adrenaline, which can help constrict blood vessels in order to increase blood pressure, reduce wheezing, improve breathing, and work to reduce hives and swelling, says Chan.  A second dose may be required if the first dose is not effective. Because a severe allergy reaction can last for hours, patients should be monitored for several hours after administration of epinephrine.

A commonly prescribed epinephrine injection, is typically only prescribed when there is a history of anaphylaxis.  If the reaction was a local reaction, it is not necessary to carry an epinephrine injection.

If your child has a history of anaphylaxis to bee or other insect stings, ask your pediatrician about a referral to an allergist/immunologist, who can provide further evaluation and allergy testing.  If allergy testing is positive, patients may be treated with allergy shots, which can almost completely eliminate the chance of a severe reaction if they get stung again.

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Protect Children with Asthma from Colds, Flu

Getting a cold or the flu is a bummer for anyone, but these common illnesses can be extra challenging for children with asthma.

Viruses more often than not will worsen asthma, says Dr. Wan-Yin Chan, a CHOC allergist/immunologist.

Already, people with asthma have inflamed airways to the lungs. Coughing and sneezing prompted by a cold or the flu adds extra stress on these airways, which can trigger an asthma attack.

“Having a cold or flu can result in inflammation of the lung tissues which leads to increased bronchial hyperreactivity, which can result in asthma symptoms such as wheezing, excessive cough, shortness of breath or chest tightness,” Dr. Chan explains.

While asthmatic children are no more susceptible to catching a cold or flu than other people, they are more likely to suffer complications, such as respiratory infections. In general, allergies may predispose a patient to such infections, and most asthmatics are allergic.

In these cases, the same added stress on the airways that triggers asthma attacks can lead to infections like bronchitis or pneumonia.

Because of their added vulnerability, it’s important that children with asthma work to avoid contracting the flu by getting their annual influenza vaccination, Dr. Chan says.

According to the Centers for Disease Control and Prevention, the injection is approved for all people aged 6 months and older. However, children ages 2 to 4 with asthma should avoid the nasal spray vaccine.

In addition to getting vaccinated, asthmatic children during cold and flu season should limit contact with sick people, wash their hands frequently, and avoid touching their eyes, nose and mouth, Dr. Chan advises.

Dr. Chan recommends some of her patients with asthma increase the dose of their daily preventative inhalers for one to two weeks at the first sign of cold or flu. Parents should check with their child’s asthma specialist for dosage instructions, she advises.

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What Parents Can do Now to Prevent Allergy Flares Next Holiday Season

Before hastily packing away holiday decorations into the garage, parents can take a few simple steps now to help prevent a sudden surge of allergy symptoms in children next holiday season, say CHOC allergists.

Dr. Wan-Yin Chan recommends that parents wipe down and air dry holiday decorations before packing them away to help minimize dust and mold accumulation when they return again next year. These allergens can prompt sudden allergy symptoms attacks in children, a phenomenon some doctors refer to as the “holiday effect.”

Dust from orna20130425_0505ments and decorations, mold from Christmas trees, exposure to new foods, and visits with others’ pets during the holidays can trigger these attacks in children and adults alike.

Holiday gatherings and spending more time indoors tends to expose people to other allergic triggers that they may not usually be exposed to during other times of the year,” says Dr. Sarah Field.

When the holidays roll around again next year, parents can take measures to prevent allergy and asthma symptoms.

Though comforting and festive to some, the fragrance emitted from a fresh tree may be irritating to others, and some trees may harbor mold spores, which can trigger asthma or allergies, cautions Dr. Field.

To combat this, Dr. Chan suggests adults leave a new Christmas tree to dry in the garage for a week and then shake it out before bringing into the home. Taking the same precautions recommended before packing away ornaments can also help eliminate the introduction of dust and mold into the home when decorating begins, she adds.

Traveling or even visiting homes of others can introduce other allergic or asthmatic symptoms.

Parents should ensure that children take any regular maintenance asthma and allergy medications, especially if traveling. They should also have an updated asthma action plan from their physician for asthma worsening.

Those with food allergies should inquire about ingredients in dishes served at others’ homes, Dr. Field says. Consider eating before visiting or bringing snacks from home, and be sure to bring an epinephrine autoinjector in case of accidental exposure, she says.

Children may also have an allergic reaction to new animals encountered in others’ homes, the doctors explain. Further, teenagers may suddenly experience allergy or asthma symptoms to their own pets after returning home from a semester at college. During their time away, the teen may lose tolerance to their pet. This phenomenon is called the “Thanksgiving effect,” explains Dr. Field.

Learn more about allergy and immunology at CHOC Children’s.

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