Full Article: “The Honey Bee Sting” by Dr. Jamie Ellis

The human body’s reaction to bee stings — Dr. Ellis explains that true allergic reactions to bee stings are rare—only 0.5 to 2 percent of people are affected—and that the body’s response can range from mild local swelling to life-threatening anaphylaxis. His research and clinical charts help both beekeepers and the public understand which sting reactions require medical attention and which resolve naturally.

Defining allergy and variability of responses — “Allergy is a general term that describes a variety of human symptoms and reactions to a diversity of materials including pollen, animal dander, foods, drugs, dust mites (house dust), stinging insects and others. Stinging insect allergy refers to sting-induced systemic reactions of the body that occur at body locations distant from the sting site. Allergic reactions do not include the immediate pain caused by the sting itself or to the burning, redness, itching and swelling that might occur at the sting site. Such reactions include very large local swelling and are referred to as ‘local reactions’.” Dr. Ellis notes that people’s normal and allergic reactions to stings can vary enormously from person to person and even from sting to sting.

Sensitization and why the second sting matters — “An allergic reaction typically occurs after the second or subsequent stinging event by the same or closely related species. The first sting (or stings) induces the production of the allergy-causing antibody, immunoglobulin E (IgE), by the body, resulting in the sensitization of the individual to the venom. Later, when the now hypersensitive individual is stung again, the venom causes an IgE-mediated allergic reaction.”

Categories of reactions —

• Normal, non-allergic reactions at the time of the sting — Sharp pain and burning at the sting site that intensifies for minutes, then decreases; redness or swelling; tenderness to the touch. Usually no medical intervention needed.

• Normal, non-allergic reactions hours or days after the sting — Itch, redness, swelling for hours–days; small red spot at puncture site (common on fingertips).

• Large local reactions — Rapid or massive swelling extending beyond the sting site (e.g., entire arm or leg). Typically not dangerous; see a doctor if mouth or neck are involved.

• Cutaneous allergic reactions — Hives, itching, redness remote from sting site (“skin-only allergic”).

• Non-life-threatening systemic allergic reactions — Allergic inflammation of nose/eyes, mild respiratory issues, nausea, vomiting, weakness. Seek medical care immediately.

• Life-threatening systemic allergic reactions (anaphylaxis) — Affects circulatory/respiratory systems; can be fatal within minutes. Call 911 immediately and use an EpiPen® if available.

Mass envenomation & Africanized behavior — Humans can tolerate roughly 5–10 stings per lb of body weight before venom toxicity becomes life-threatening (≈ 500–1,000 stings for a 100-lb adult). African-derived honey bees are dangerous not because their venom is more toxic, but because far more bees attack at once.

Best-practice first aid — Leave the area quickly, cover head and neck, and get into an enclosed space (vehicle or building). Do not jump into water. Once safe, remove the stinger fast—scrape or pinch, speed matters more than method. Wash with soap and water, apply a cold pack, consider an oral antihistamine, and use a topical sting aid if needed.

Excerpted and used with permission from the American Bee Journal, “The Honey Bee Sting,” by Dr. Jamie Ellis (Vol. 156 No. 1).

Disclaimer: This guide is educational and not a substitute for professional medical advice, diagnosis, or treatment. If you have any concerns after a sting, seek medical care.