Bee sting

A bee sting strictly means a sting from a bee (honeybee, bumblebee, sweat bee etc). In the vernacular it can mean a sting of a bee, wasp, hornet, yellowjacket or sawfly. Some people may even call the bite of a horsefly a bee sting. It is important to differentiate a bee sting from an insect bite. It is also important to recognize that the venom or toxin of stinging insects is quite different. Therefore, the body's reaction to a bee sting may differ significantly from one species to another.

The most aggressive stinging insects are wasps (including bald-faced hornets) but not in general hornets (the European hornet is gentle). All of these insects aggressively defend their nests, although they have not developed a sting targeted at mammals like the honeybees.

In people who are allergic to bee stings, a sting may trigger a dangerous anaphylactic reaction that is potentially deadly.

Honeybee stings
A honeybee that is away from the hive foraging for nectar or pollen will rarely sting, except when stepped on or roughly handled. Honeybees will actively seek out and sting when they perceive the hive to be threatened, often being alerted to this by the release of attack pheromones (below).

Although it is widely believed that a worker honeybee can sting only once, this is a misconception: although the stinger is in fact barbed so that it lodges in the victim's skin, tearing loose from the bee's abdomen and leading to its death in minutes, this only happens if the victim is a mammal (or bird). The bee's stinger evolved originally for inter-bee combat between members of different hives, and the barbs evolved later as an anti-mammal defense: a barbed stinger can still penetrate the chitinous plates of another bee's exoskeleton and retract safely. Honeybees are the only hymenoptera with a barbed stinger.

The stinger's injection of apitoxin into the victim is accompanied by the release of alarm pheromones, a process which is accelerated if the bee is fatally injured. Release of alarm pheromones near a hive or swarm may attract other bees to the location, where they will likewise exhibit defensive behaviors until there is no longer a threat (typically because the victim has either fled or been killed). These pheromones do not dissipate nor wash off quickly, and if their target enters water, bees will resume their attack as soon as the target leaves.

(Alarm pheromones have been characterized as having a "dirty socks" smell, which is why amateur beekeepers will often bathe and change into clean clothes before working a hive.)

The larger drone bees do not have stingers. In worker bees, the stinger is a modified ovipositor. The queen bee has a smooth stinger and can, if need be, sting skin-bearing creatures multiple times, but the queen does not leave the hive under normal conditions. Her stinger is not for defense of the hive; she only uses it for dispatching rival queens, ideally before they can finish pupating. Queen breeders who handle multiple queens and have the queen odor on their hands are sometimes stung by a queen.

The main component of bee venom responsible for pain in vertebrates is the toxin melittin; histamine and other biogenic amines may also contribute to pain and itching. In one of the medical uses of honeybee products, apitherapy, bee venom has been used to treat arthritis and other painful conditions.

Treatment
Following a honeybee sting the first step in treatment is removal of the barbed stinger. The stinger should be removed as fast as possible without regard to method: studies have shown the amount of venom delivered does not differ if the stinger is pinched or scraped off and even a delay of a few seconds leads to more venom being injected. Once the stinger is removed, reduce pain and swelling with a cold compress.

Many traditional remedies have been suggested for bee stings including damp pastes of tobacco, salt, baking soda, meat tenderizer, toothpaste, clay, aspirin or even application of copper coins. Bee venom is acidic and these interventions are often recommended to neutralize the venom; however, neutralizing a sting is unlikely to be effective as the venom is injected under the skin and deep into the tissues, where a topically applied alkali is unable to reach, so neutralization is unlikely to occur. In any case, the amount of venom injected is typically very small (between 5 and 50 micrograms of fluid) and placing large amounts of alkali near the sting site is unlikely to produce a perfectly neutral pH to stop the sting hurting. Many people do claim benefit from these home remedies but it is doubtful they have any real physical effect on how much a sting hurts or continues hurting, the effect is probably related to rubbing the area or the mind perceiving benefit. Furthermore, none of these interventions have been proven to be effective in scientific studies and a randomized trial of aspirin paste and topical ice packs showed that aspirin was not effective in reducing the duration of swelling or pain in bee and wasp stings, and significantly increased the duration of redness. The study concluded that ice alone is better treatment for bee and wasp stings than aspirin.

The sting may be painful for a few hours. Swelling and itching may persist for a week. Do not scratch the area as that will only increase the itching and swelling. If a reaction persists for over a week or covers an area greater than 3 or 4 inches, seek medical attention. Also, doctors may recommend a tetanus immunization. For about 2 percent of people, anaphylactic shock from certain proteins in the venom can be life-threatening and requires emergency treatment by a physician. If the victim is allergic to bee stings, the victim must be treated to prevent shock. People known to be highly allergic may carry around epinephrine in the form of a self-injectable Epipen for the treatment of an anaphylactic shock.

For patients who experience severe or life threatening reactions to insect stings, researchers at Johns Hopkins have developed a series of allergy injections composed of increasing concentrations of naturally occurring venom which provide excellent and usually life-long protections against future insect stings.