5 August 2011
British summers are famously unpredictable, but even when it's not pouring down with rain thousands of people across the country are driven indoors by another problem particular to the season.
Although nothing more than an irritating sideshow to a picnic for most, for a significant minority of people bee and wasp stings can be deadly.
Fortunately, help is at hand for those who are allergic to insect stings. A small team based at St Helier Hospital is responsible for investigating, diagnosing and helping people manage their allergies for the whole of south-west London.
A key member of the team is Amena Warner, the sole clinical nurse specialist in immunology and allergies at the Trust and one of only 108 in the whole of the UK. Amena was keen to highlight how serious an allergy to wasp or bee stings can be.
Amena said: "A person who suffers an anaphylactic reaction (a severe allergic reaction) to a sting will certainly require attention in A&E and may have to be admitted to an intensive care unit. At worst it can cause breathing difficulties, loss of consciousness or cardiac arrest, and between six to ten people die each year in the UK as a direct consequence."
The first stage of combating adverse reactions is to confirm that an individual is indeed allergic to insect stings. Amena explained: "The first step is a thorough check of a patient’s clinical history, before going on to test for allergic antibodies in their blood to bee and wasp venom. We can then follow up with skin-prick testing using the venom itself.
"If they are allergic we can prescribe an EpiPen, which patients use to self-administer adrenaline in case of a sting. Adrenaline helps by raising blood pressure, opening up airways, relieves swelling and makes the heart beat faster, thus increasing blood flow to vital organs.
"The majority of patients also opt for a desensitizing course of injections, even though it’s a long-term programme. An individual will receive weekly injections for twelve weeks, followed by monthly injections once a month for three years. They are injected with, initially, minute amounts of venom, which is gradually increased over time.
"The patient slowly becomes desensitised, and the top dose of venom administered is equivalent to two sacs of wasp venom. If the patient can tolerate this amount in a clinical setting they are much safer if they get stung out in the community.
"It takes a long time, but the bottom line is that it’s effective; success rates are between 90 – 95%."
And it’s not just the physical side of a wasp or bee sting allergy that affects individuals. As Amena points out, individuals can build mental barriers and even pass them on to others: "The psychology of insect allergies can affect more than just the patient – for example, a child who sees a parent petrified by wasps will also grow up in fear, too.
"A wasp is a minor irritant for most, but for some it can make them a prisoner in their own homes during the warmer months."
In 2010 the A&E departments at Epsom and St Helier hospitals treated 161 cases of insect bites and stings. If you think you may be allergic to wasp or bee stings and would like advice, visit your GP.
