Of Bites and Stings

spider

By John Morlino, DO

“Hey Doc, take a look at this. It’s a spider bite, right?” I’ve heard that line many times as an urgent care physician. As the warmer weather approaches we spend more time outside, leaving ourselves vulnerable to bee stings and mosquito bites. Despite our best efforts of lighting citronella candles or dousing our skin in greasy sprays, we still fall prey to these small creatures.

It seems we can’t escape these pesky insects, but after reading this you’ll at least be better prepared for when they strike.

Bees, Stings and Other Things

A bite is inflicted with the mouth or mandible part of an insect, reptile or animal, resulting in a mosquito bite, snake bite or dog bite. A sting is inflicted from the back or posterior end of an insect, resulting in a bee or wasp sting or a scorpion sting (fortunately not in New Jersey).

Bees, wasps and hornets sting and inject venom into the skin. However, the honeybee better think twice before she stings you. Nature has endowed them with only one chance to sting. They will die after this one event. On the other hand, wasps and hornets can sting multiple times and just fly away.

You’ve Been Stung – Now What?

We must appreciate the fact that a very small amount of venom from a bee can be lethal. It is estimated only 30 millionths of a gram of bee venom (30 micrograms) can kill a person. A small percentage of people will have a severe, life-threatening reaction to a bee sting. This is call anaphylaxis and it can be fatal. It is estimated that about 2 million U.S. citizens are highly allergic to bee strings (about 1 in 155 people) and of all of those who are allergic, only 1 in 1,000 will experience the severest allergic reaction. On average, 65 people will die of a bee sting in the U.S. each year. This is compared to five deaths for snake bites. Of course, many more people are stung by bees than snakes.

Fortunately for most people, a bee sting will result in red, itchy, swollen skin which will subside in a few days. If stung, make sure you take out the stinger from the surface of the skin. This is only necessary if a honey bee was the culprit. Tweezers and magnifying glass will be valuable in this task. Later, apply ice to the area, and an oral antihistamine such as Benadryl (diphenhydramine) can help relieve itch and swelling. For a more widespread reaction or persistent swelling (more than 2 or 3 days), you should seek medical attention.
If you have experienced dizziness, fainting or shortness of breath after a bee sting, you are advised to carry a bee sting kit with you at all times. See your healthcare provider, as you will need a prescription for this device.

Shoo, Fly, Don’t Bother Me

While bug bites aren’t 100 percent avoidable, there are certain preventive measures we can take to best protect ourselves from those pesky insect bites.

Avoiding Bee Stings

  • If you look like a flower or smell like a flower, you increase your chances of getting stung by a bee or wasp. Avoid perfumes or bright colors to keep the bees away.
  • Eating outside on a warm summer afternoon is ideal, but just be careful of sweet snacks and sugary drinks – they bees will certainly stop by for a bite.
  • Should you come in close proximity of a bee or wasp, remain still. It may feel more natural to swat at the bug but you will only agitate it, and the likelihood of getting stung increases.

Avoiding Mosquito Bites

  • Using insect repellent is an easy way to prevent mosquito bites. For those with sensitive skin, many brands offer insect repellent clips that attach to your clothing. Lighting a citronella candle is another alternative.
  • Mosquitos like the hours between dusk and dawn. If weather permits, wear long-sleeved shirts and long pants to keep them away.
  • Standing water serves as a breeding group for mosquitos. Getting rid of standing water is an easy option to avoid mosquito bites.

When in Doubt, Don’t Blame it on a Spider

The spider is probably the scapegoat of the insect world. They are blamed for considerably more bites than they inflict. Many patients will say they have a spider bite, but only a few actually saw the creature. The vast majority of so-called spider bites are actually a type of resistant staph infection. They are skin sores that are red, painful, elevated and may have a black center. They do resemble actual spider bites and are treated with one or more antibiotics.

Spider bites in the U.S. measure in the thousands and are lethal to about 10 individuals per year. Children and seniors are most vulnerable.

It is estimated there are more than 100,000 different types of spiders, yet only a tiny fraction of 1 percent are harmful to humans. At the top of the list are black widows and the brown recluse. Both of these spiders are small, about 3/8 of an inch. Some of those bitten report little or no initial pain. Best thing to do is to apply a cold compress or ice pack on the wound site and get medical attention. Some spider bites require administration of an anti-venom serum as in some snake bites.

What bug do you think presents the most serious threat to the health and well-being of all mankind? No, it’s not a bee or spider, they don’t even come close. Did you say mosquito? Yes, that’s correct! Each year, just from the transmission of malaria alone, mosquitoes cause an estimated 2.7 million deaths. Mosquito commissions, we thank you!

John Morlino, DO, has been with eMedical Urgent Care since 1984. He is board-certified in emergency medicine. Dr. Morlino earned his medical degree from Philadelphia College of Osteopathic Medicine and completed his family practice residency at Union Memorial Hospital, Union, N.J.  Dr. Morlino holds a bachelor’s degree in biology and physics/mathematics. He also is a certified paralegal.

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