The Sneeze

Stinging Insect Venom Allergy

Stinging Insect Venom Allergy

June 15, 2023

Written By:

Andy Dang, MD, FAAAAI

What You Need To Know

A majority of people get mild swelling and pain at the site of the sting, but patients with venom allergies can suffer anaphylaxis, which is a systemic allergic reaction that includes a combination of symptoms such as nausea, vomiting, dizziness, lightheadedness, cough, wheeze, trouble breathing, rash, hives, flushing, and/or swelling.


Bees, wasps, yellow jackets, hornets, and fire ants are all stinging insects in the order Hymenoptera whose venom can cause anaphylaxis in 0.5 to 3.3% of people in the US [Shaker et al. JACI April 2020]. 


Allergy testing via skin testing or blood work ordered by an allergist, in combination with a clinical history of systemic reaction to a sting, confirms a venom allergy.  Venom skin testing is preferred over blood work, and involves using diluted amounts of stinging insect venom and doing a skin prick, which if negative is followed by subsequent increasing amounts of venom injected in small amounts under the first layer of skin.  If at any point there is a wheal/flare response during this process, the test is considered positive for that venom allergy. 

Stinging Insect Venom Allergy

How Is Venom Allergy Treated?

If a venom allergy is confirmed, management includes:

1. Avoidance measures (strategies to avoid getting stung)
  • Stinging insects generally do not sting unless provoked. Most stings are from accidental contact: stepping on an insect by accident, pressing/striking an insect, or taking the insect into the mouth from food/drink. Be vigilant about where stinging insects are foraging to minimize accidental contact.
  • Try to keep feet covered (don't walk barefoot outside)
  • Exercise care with beverages and food.  Using clear food and drink containers for outdoor gatherings can help visualize if a stinging insect could be within.
  • Clean up food and beverage waste and spills quickly, and use tight-fitting lids on food and beverage storage containers.
 2. Carrying an epinephrine autoinjector to treat anaphylaxis if it were to occur
3. Venom immunotherapy (VIT) - allergy shots to desensitize the venom allergy!)
  • VIT has been available for decades and is highly effective. VIT can protect against anaphylaxis and can possibly cure a venom allergy.  VIT is a controlled protocol performed by allergists where gradually increasing concentrations of diluted insect venom are injected subcutaneously over time to desensitize the immune system (induce tolerance to the allergen). Once a goal maintenance dose is achieved, the injection frequency can be spaced out and maintained, typically for several years or more.  While on VIT, there is protection against anaphylaxis, and for some patients who have done VIT for long enough, they may be able to stop the treatment and continue to have long-lasting protection off of the immunotherapy.

Contact Premier Allergy & Asthma to Learn More About Venom Allergies

If you want to learn more about venom allergies, stinging insects, or need help with diagnosing and treating a stinging insect allergy, schedule an appointment to speak with an allergist at Premier Allergy & Asthma!