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Tuesday, February 08, 2005
Stung by bees
By Henrylito D. Tacio
Health 101
IT WAS supposed to be a memorable vacation for the family.
Ten-year-old Cesar was having fun out in the farm when suddenly some bees stung him in his left arm and neck. He cried in pain while scratching the affected areas, as these were very itchy. His mother, Edith, tried to pacify him but started to worry when she observed the swelling was getting larger each minute. Before long, Cesar was gasping for breath and wheezing.
"Frank, we need help!" she cried as Cesar collapsed. When Frank saw his boy losing consciousness, he immediately carried Cesar to their vehicle. It was the longest 10-kilometer drive Frank had driven in his life.
When they arrived at the hospital, a doctor tried to revive Cesar. But it was already too late. Cesar succumbed to sting-induced anaphylactic shock.
Unknowingly, these allergic reactions can trigger a life-threatening anaphylaxis (from the Greek for "non-healing"). In the United States, as many as 100 people a year die from bee stings.
That's more than the number who die from the bites or stings of all other animals combined, says Dr. Kenneth Kizer, professor of emergency medicine at the University of California.
For these people, a bee sting results in high levels of immunoglobulin E (IgE) produced in the body. "IgE, which is associated with allergies, is an unusual antibody," says Dr. Che Maraina Che Hussin, of the immunology department of the School of Medical Sciences in Kelantan, Malaysia.
"What this antibody does is stick to certain cells, and induces the release of chemicals such as histamines in large amounts. If they are spread all over the body, a person will get an allergic reaction which involves many of the body's organs," the medical-based lecturer in immunology.
Symptoms normally appear rapidly, usually within seconds or minutes, after exposure to an allergen. In rare cases the anaphylactic reaction may be delayed for about 12 hours. Studies have shown that victims who develop an anaphylactic reaction first sense a feeling of foreboding and feels uncomfortable. Early symptoms of anaphylaxis may include itchiness of palms or soles or roots of hair.
This is immediately followed by swelling of the face, sensation of faintness, feeling of generalized warmth, tingling sensation all over, or metallic taste in the mouth, discomfort in throat or chest, and breathing difficulty.
In his book, Dr. Yadav writes: "The skin is usually the first organ to react with development of initial itching, followed by hives, swelling usually facial swelling, redness or a stinging or burning sensation.
The individual may begin to feel distressed and frightened by these symptoms. The continuous loss of fluid from blood vessels causes a drop in blood pressure and the individual may feel light-headed or even lose consciousness. The drop in blood pressure leads to anaphylactic shock.
No matter what the species of bee or wasp, the spot it stings will feel red and swollen. But these stinging insects are not the same, and neither is their method of stinging, according to Dr. Edgar Raffensperger, professor of entomology at Cornell University.
The only insects with true stingers belong to the order Hymenoptera, including the Apidae (honeybees and bumblebees) and Vespiade (wasps, yellow jackets, white-faced hornets, and yellow hornets). The stinging mechanism, located in the female's abdomen, consists of a stringer attached to a venom-filled sac.
The honeybee's stinger has multiple barbs so that it usually remains in the wound, causing the bee's death. Wasps, whose stingers do not have barbs, can sting more than once. Yellow jackets can also string repeatedly.
Aside from bees and wasps, food can also cause anaphylactic shock. Other common allergens that could be a problem to a select group of individuals include:
* Drugs: Particularly penicillin and its related antibiotics, anaesthetic drugs, some intravenous infusion liquids and contrast media injected during x-rays.
* Latex: Proteins in rubber latex gloves, catheters, medical devices and other household products made of latex can trigger the reaction.
* Exercise-induced: In these patients exercise or exertion after ingestion of some specific food, for example wheat, shellfish, fruit, milk, celery and fish, precipitates the anaphylactic reactions.
* Beta-blockers: These medicines are widely prescribed for heart disease or high blood pressure. Their use during systemic allergic reaction triggered through other causes can result in the development of severe anaphylaxis.
The beta-blockers interfere with the body's main defenses against anaphylaxis and must be excluded in the management of the disease.
For anaphylactic shock, the usual treatment is the bronchodilator epinephrine (EpiPen). A victim may give himself an injection from a bee-sting kit; but after the injection, he must see a doctor immediately for further treatment. For Bisaya stories from Davao. Click here.
(February 8, 2005 issue)
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