Jump to content
Alastair

The importance of being stung

Recommended Posts

Posted (edited)

Here Michael Palmer explains a little about the immune system, why bee sting allergy is common in children of beekeepers, and what can be done about it. This is based on what was told him by his immunologist.

 

 

Edited by Alastair
  • Thanks 1

Share this post


Link to post
Share on other sites

When I get stung I try and  flick out the sting with the poison sack intact .

I wonder if I should squash it and give my self a proper sting occasionally.

Share this post


Link to post
Share on other sites

My guess, the amount you get in the first 2 - 3 seconds should be enough.

 

On this subject, a general question. -  We have probably all heard the story of a beekeeper who had been keeping bees for years, then suddenly developed an allergy. But I've never actually found out who it is, or personally met someone in this situation. Is the story true?

  • Agree 1

Share this post


Link to post
Share on other sites

Very true, we are still working through bee venom therapy with our boy, it is taking an incredibly long time to de sensitise him with each 3 week hospital visit causing mild throat closure which for the last couple of visits hasn’t required adrenaline luckily. 

 

  • Like 2

Share this post


Link to post
Share on other sites

There was a hobby beekeeper here on the forum a while ago who had to give up because she developed a severe allergy to beestings.

 

  • Like 2

Share this post


Link to post
Share on other sites

Yes. An old bee keeper down the road developed it in recent years and has now given up. ☹️

Share this post


Link to post
Share on other sites
Posted (edited)

Thanks Paul, and that gives opportunity for my next question. Was this old beekeeper a commercial who was regularly stung, or was he a keeper of just  few hives and he always wore veil and gloves and was rarely stung?

 

That's what I'm wondering, could some of these stories relate to people who like in Michael's video, were exposed to bee proteins, but not actually stung enough.

Edited by Alastair

Share this post


Link to post
Share on other sites
On 3/08/2019 at 8:07 AM, Alastair said:

My guess, the amount you get in the first 2 - 3 seconds should be enough.

 

On this subject, a general question. -  We have probably all heard the story of a beekeeper who had been keeping bees for years, then suddenly developed an allergy. But I've never actually found out who it is, or personally met someone in this situation. Is the story true?

I had a guy come through looking at some of my hives and he said his main helper developed allergies, he said first it was heart burn and then the next time tingling lips

  • Thanks 1

Share this post


Link to post
Share on other sites

I developed some level of allergeic reaction. Regardless of sting site, I normally got a reaction going around my body, itchy soles of my feet, itchy balls, itchy scalp, heat, irritation, hives, scratching of hives == 10x more hives. Nausea was quite rare, but irritation from a single sting could last up to a week. On rare event of mowing the lawn at home I got stung on the eyelid between my eye and my glasses, that was a real bad one. So, I started wearing gloves full time and really hunkered down. However, in the season just past, I still got a few stings along the way. One was just a week ago. Aside from minor pain at the sting site there was no other reaction all of this season. So I was definitely on the 'scale' and I'm not saying I am cured; this season anything could happen, but it is interesting to me, that I was part way up the scale and now just as randomly I have gone back down the scale. I don't have any explanation, but it is a lot nicer.

  • Like 2
  • Thanks 1

Share this post


Link to post
Share on other sites

Good luck with it Chris.

 

When i got my first hive as a kid, it was one of those super aggro AMM's that are pretty much extinct now. One of the first things i did was get it riled up and they gave me a real pasting, I ripped of my veil and shirt cos they were inside both of those, bad mistake.

 

Anyhow I sat in the bath pulling out whatever stings i could find, those plus lumps where a sting had been, totalled 64. I did have symptoms of anaphilaxis, and i was unwell and sore all over for a couple of days. We were advised that this might bring on more severe reactions in the future, but luckily, it didn't. Could have been the end of my beekeeping career before it even began. 😳

  • Like 3

Share this post


Link to post
Share on other sites
22 hours ago, Alastair said:

Thanks Paul, and that gives opportunity for my next question. Was this old beekeeper a commercial who was regularly stung, or was he a keeper of just  few hives and he always wore veil and gloves and was rarely stung?

 

That's what I'm wondering, could some of these stories relate to people who like in Michael's video, were exposed to bee proteins, but not actually stung enough.

Good question.

The retired commercial beek I had help from had developed a reaction to propolis- but stings no issue.

 

  • Good Info 1

Share this post


Link to post
Share on other sites

Interesting Mummzie, when I first came to Auckland i developed a major allergy to not all propolis, but just one particular kind. I usually had propolis on my fingers 24/7, but if i got the smallest bit of this one not very common kind, my nose would itch, felt like i had inhaled pepper, and I'd have constant sneezing.

 

However, for whatever reason, this too went away over time, i am grateful for small mercies. 🙂

  • Like 1

Share this post


Link to post
Share on other sites
5 hours ago, Mummzie said:

Good question.

The retired commercial beek I had help from had developed a reaction to propolis- but stings no issue.

 

I know of two commercial beeks who gave up because of a propolis allergy .

Share this post


Link to post
Share on other sites
1 hour ago, kaihoka said:

I know of two commercial beeks who gave up because of a propolis allergy .

Did they used to eat any propolis out in the field? I usually make a nice pill sized ball and swallow, I was told propolis is really good for you like getting stung. 

  • Good Info 1

Share this post


Link to post
Share on other sites
12 hours ago, Maru Hoani said:

Did they used to eat any propolis out in the field? I usually make a nice pill sized ball and swallow, I was told propolis is really good for you like getting stung. 

I think at least one would never have eaten it .

They never wore gloves .

Share this post


Link to post
Share on other sites
12 hours ago, Maru Hoani said:

Did they used to eat any propolis out in the field? I usually make a nice pill sized ball and swallow, I was told propolis is really good for you like getting stung. 

I also eat the propolis straight off the hive.I remember telling the boys in Canada to do it.The propolis was poplar disgusting tasting stuff.

Share this post


Link to post
Share on other sites

I’ve had a number of people tell me they are allergic to bees. When I asked what happens they tell me they get swelling around the sting and sometimes further up the limb. 

  • Agree 2
  • Haha 4

Share this post


Link to post
Share on other sites
Posted (edited)

INFO:  never wash your bee kit with your normal washing.  Any bee venom very dilute gets on the other clothes and your body then gets sensitive to it at low levels., then reacts extremely when you get the real thing.  Especially important for kids clothes.

Edited by Norm
add
  • Like 2

Share this post


Link to post
Share on other sites
On 5/08/2019 at 2:11 PM, Alastair said:

Thanks Paul, and that gives opportunity for my next question. Was this old beekeeper a commercial who was regularly stung, or was he a keeper of just  few hives and he always wore veil and gloves and was rarely stung?

 

That's what I'm wondering, could some of these stories relate to people who like in Michael's video, were exposed to bee proteins, but not actually stung enough.

 

Can’t answer that. Will have to ask him next time I see him (which isn’t often now he doesn’t have bees). 

 

He was a hobbyist when I met him. But his son is a commercial...

Share this post


Link to post
Share on other sites

Have a commercial of three generations up north here who went down with one sting,,, I will say semi:) mature of age:) had to go throu the injection thing.  When i have a bad reaction some american or canadian doc  i had to see said keep the stings to a minimum of three a day,,, anymore were far to much, She said it works the opposite to what we think when it comes to the immunity thing with the bigger hits.  Its the neck areas i am careful of, usually use a neck sleeve when i dont use a veil  it seems to be one of the bad spots to go down.

Share this post


Link to post
Share on other sites

 

Canterbury Hub Beekeepers’ Day Out, Lincoln University May 2019:

 

We were incredibly lucky to have two speakers from the South Island Honey Bee Venom Desensitisation Programme. 

 

This was followed by analysis of – are ACC honey bee sting claims, increasing with hive numbers. 

 

Below are the speaker abstracts for these two presentations, followed by editorial written by Rae Butler, VSH Specialist Ashburton

 

HONEY BEE VENOM ALLERGY AND TREATMENT

Abstract: The Immunology service at Christchurch Hospital provides an outpatient-based service and regularly receives referrals of patients who have had anaphylaxis for assessment. This talk will touch on anaphylaxis diagnosis and treatment, bee sting reactions, the role of laboratory testing and our experience with bee venom desensitisation.

 

Biography: Dr Ignatius (Iggy) Chua trained in London, United Kingdom and was appointed Consultant Immunologist at Christchurch Hospital, Canterbury District Health Board in 2015. His clinical practice involves seeing patients with autoimmunity, immunodeficiency and allergy. His other role is as an immunopathologist in Canterbury Health Laboratories, CDHB and has oversight on laboratory tests related to autoimmunity, immunodeficiency and allergy.

 

Biography: Maija-Stina Out, Registered Nurse, works in the Immunology Department alongside Dr Chua. Once people have been offered venom desensitisation Maija-Stina arranges for this to be done in the Christchurch Hospital Medical Day Unit. Maija-Stina will share what people can expect to happen during desensitisation. Maija-Stina Out trained in Auckland, moving to the Mainland 16 years ago. Initially working in the Medical Day Unit, developing an interest in allergy. Maija-Stina’s role as the only adult Immunology/Allergy Nurse in the South Island was created five years ago.

 

WHO’S GETTING STUNG? HAVE ACC BEE STING CLAIMS DOUBLED WITH DOUBLING NZ HIVE NUMBERS? 

Abstract: A summary of ACC statistics and NZ Apiary Register hive numbers 2009-2018. 

Maggie James, queen cell and queen bee producer, 12 years ago successfully completed the honey bee desensitisation programme at Christchurch Hospital.

 

Available as handouts:

*Bee Stings and Prevention pamphlet, written by Maggie James

*Clinical Immunology Allergy and Prevention handout. 

 

HONEY BEE VENOM ALLERGY AND TREATMENT

Dr Ignatius Chua (Consultant Immunopathologist from the Canterbury Health Laboratories, Christchurch Hospital) and Maija-Stina Out (Allergy Nurse, Christchurch Hospital) spoke for 40 minutes, followed for 20 minutes by Maggie James (queen breeder extraordinaire and Canterbury Hub Secretary) shedding some light on the hypothesis ‘Are beekeepers’ spouses and/or offspring more prone to bee venom allergies than the general public?’

Beekeepers’ spouses and/or offspring are more prone to bee venom allergies than the general public because they are more exposed to dry, airborne bee venom off the beekeeper’s body, overalls, vehicles and beekeeping equipment. Instead of this exposure building up an immunity, it can in some cases have the opposite effect where the person develops an allergy that is life threatening, especially when subjected to a bee venom sting.

Exposure to bee venom by family members therefore should be kept at a minimum, precautions such as clothing worn during beekeeping should be washed separately to normal day wear (or ideally in a different washing machine), along with other controls.

When asked, Dr Ignatius Chua could not be drawn into any discussions on the reasons whyor even ifallergy instances were higher in the family of beekeepers. Dr Chua did touch on anaphylaxis diagnosis and treatment, bee sting reactions, the role of laboratory testing and bee venom desensitisation, which helped endorse the hypothesis. He also reiterated that beekeepers themselves may be at risk.

Dr Chua explained that when a person is exposed to an allergen (in this case an insect sting), their immune system protects their body from an infection by triggering the production of antibodies called Immunoglobulin E (IgE). These antibodies (IgE) travel about the body and cause other cells to release chemicals that in turn cause symptoms, most often in the nose, lungs, throat, sinuses, ears, stomach lining or on the skin.

An allergic reaction can take seconds to several hours to develop into symptoms such as generalised hives, itching or flushing, and swollen lips-tongue-uvula.

The person is having a severe allergic (anaphylaxis) reaction if these conditions are compounded with at least one of the following:

  • respiratory problems: shortness of breath, wheezing, coughing, stridor (vibration noise when breathing)

  • blood pressure issues: collapsing, passing out

  • end-organ dysfunctions: stomach cramps, vomiting, incontinence.

If a person with a bee venom allergy is exposed to the allergen, it may not necessarily cause a reaction at first. However, the person’s cells have been triggered to produce IgE, making the body sensitive to the venom; therefore, even minor future exposures to the allergen may produce an allergic reaction.

All immune systems are different; some produce Immunoglobulin G (IgG) antibodies that offer immunity to the allergens, and others produce IgE at varying levels of allergy reaction. The IgE can be measured from lower end risk to severe (which can be fatal), but no test is available that predicts the severity of a reaction. Reactions to bee stings vary widely and anyone can have an anaphylaxis attack.

Those more at risk of having an anaphylaxis attack from a bee sting may already suffer from asthma and eczema, recent anaphylaxis, heart disease, diabetes or other skin and internal organ issues. Other identified risks are the infrequency of bee stings (fewer than 15 stings a year), spring season and the first year in beekeeping.

We know how, why and what to do if individuals have an allergic reaction to a bee sting, but we do not know exactly when an allergic reaction will generate into an anaphylactic attack.

There is a 35% chance of an anaphylactic reaction; beekeepers should identify this as a fairly high risk and have a health and safety management plan in place.

Part of the management would be to reduce exposure to bee stings, carry emergency treatments that can be self-medicated and venom immunotherapy.

If a mild allergic attack treated with antihistamine extends to respiratory, blood pressure or organ dysfunction problems, apply adrenaline, lie down with feet up so blood can get to the brain and seek medical assistance. Always know where your closest ambulance base is and carry adrenaline; the most user-friendly form is an EpiPen®. Adrenaline has a short expiry time and must be kept at a consistent temperature between 15–25°C. Do not refrigerate: if adrenaline is not stored appropriately it will lose its effectiveness.

Only severe cases are considered for immunisation. A GP consultation is required, and certain criteria must be met to attain funding for the treatment. Even though it reduces the frequency of an anaphylaxis reaction by 10 times, there is a chance it does not induce tolerance, the waiting time can be several months, it involves multiple injections, holds potential for further anaphylaxis reactions and it is very supply dependent.

Maija-Stina Out reiterated that at the Allergy Clinic at Christchurch Hospital, the immunisation treatment involves multiple injections of low-dose venom in one day, over the first week fewer injections daily but stronger doses, then weekly doses of up to the equivalent of two bee stings for four weeks. Patients are closely monitored at the hospital and treatments are adjusted according to tolerance levels. Once reactions to the bee venom are stabilised, the patient’s GP will carry on with monthly treatments for three years, taking approximately 20–50 injections to attain tolerance.

Medical-grade bee venom is processed under medical regulatory authority requirements. The bees are squeezed between two panes of glass, and the venom is collected in certified amounts and graded.

New Zealand does not produce medical-grade bee venom and buys it from Spain. Spanish reserves are under strain due to the Australia and the USA having their own production issues.

In general, the number of people immunised is related to the supply of medical-grade bee venom. Approximately 10 people are immunised for insect stings a year, 80% are for bee venom and 20% for wasp venom. These low figures are indicative of a shortage in medical-grade bee venom.

WHO’S GETTING STUNG? HAVE ACC BEE STING CLAIMS DOUBLED WITH DOUBLING NZ HIVE NUMBERS? 

Maggie James’ talk also emphasised the need to increase public awareness of the seriousness and speed of anaphylaxis deterioration after a bee sting.

Since 2009/10, beehive numbers have increased 137% from 374,953 to 888,400 in 2017/18. In that same timeframe, the number of ACC claims for bee stings rose 113% from 3020 to 6426.

From the 2017/18 figures, 80.6% of the claims were laid in the North Island (of which 25.3% were from the Auckland region only). Overall, 6.92% were work claims, 66.25% were bee stings in the home environment and 4% led to an anaphylaxis reaction. Consistently over the nine years surveyed, bee sting claims were not gender specific but the largest age claim bands were for those aged five to 14 years.

The fact-stacked PowerPoint was entertaining but had a serious message: beekeepers are paying high ACC levies of $2.69 for every $100 earnedis this amount relative to today’s beekeeping environment? Work claims, lost productivity days and fatalities were minimal, and there is an increased industry health and safety awareness for the beekeeping workforce and public safety. Much of the physical work has been replaced with hydraulic equipment, bees have been genetically improved for temperament, and improved drug and alcohol awareness. Do these factors outweigh the long truck hauls shifting hives, the difficult terrain some sites are on, increased numbers of hobbyist beekeepers, and risk of an allergic reaction?

What is evident from the messages provided by all three speakers is the need to continue educating and promoting awareness to the general public by ACC and the New Zealand bee industry about the need to be prepared for an anaphylaxis reaction, especially amongst our most vulnerable: our children. In my view, there is an opportunity for ACC, Ministry of Health and industry to facilitate the production of medical bee venom for the domestic market.

Ours is a small industry; most of us will know someone who has undergone a bee venom immunisation procedure or experienced a tragic anaphylactic fatality.

  • Like 1
  • Good Info 3

Share this post


Link to post
Share on other sites

The bit about people who suffer from asthma and eczema being more susceptible to severe reaction was interesting ..

I do not react very strongly to stings and neither do my bloodline .

There is no ezcema or asthma or other auto immune diseases in our family .

Share this post


Link to post
Share on other sites
On 20/08/2019 at 8:42 PM, Maggie James said:

Since 2009/10, beehive numbers have increased 137% from 374,953 to 888,400 in 2017/18. In that same timeframe, the number of ACC claims for bee stings rose 113% from 3020 to 6426.

From the 2017/18 figures, 80.6% of the claims were laid in the North Island (of which 25.3% were from the Auckland region only). Overall, 6.92% were work claims, 66.25% were bee stings in the home environment and 4% led to an anaphylaxis reaction.

 

I wonder if the rate of reporting remained static (eg what portion of people stung sought medical attention in 2009 versus  2018).  I had a brief look at the stats here but was a bit daunted by the volume of data and a quick skim seemed to show that people weren’t making more claims.

 

Obviously anaphylaxis warrants medical attention, and small children badly stung do too, but I’m surprised so many people seem to have gone for medical help for bee stings.

Share this post


Link to post
Share on other sites

The statistics used in my presentation did not come from the source you mention above.  I presented ACC with a set of questions, and the statistics I used were obtained from ACC under the Official Information Act, and yes ACC bee sting claims have definitely risen.

 

  • Good Info 1

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...