Bumblebees (genus Bombus) are found worldwide, typically in higher latitudes that range from warm to cold climates. Approximately 45 species exist in North America and about 160 species in other parts of the world.
They are relatives of the honeybees but are larger, much more hairy, and characterized by distinct yellow or white bands on their abdomen. Bumblebees are social bees that live in smaller colonies than honeybees. Most species are docile, but queen and worker bees will sting in self defense or when their nest is disturbed. Unlike the honeybee, the stinger is not barbed and does not get stuck in the skin. Therefore, bumblebees can sting more than once.
Bumblebee venom is similar to honeybee venom, and there is cross-reactivity. Bumblebee venom contains phospholipase A2, serine protease, hyaluronidase, acid phosphatase, and several allergens not found in honeybees.
Bumblebee anaphylaxis is rare compared to stings from wasps, hornets, and honeybees due to their docile nature. People at highest risk are those who are occupationally exposed to bumblebees, such as gardeners who use bumblebees for pollination, scientists, and bumblebee breeders. Some individuals are sensitized to bumblebee venom, while others are sensitized to honeybee venom and then develop an allergic reaction to a bumblebee sting due to cross-reactivity.
Local bumblebee sting reactions include immediate pain, swelling, and redness at the sting site that often subsides within a few hours.
Regional reactions (exaggerated local reactions) occur in some individuals with extended swelling that can last 2-7 days. These reactions are not allergic in origin.
Anaphylactic reactions cause diffuse urticaria, pruritus, angioedema, bronchoconstriction, respiratory distress, hypotension, loss of consciousness, and cardiac arrhythmias. Typically, anaphylactic signs occur within 10 minutes of the sting.
Codes
ICD10CM: T63.441A – Toxic effect of venom of bees, accidental, intial encounter
Bites or stings from insects (arthropods) are very common. Most reactions are mild and result from an allergic reaction to either the insect or the toxins injected with the bite or sting. Some people have severe reactions to the stings of:
Bees
Wasps
Hornets
Yellow jackets
These stings may require emergency help. The bites of most insects – such as ants, mosquitoes, flies, spiders, ticks, bugs, and mites – do not cause such a severe reaction.
Sometimes, it may be hard to tell which type of insect has caused the skin lesions, as many insect reactions are similar. Flying insects tend to hit exposed skin areas, while bugs such as fleas tend to hit the lower legs and around the waist, and often have several bites grouped together. Some individuals are far more sensitive to insects and have more severe reactions, so the fact that no one else in the family has lesions does not rule out an insect bite.
Who’s At Risk
Insect bites and stings are a problem in all regions of the world for people of all ages. In the Midwest and East Coast regions of the US, mosquitoes, flying insects, and ticks account for most bites. In drier areas of the Western US, crawling insects are more of a problem.
There is no proven effect of race or sex in terms of bite reactions. However, some individuals clearly appear more attractive to insects, perhaps related to body heat, odor, or carbon dioxide excretion.
Severe allergic reactions to stings occur in .5–5% of the US population.
Signs & Symptoms
Bumblebee sting reactions include immediate pain, swelling, and redness at the sting site that goes away in a few hours.
Flying insects tend to choose exposed areas not covered by clothing.
Possible reactions to stings include:
Redness, pain, and swelling
Severe reactions such as facial swelling, difficulty breathing, and shock (anaphylaxis)
Fever, hives, and painful joints
Self-Care Guidelines
Wash the wound with soap and water.
Apply an ice pack or cold water for a few minutes.
Take acetaminophen for pain and an antihistamine (diphenhydramine or chlorpheniramine) for itching, as needed.
When to Seek Medical Care
When dealing with stings, be sure to watch out for symptoms such as:
Hives, itching, or swelling in areas beyond the sting site
Swelling of the lips or throat
Tightness in the chest or difficulty breathing
Hoarse voice or tongue swelling
Dizziness or loss of consciousness
Treatments
Depending upon the type of insect bite and reaction, your primary care giver might treat you in the following manner:
Antihistamines or corticosteroids
Epinephrine, antihistamines, corticosteroids, intravenous fluids, and oxygen (for anaphylaxis)
Injectable epinephrine, for those with known severe allergic reactions
Immunotherapy to reduce the chance of repeated severe reactions
Patient Information for Bumblebee sting in Adult