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Wasp or yellow jacket sting in Adult
Other Resources UpToDate PubMed

Wasp or yellow jacket sting in Adult

Contributors: Robert Norris MD, Joanne Feldman MD, MS
Other Resources UpToDate PubMed


Wasps are a diverse group of insects with worldwide distribution that includes any insect of the order Hymenoptera, suborder Apocrita, that is not a bee or ant. However, the term wasp is often used in a narrower sense to just describe members of the Vespidae family, which include the medically important hornets (Vespa species), yellow jackets (Vespula and Dolichovespula species), and paper wasps (Polistes species). Vespidae wasps look similar to bees but are less hairy and have thin waists (except the yellow jackets). Yellow jackets are typically black and yellow in color, although a few are black and white, including the large black-faced hornet (Dolichovespula maculata), which is misnamed a hornet.

Wasps are social insects, living in colonies, and they build paper nests, which they will fiercely defend. Yellow jackets build nests underground (Vespula) or aboveground in trees or buildings (Dolichovespula).

Wasp stings are the most common human envenomation. The stings from all species are similar, but hypersensitivity reactions may be quite specific. Wasps (including yellow jackets) can sting repeatedly, especially when trapped in clothing, because their stingers do not have barbs, like some bees.

Wasp venom is similar to bee venom, but the venoms are generally not cross-reactive. Wasp venom contains enzymes, small peptides, and amines. The allergens include the phospholipases, hyaluronidases, and cholinesterases. Some peptides cause histamine release by degranulating mast cells. Histamine, serotonin, and acetylcholine contribute to the pain associated with wasp stings.

Local wasp 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, onset of life-threatening, anaphylactic signs will occur within 10 minutes of the sting.

Acute myocardial infarction, hepatitis, intravascular hemolysis, rhabdomyolysis, acute renal failure, and glomerulonephritis following a wasp sting have been rarely reported.


T63.461A – Toxic effect of venom of wasps, accidental, initial encounter

241819002 – Wasp sting

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Last Updated:03/22/2018
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Patient Information for Wasp or yellow jacket sting in Adult
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Contributors: Medical staff writer


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

Wasp sting (including yellow jacket 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.

Common reactions to stings include:
  • Redness, pain, and swelling
  • Severe reactions such as facial swelling, difficulty breathing, and shock (anaphylaxis)
  • Fever, hives, and painful joints (though these reactions are not as common)

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


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

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Wasp or yellow jacket sting in Adult
A medical illustration showing key findings of Wasp or yellow jacket sting : Edema, Erythema, Wasp sting
Clinical image of Wasp or yellow jacket sting - imageId=6380700. Click to open in gallery.  caption: 'An edematous papule with a central tiny punctum and a surrounding red flare on the arm.'
An edematous papule with a central tiny punctum and a surrounding red flare on the arm.
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