Tick Bites, Bees, Wasp and Ant Stings

Single stings from a bee, wasp, or ant, while painful; seldom cause serious problems except for persons who have an allergy to the venom. Multiple insect stings can cause severe pain and widespread skin reaction. Stings around the face can cause serious envenomation and difficulty breathing even if the person is not known to be allergic.

It is important to remember that bee stings with the venom sac attached continue to inject venom into the skin, whilst a single wasp or ant may sting multiple times.

Ticks can inject a toxin that may cause local skin irritation or a mild allergic reaction, however most tick bites cause few or no symptoms.

In susceptible people tick bite or other bites/stings may cause a severe allergic reaction or anaphylaxis, which can be life threatening. This can also occur in victims with no previous exposure or apparent susceptibility.

Recognition (Tick Bites and Bees, Wasp and Ant stings)

Symptoms and signs may include:

Minor

• Immediate and intense local pain
• Local redness and swelling

Major/Serious

• Allergic reaction/anaphylaxis
• Abdominal pain and vomiting in the case of allergic reaction to insect venom.

Airway obstruction may result from swelling of the face and tongue due to anaphylaxis, or from insect stings in or around the mouth. This may occur immediately or over several hours and always requires urgent medical care.

Management (Tick Bites and Bees, Wasp and Ant stings)

• If the victim is unresponsive and not breathing normally, commence resuscitation.
• If the victim has signs of anaphylaxis, follow Anaphylaxis action plan.
• In the case of a bee sting, remove the sting, by any means, as quickly as possible.
• Move victim to a safe place.
• Apply a cold compress to help reduce pain and swelling.
• Monitor the victim for signs of allergic reaction (difficulty speaking, breathing difficulties, collapse, and generalised rash)
• Refer the victim to hospital if sting is to the face or tongue.
• In the case of a tick bite: For small ticks (larvae and nymphs) use permethrin cream (available at pharmacies). For adult ticks, freeze with an ether containing spray. Avoid the use of freezing or permethrin cream for ticks close to the eyes, genitals or in ear canal.
• For tick bite, if in a remote location, or freezing is not possible, consultation with healthcare professionals is recommended. If this is not possible, assess whether there is a history of anaphylaxis to tick bite. If there is a history of anaphylaxis to tick bite, the person should be carrying an adrenaline auto-injector (eg Epipen) and this should be used.