36 : Anaphylaxis in Beekeeping


the above symptoms nor will symptoms necessarily come on in the same order. In venom allergy specifically, many of the common severe allergy symptoms could be absent, including breathing difficulty. In fact, the first symptom might be hypotension whereby the blood pressure drops very abruptly and the casualty just suddenly collapses.


Local Reaction SOME THOUGHTS ON THE RISKS


Anaphylaxis in Beekeeping


Andrea Woolley, RGN, BSc B


eekeepers, along with anyone else, can be touched by a severe allergic reaction. It might be due to the venom injected when a bee stings or any of a huge number of other triggers we encounter regularly in everyday life – foods, therapeutic drugs, latex rubber, plants and many others. A proportion of beekeepers who suffer anaphylaxis will be allergic to things other than bee venom.


In Perspective To keep anaphylaxis in perspective, there


are thought to be approximately 20 deaths per year from severe allergic reactions, including an average of four caused by bee and wasp venom. Obviously, one death is too many, but anaphylaxis is rare, including amongst those keeping bees. It is a complex condition, difficult to predict and recovery depends on both recognition and very prompt action.


Causes and cases of severe allergic www.bee-craft.com


reactions are on the increase, perhaps the greatest being in response to peanut – noting, of course, that a peanut is not in fact a nut but a legume!


So what is Anaphylaxis or Anaphylactic Shock?


Many working definitions exist. The Resuscitation Council describes anaphylactic reactions as involving ‘life-threatening airway and/or breathing and/or circulation problems usually associated with skin and mucosal changes’. As a severe allergic reaction develops, it is characterised by a range of symptoms, which typically include swelling, breathlessness, dizziness, sudden onset diarrhoea and vomiting, collapse as a result of a catastrophic drop in blood pressure, and unconsciousness. Urticaria – a rash (often referred to as hives or nettle rash) – nausea, anxiety, abdominal pain and many other less severe symptoms are also common. Not everyone suffering this extreme, systemic, allergic reaction will exhibit all of


It is important to remember that most allergic reactions are nothing like as severe as anaphylaxis. If you are stung, for example by a wasp or bee, you would expect pain, swelling and discomfort at the site and for this to last perhaps a few days. This is a local, not systemic, reaction and not an indication that a future sting would be likely to cause anaphylaxis. In the case of venom allergy, even if the last sting did cause anaphylaxis, evidence suggests that there is only an average 50% risk that a subsequent sting would invoke a similarly serious reaction. On the other hand, if the severe allergic reaction was to peanut, for example, there would be a very high chance of anaphylaxis resulting from any future exposure.


Risk Assessment and Management


Keeping the risk of venom allergy in


proportion and perspective is important. In order to understand the level of any risk, it is necessary to be able to judge likelihood and severity. Managing that risk is achieved by developing avoidance strategies and procedures to deal with an emergency. As with most things in life, it is neither possible nor necessarily desirable to remove the risk completely. Hence, despite the risk of being stung and the possibility of reacting, beekeepers keep beekeeping! This is because bees are essential to the world’s wellbeing. Oh, and we love honey! It is a valuable foodstuff and, arguably, has medicinal qualities and yes, quite rightly, we still keep bees. It is just that appropriate and proportionate control measures are applied both to reduce the risk of being stung and deal with sting reactions if they occur.


What Is the Risk?


So what is the risk of venom allergy in general and bee venom allergy in particular?


April 2015 Vol 97 No 4


Adrian Waring


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