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Bee Sting Allergy in Children

Dr. Kagen:

My daughter (9 years old) had an allergic reaction to a bee sting last summer. Since then she has carried an Epi-Pen Jr jr and benadryl with her. I am looking for some kind of printed information that she can carry with her, in case she is stung.

I'm wondering if there is something simple and clear that she could have with her. We try to tell everyone she is with how to use the Epi-Pen Jr and other details, but I'm sure she is not ALWAYS around an informed person.

Is there something we could get? (How to use Epi-Pen Jr, how long it protects for, when to use a second one, when to give benadryl, etc.) ALso, is there any kind of newsletter or organization that helps deal with this in children/adolescents.

I need help with issues like: camping trips, etc.


Thank you for asking about bee sting allergy in children.

It is not clear from your email to me if your daughter has experienced a systemic life threatening reaction to a stinging insect. Often times children will have what we Allergy Specialists refer to as a "large local reaction". A large local insect sting reaction is when a person is stung and a large swollen and painful area occurs only around the sting site. The reaction begins slowly and may last several days due to the toxic effects of the venom in the human skin. There are no "total body" type symptoms when a large local reaction occurs, even though there is a good deal of pain and swelling.

A large local reaction to a sting is not predictive of future sting reactions. Some people mistakenly believe that increasingly larger local sting reactions predict that a life threatening reaction is going to occur with the next sting. This is not really true.

If your daughter had symptoms of wheezing, shortness of breath, light headed and hives all over the body immediately following a sting (within 20 minutes), then this she had a systemic allergic response which requires an Allergy Specilist's attention. Systemic reactions are referred to as anaphylaxis. The condition can be fatal. Allergy injections with the specific venom allergens that a patient is allergic to is almost always curative.

The important point is that bee sting anaphylaxis is treatable and curable. After going through venom allergy injections, your daughter can be expected to be stung without having any allergic systemic reactions. We call this process venom desensitization.

Ask your daughter's doctor which Allergy Specialist in your area you can consult with. Do not delay. Your local Allergy Specialist and your local pharmacist can give you educational materials about the Epi-Pen and other adrenaline containing devices and injections.

I teach my allergy patients that they need to have a "buddy system" so that there is always someone with the patient who not only knows about the possibility of a severe allergic reaction, but more importantly, that someone there is willing to give a shot of epinephrine/adrenaline if necessary.

In the mean time, ask your daughter to demonstrate to you that she knows how to give herself an injection, and also ask her to carry the device with her in a fanny-pack.

I hope this brief info is useful to you. Good luck. Please let me know which stinging insect she is allergic to once you have had her evaluated by an Allergist.

Steve Kagen, M.D.