Bee stings are a common occurrence, especially during the summer and fall months (bees are more active in the summer and wasps in the fall!). For most people, a bee or wasp sting results in a sharp pain, redness, and swelling that subsides after a few hours. However, for some individuals that have an allergic response, a simple sting can become much more severe.
While stinging insect allergies are relatively common with 16 million Americans living with a potentially life-threatening allergy1, there is another potential reaction with similar symptoms called bee sting serum sickness. Understanding these conditions and their differences is essential for proper diagnosis and effective treatment, especially for those at risk for severe reactions.
What is Bee Sting Serum Sickness?
Serum sickness is a delayed immune response that occurs after exposure to certain medications or antigens, such as those found in bee venom and antivenoms. Serum sickness typically arises following the administration of antivenom, certain medications, or is a delayed reaction to a bee sting.
While some of the symptoms of bee sting serum sickness are like an allergic reaction, serum sickness manifests days to weeks after exposure to the venom.
Bee sting serum sickness occurs when the immune system mistakenly reacts to antiserum in the blood’s plasma after an initial, appropriate response to the bee venom. This secondary reaction differs from a typical allergic response, as the body treats the antiserum produced by the body as a threat.2 This is what ultimately causes the symptoms of bee sting serum sickness.
Symptoms of Bee Sting Serum Sickness
- Fever
- Rash
- Joint pain or swelling
- Muscle aches
- General malaise
- Swollen lymph nodes
- Swelling or edema of the extremities
Diagnosis of Serum Sickness
Diagnosing serum sickness involves a thorough medical history and evaluation of symptoms. Physicians may conduct blood tests to detect immune complexes or measure specific markers of inflammation. Identifying a recent exposure to bee venom or antivenom is vital in confirming the diagnosis of serum sickness.
What is a Bee Sting Allergic Reaction?
An allergic reaction to a bee sting occurs when the immune system overreacts tot he venom injected by the bee. This reaction can range from mild to life-threatening.
Types of Reactions
- Local reactions: These are the most common and involve pain, redness, and swelling confined to the sting site. These symptoms usually resolve within a few hours to days.
- Moderate reactions: These reactions extend beyond the sting site, causing swelling that can last up to a week. For example, a sting on the hand might result in swelling of the entire arm.
- Systemic (anaphylactic) reactions: These are severe allergic reactions that affect multiple body systems. Symptoms can include hives, swelling of the face or throat, difficulty breathing, dizziness, and/or rapid drop in blood pressure. Anaphylaxis is a medical emergency that requires immediate treatment. If you or a loved one experience an anaphylactic reaction call 911 immediately for help.
Allergic Reaction Symptoms
Symptoms of a bee sting allergic reaction can appear quickly and may include:
- Swelling and redness at the sting site
- Hives or itching on the body
- Difficulty breathing or wheezing
- Swelling of the lips, tongue, or throat
- Nausea, vomiting, or diarrhea
- Dizziness or fainting
The severity of these symptoms can vary, with anaphylaxis being the most serious form of allergic reaction.
Venom Allergy Diagnosis
Diagnosing an allergic reaction to a bee sting involves assessing the symptoms and the timing of their onset. Skin tests and blood tests can help identify an allergy to bee venom. Individuals with a history of severe allergic reactions to bee stings are often advised to carry an epinephrine auto-injector and should check with their provider to see if they qualify for venom immunotherapy treatments.
Key differences between serum sickness and allergic reactions
Understanding the differences between serum sickness and allergic reactions is an important part of appropriate treatment and management. Here are the key distinctions:
- Timing of symptoms: With serum sickness, symptoms present several days to weeks after exposure to bee venom, reflecting a delayed immune response. Allergic reaction symptoms appear almost immediately, within minutes to hours after a bee sting, indicating an immediate hypersensitivity reaction.
- Symptom differences: While some symptoms may appear similar between an allergic reaction and serum sickness, the main difference between the two is that serum sickness symptoms develop gradually compared to allergy symptoms which tend to be acute and severe.
- Treatment approaches: With serum sickness, treatment focuses on managing symptoms with antihistamines, corticosteroids, or pain relief medications. Although in severe cases, hospitalization may be necessary. Allergic reactions can be immediately treated with antihistamines or an epinephrine auto-injector in the case of anaphylaxis, There are also long-term treatment options such as venom immunotherapy that reduces sensitivity to bee venom over time.
Treatment and Management for serum sickness
- Discontinuing or limiting exposure
- Medications to reduce inflammation, antihistamines to reduce response, and pain relievers
- Monitoring for potential complications where hospitalizations might be needed
Prevention Tips
Preventing bee stings and managing exposure makes a difference for those at risk of allergic reactions or serum sickness. The best way to prevent a bee sting is to avoid being stung. Some ways you can do this include:
- Stay calm: Bees are less likely to sting if they don’t feel threatened. Avoid swatting them!
- Avoid scented products: Perfumes, lotions, and hair products can attract bees. Opt for unscented products.
- Wear protective clothing: Long sleeves, pants, and closed shoes provide a barrier against stings. Light-colored clothing is less attractive to bees.
- Be mindful of food: Bees are attracted to sweet foods and drinks. Keep food covered outdoors and avoid drinking from cans where bees can hide.
Understanding the differences between bee sting serum sickness and allergic reactions is vital for those at risk and their loved ones. While both conditions can arise from bee stings, they differ significantly in symptom onset, manifestation, and treatment. If you or a loved one has experienced symptoms of serum sickness or a severe allergic reaction to a bee sting, consulting with an allergist is important to treatment and health. Proper diagnosis and management can prevent complications and improve quality of life. If you need to locate a provider for diagnosis or treatment, use our find a provider tool now.
- S. Census Bureau Quick Facts: United States. Retrieved 2021, https://www.census.gov/quickfacts/fact/table/US/PST045219
- WebMD Editorial Contributor. “What Is Bee Sting Serum Sickness?” WebMD, WebMD, 18 May 2012, www.webmd.com/allergies/what-is-bee-sting-serum-sickness. Accessed 15 Aug. 2024.
- Rixe, Nancy, and Melissa M. Tavarez. “Serum Sickness.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK538312/.
