When deciding on the use of bee venom for medicinal purposes, it is necessary to take into account the fact that it is a strong biological agent and in some cases may have a toxic effect. This is especially true for people with diseases of the liver, kidneys, and pancreas. The use of bee venom in such patients, even in therapeutic doses, can exacerbate the pathological process, worsening the general condition. Bee venom cannot be used for any form of tuberculosis, diabetes mellitus, infectious diseases, severe heart failure, cancer, and diseases of the blood system. That is why the physician, starting treatment with bee venom, should have a full understanding of the patient’s health, take into account his individual characteristics, and clearly define contraindications to treatment:
- Individual intolerance;
- Acute infectious diseases;
- Leukemia;
- Decompensation of the cardiovascular system in any stage;
- Pregnancy;
Clinical Manifestation of Intolerance to Bee Sting Therapy
A reaction to the bee sting varies greatly; for some people it is rather weak, while others develop the most severe response, even death. A healthy person usually easily tolerates 5 or even 10 stings. Larger doses of bee venom are often accompanied by toxic and allergic manifestations.
Majority of beekeepers show absence of local reaction to bee stings. This phenomenon has not yet received a full explanation. It is believed that to get strong immunity a person needs to receive about 700 stings for over the period of six months. However, this immunity is retained only for up to six months and to maintain it, it is necessary to constantly deliver new doses of bee venom into the body. Some beekeepers, after being stung after a long break can have severe reaction and even die.
Response of the human body to a bee sting has local and general manifestations.
The local effect (local tissue reaction) is observed in almost all people. For most, all local symptoms disappear within 1-2 days, but for some they are held for up to 3-5 days. Immediately after sting, there is a burning pain, redness, fever, pale skin edema with a small area of necrosis in the center. Infiltration can be from a few millimeters to 7-10 cm. Itching is possible. The degree of local reaction depends on the sensitivity of the tissue and the place (localization) of the sting. Especially strong swelling is observed when stinging the face, oral mucosa, lips, and neck. Stinging in the neck can lead to a violation of the airway. The stinging in the eye area is accompanied by sharp pains, blepharitis, purulent conjunctivitis, the eye slit closes, tearing occurs. Vision can be significantly reduced, in most cases it is restored only after 7-10 days, but later may develop cataracts and glaucoma.
General symptoms of intoxication are manifested by headache, dizziness, fever, chilling. Severe toxic effects of bee venom are accompanied by more pronounced symptoms – significant weakness, dizziness, nausea, vomiting, drooling, profuse cold sweat, involuntary urination. Possible loss of consciousness, pulse increases, blood pressure drops, due to violation of hemodynamics develops cyanosis of the skin, convulsions, paralysis, and asphyxiation. Urine and hemoglobin are detected in blood. Possible paralysis of the respiratory center and death from suffocation and respiratory arrest. Severe symptoms usually develop after multiple stings (100 stings and more), but they are also possible after one sting due to severe allergic shock. 500-1000 stings correspond to a dose of 0.2 g of bee venom and are considered to be a lethal dose.
Biological Test of Bee Venom Intolerance
Biological test – trial sting by one bee, is performed for ALL patients recommended for bee sting therapy and who never had an allergic reaction to bee sting, wasp or pharmaceutical preparations containing bee venom. The test is carried out in 2 stages (double test) – on the 1st and 3rd day.
It is recommended to place a bee on the inner surface of the forearm. This is convenient because in case of allergic reaction, it is easier to apply a tourniquet to the forearm above the sting location (thereby limiting the flow of bee venom into the patient’s body) and surround it with adrenaline and novocain injections and place ice on it.
The first test. The bee is applied to the inner surface of the forearm 7-10 cm from the wrist joint. The sting with a sac of venom is removed after 5-10 seconds by sliding a scalpel on top of the skin. After that, the patient sits in the office and is observed by the medical staff for 1.5-2 hours. Attention is paid to the general and local reaction of the patient to a sting. In the absence of a pronounced reaction, the patient is released home with a recommendation to monitor his condition: measure body temperature every 3 hours, count the pulse, and monitor the skin color. The next day, the patient comes to the physician, who interviews and examines him, prescribes a complete blood and urine test (protein, sugar). It is advisable to assess the state of the blood coagulation system (clotting time, bleeding, prothrombin time, and platelet count).
The second test is carried out on the third day after the first, with the patient in a favorable condition and good laboratory test results. The sting is made on the other forearm and removed after 1 minute. If there is no pronounced reaction in 1.5-2 hours, the patient goes home. The next day again the patient is examined by a physician. In the absence of abnormalities the treatment begins on the 4-5th day under permanent physician control.
Degrees of Intolerance to Bee Venom
I degree (easy)
Feelings of heat, chills, increase in body temperature to 38-39 ° C, general excitement, anxiety or lethargy, general weakness, and a state of depression.
- General reaction – itching and hives.
- Local reaction – swelling, redness, and fever may occur, sometimes necrosis is developed.
II degree (moderate)
A short-term decrease in blood pressure, pallor of the skin, weakness, darkness in vision, rapid and weak pulse, a feeling of fear.
- General reaction – possible itching, hives, swelling of the face, tongue, lips, larynx and mucous membranes of internal organs. Increase in body temperature to 39° C, chills. Spasm of smooth muscles (bronchospasm, intestinal colic, diarrhea, nausea, vomiting, uterine spasm, vaginal bleeding).
- Local reaction – swelling and redness are moderate, sometimes pronounced.
III Degree (severe)
- General reaction – severe anaphylactic shock (a sharp drop in blood pressure, threadlike pulse, loss of consciousness, ischemia of the internal organs, spasm of smooth muscles, convulsions, involuntary urination and defecation, itching, urticaria (hives), respiratory depression, hemolysis, hemoglobinuria.
- Local reaction – edema and redness.
Patients with II and III degrees of bee venom intolerance are subject to immediate hospitalization. The patient’s lack of a local or general reaction to a biological test does not exclude possibility of severe reaction during a treatment (including anaphylactic shock).
Prevention of Accident Stings by Bees and Wasps
Random stings are possible when a person finds himself in an area inhabited by bees and wasps (apiary, tree or dwelling nest, etc.), as well as visiting a vegetable garden, a garden during the period of active nectar collection. Especially bees and wasps are active when there is no nectar. In summer and autumn, they visit open markets in large numbers, attracted by the smells of honey, fruit, and meat. In search of food, they fly through the doors and windows into our homes.
Once near the bees and wasps, you should strictly follow certain rules of conduct and recommendations. It must be remembered that bees and wasps are strongly irritated by sharp odors and they sometimes for no apparent reason, can attack a person who emanates a sharp smell of sweat, garlic, alcohol, cologne, perfume and oil products. Bees (wasps) become aggressive, if somewhere around their nest happened to be crushed bee (wasp); the smell of a crushed insect induces them to collective defense and attack on all things living and hairy.
It should be remembered that after consuming honey, berries, jam, or applying honey lipstick and honey cream, you should not visit places where bees and wasps are present. The aromas of these products in the exhaled air attract insects and they will spin around your face, often without showing any hostility.
Bees and wasps are often annoyed and induced to attack inadequate human behavior – anxiety, waving his arms in an attempt to ward off insects, sudden movements. Therefore, when the insect is approaching to the face, one should not make sudden movements of the head, hands or move quickly. It is better to stand still, or slowly turn away and move away. It is advisable, without sudden movements, to cover your neck, face and eyes.
Before visiting the apiary or places of large concentrations of bees and wasps, it is necessary to cover the open parts of the body. Remember that an irritated bee will always look for the slightest opportunity to penetrate and sting uncovered parts of your body. Also, it is better to cover the hair on your head, as it is very annoying to the bee. To repel insects, smear exposed parts of the body with castor or lavender oil, with pickled cucumber, cabbage or tomato juice or brine. For these purposes, you can also use Lemon Balm.
Some categories of people should be especially cautious to avoid a sting by bee (wasp): this applies to persons suffering from hypertension and taking such drugs as beta-adrenergic blockers (inderal, atenol, etc.) or ACE (angiotensin-converting enzyme) inhibitors (capoten, captopril, etc.). In the event of sting by a bee or wasp, intoxication in them proceeds with particular severity.
A patient who was stung (bee) in the past should maintain even stricter observance of precautionary measures and the prevention of repeated stinging. If it happens a few weeks after the previous one, it can cause anaphylactic shock.