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Apis mellifera
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Apis mellifera (Honey Bee) [ Original photo copyright © Dr Julian White ]
Phylum: Arthropoda
Class: Insecta
SubClass: Hymenopteroidea
Genus: Apis
Species: mellifera
Common Names
Honey Bee
Region
Global-land only
 
Taxonomy and Biology
Description
Typical honey bee, total body length about 20 mm.
 
Venom
Average Venom Qty
0.5 to 2.0 microlitres per sting.
General: Venom Neurotoxins
Not present
General: Venom Myotoxins
Not present
General: Venom Procoagulants
Not present
General: Venom Anticoagulants
Not present
General: Venom Haemorrhagins
Not present
General: Venom Nephrotoxins
Not present
General: Venom Cardiotoxins
Not present
General: Venom Necrotoxins
Not present
General: Venom Other
Histamine, dopamine, norepinephrine, amino acids, oligopeptides, phospholipids, carbohydrates, melittin, apamin, mast cell degranulating peptide, secapin, tertiapin, protease inhibitor, procamine A&B, phospholipase A&B, hyaluronidases, acid phosphomonoesterase, alpha-D-glucosidase
 
Clinical Effects
General: Dangerousness
Severe envenoming only possible with high numbers of stings, at least >50. In adults usually requires >300 stings.
General: Rate of Envenoming: All stings cause local envenoming
General: Untreated Lethality Rate: Except in individuals with severe sensitivity to the venom, lethality rate is almost zero in single or small numbers of stings.
General: Local Effects
Local pain & swelling
General: Local Necrosis
Does not occur, based on current clinical evidence
General: General Systemic Effects
General systemic effects unlikely, except with severe allergy or high numbers of stings
General: Neurotoxic Paralysis
Does not occur, based on current clinical evidence
General: Myotoxicity
Does not occur, based on current clinical evidence
General: Coagulopathy & Haemorrhages
Very rare, associated with either anaphylactic shock and secondary DIC, or direct venom toxicity from large numbers of stings, again secondary shock and DIC.
General: Renal Damage
Rare, secondary effect of anaphylactic shock or direct venom toxicity from large numbers of stings
General: Cardiotoxicity
Does not occur, based on current clinical evidence
General: Other
Rarely haemolysis, following massive envenoming by large numbers of stings
 
First Aid
Description: First aid for Bee Stings (honey bee)
Details
1. If the stinging apparatus is still present in the skin, as is usually the case for honey bee stings, remove it by gently scraping it out, using a finger nail or similar. Do not try and pull it out by holding the stinger, as this may squeeze more venom into the victim.
2. Apply a cold pack to the sting area.
3. If the patient develops generalised rash, difficulty breathing or becomes faint or collapses, urgent treatment is required, as this is an acute allergic reaction (anaphylaxis) to the venom. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention.
4. If the victim is already known to have an allergy to insect venom (bee or wasp), they are at risk of a major allergic reaction. At the first sign of such a reaction, if available, administer epinephrine (adrenaline, "epipen") as instructed on the medication. If the reaction includes airway constriction (asthma) and a "ventolin" puffer is available, use it. Seek urgent medical attention.
5. Stings inside the mouth may cause dangerous swelling, even in people who are not allergic to venom, and require urgent medical attention.
6. Multiple stings involving several hundred separate stings are potentially able to cause direct toxic effects. Urgent medical treatment should be sought.


 
Treatment
Treatment Summary
Most bee stings cause minor short lived local effects, especially pain & swelling. Only local treatment is required. Remove the attached sting, before more venom is pumped in. A local cold pack is often helpful.

For cases with systemic allergic reactions, treatment is directed to maintaining vital functions. There is no antivenom. Patients sustaining anaphylactic reactions should be advised to avoid further bee stings and to carry emergency treatment (eg adrenaline; Epipen®) and be shown how to use it.
Key Diagnostic Features
Most reactions; local pain & swelling only, sting & venom gland in situ.
Allergic reactions; vary from mild to full anaphylaxis.
General Approach to Management
Only cases with systemic allergic effects or cases with massive multiple stings or intraoral stings need medical input. In these case, admit & observe, treat as appropriate for the type of effect evident.
Antivenom Therapy
No antivenom available
Antivenoms
No Antivenoms
Apis mellifera (Honey Bee) [ Original photo copyright © Dr Julian White ]
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