James H. Diaz, MD, MPH&TM, DrPH
Insect bites and stings, often complicated by allergic reactions or skin infections with community-acquired pathogens, are common sources of morbidity following hurricanes and flooding disasters. The hymenopterids are the most commonly stinging arthropods to cause allergic reactions, and include bees, wasps, and ants. To assess the evolving epidemiology of hymenopteridinflicted injuries, and the impact of hurricanes and flooding disasters on hymenopterid-inflicted injuries in the United States, an epidemiological analysis of the scientific literature on hymenopterid stings and allergic sting reactions was conducted by MEDLINE search, 1966-2006. The increasing incidence of hymenopteridinflicted injuries following hurricanes and flooding disasters was described. Common immunological reactions to hymenopterid-inflicted injuries were stratified by clinical severity and outcome. Current recommendations for management, prevention, and prophylaxis of hymenopterid-inflicted injuries were presented. Hymenopterid stings and allergic reactions remain common indications for emergency department visits, especially following hurricanes and flooding disasters. Unrecognized anaphylactic reactions to hymenopterid stings remain significant causes of unanticipated deaths outdoors in young people. Disaster planners and managers are obliged to alert regional healthcare providers of the increased risks of hymenopteridinflicted injuries following flooding disasters and to assure that emergency drug formularies are properly stocked to treat hymenopterid-inflicted injuries.
