Be armed, ready for insect stings
TORONTO — The death of a Quebec mayor who was stung multiple times after stepping on a wasps’ nest while gardening is a tragic but cautionary tale for those who run afoul of bees, hornets or other stinging insects — especially if they have a severe allergy to their venom, experts say.
Lucie F. Roussel, mayor of La Prairie, died in hospital Sunday after being stung at least 15 times in the garden of her cottage near Stratford, Que., municipal authorities said.
There are conflicting reports if the 51-year-old widowed mother of two teens had an allergic reaction, but La Prairie spokeswoman Chantal Charron said Roussel had never been diagnosed with an allergy to wasp stings.
“She was not diagnosed by a doctor. She did not know that she was allergic — if that was the case,” Charron said, noting Roussel had emergency injectable epinephrine at her home because her late husband had been allergic.
Dr. Susan Waserman, an allergist at McMaster University, said it’s extremely uncommon for someone to die as a result of insect venom directly, although there are a few cases in the medical literature.
Most deaths resulting from insect stings are caused by a severe allergic reaction known as anaphylaxis, characterized by symptoms such as breaking out in diffuse hives, difficulty breathing, lightheadedness and sometimes vomiting, she said.
“Usually, most acute allergic reactions occur within minutes to an hour,” Waserman said, noting that people may feel their tongue start tingling and their throat swelling.
“And if you have no reason to believe you are allergic, many people are caught off guard, and they don’t generally carry an epinephrine auto-injector.”
Symptoms of anaphylaxis can vary from person to person and from one reaction to the next, said Beatrice Povolo, a spokeswoman for the charitable advocacy group Anaphylaxis Canada.
What makes this allergic reaction so life-threatening is that the airways swell and close up, the blood pressure plummets and the heart starts beating irregularly — signs the person is experiencing anaphylactic shock.
“Our key messaging to patients is always to be prepared,” said Povolo, advising anyone with a diagnosed allergy to insect stings to carry two epinephrine auto-injectors, the second as backup or in case a double dose is needed.
Epinephrine is a form of adrenalin, given by a shot typically in the muscles of the thigh, that can counteract the allergic reaction until the affected person can receive medical treatment in hospital or by paramedics.
“Realize that all the EpiPen does is buy you time,” stressed Dr. Mitch Shulman, a Montreal emergency medicine specialist.
“If you’ve used the EpiPen, you must be seen in an emergency room or by somebody who’s competent. And the reason is the venom is still in your system,” he said, explaining that epinephrine will wear off, potentially allowing a rebound reaction hours later.
Waserman said sometimes people don’t know they are allergic to insect venom, even though they may have been stung once before.
Anyone who suspects they may be allergic to stinging insects should ask to be referred to an allergist, who will do skin tests to confirm if they react to the venoms of particular bugs.