When One Bee Sting is Your Last

Millions of Americans live out their lives unaware that they are severely allergic to bee and wasp stings, so much so that a single sting can send them into anaphylactic shock and cause death.

That was apparently the case for Ray Shaw, a former Dow Jones & Co. president and Wall Street Journal publisher, who died last week at the age of 75. His family said he had no known allergy to stings, yet he was found dead in his garage from a single wasp sting.

College freshman Helen Tobin has practically grown up with an EpiPen in her pocket after suffering multiple severe allergic reactions to bee stings.

The 18-year-old from Des Moines, Iowa, was stung for the first time when she was only 4 when a bee sting on her neck made it swell to the size of a "balloon."

She has been stung four times since, and was never formally diagnosed with having a venom allergy, but was immediately prescribed the autoinjector, EpiPen, a dosage of epinephrine used as emergency treatment for life-threatening allergic reactions.

"When I get stung, the feeling is just panic because I don't know exactly how my body will react," Tobin said.

According to government statistics, about 3.3 percent of adults will experience anaphylaxis after an insect sting and there are 40 to as many as 100 deaths annually from insect-sting-related anaphylaxis. Anaphylaxis is a severe type I hypersensitivity allergic reaction in humans and other mammals.

Dr. David Golden, associate professor in the Division of Allergy and Clinical Immunology at Johns Hopkins University's Medical Institute, told ABCNews.com it's "nearly impossible" for someone to die from being stung the very first time, although any sting can trigger the development of the allergic sensitivity.

Commenting on the Shaw case, Golden said, "It's likely that he had one sting before because the allergy can be dormant in your system for that long. He may not remember."

Golden said there have been about 40 sting deaths per year based on 10-year national statistics. The statistic was confirmed in a similar study done in the 1990s by physician David Graft.

"About 3 percent of adults have had a history of one systemic reaction. On the other hand, almost none of them ever told their doctor about it. Of these 40 people a year, how many of them knew? The answer is about 50 percent."

Unlike allergies such as asthma, there is not a clear pre-screened test for insect sting reactions if someone has never been stung before, although an allergist can conduct a skin test, which can show if the patient has a strong negative indication.

During skin testing, a tiny bit of bee venom is pricked into the skin of the arm or upper back. If a raised bump develops, the test would indicate a positive allergic reaction.

But as for routinely testing people for the allergy, Golden says that wouldn't be practical or desirable.

"There's no screening test that we could or should do," Golden said. "The rule among allergists is that we shouldn't test people unless they've had a clearly systemic reaction."

Government statistics also indicate that among people who have symptoms of anaphylaxis after being stung, there is a 60-70 percent chance that future stings will cause a similar reaction. The chances of a reaction with a future sting will decrease over time, but still remains at about 20 percent many years after the last sting.

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