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Allergy & Asthma Issues: Summer 2009

The sting of fire ants

Fire Ants
A single queen fire ant mound at street curb.

As summer gears up, the warmer temperatures mean your children are likely to spend more time playing outside. But for some kids, outdoor activities need to come with special precaution in regards to fire ants.

Fire ants are a specific kind of insect that can sting. Usually an insect sting means pain and discomfort lasting only a few hours. Symptoms may include redness, swelling and itching at the site of the sting.

However, if your child is allergic to insect stings, it means that his or her immune system has overreacted to the venom injected. After the first sting, your child's body produces an allergic substance called Immunoglobulin E (IgE) antibody. If stung again by an insect of the same species, the insect venom interacts with this specific IgE antibody, which triggers the release of substances that cause allergic
symptoms.

What are the symptoms of severe reactions?
For a small number of people with fire ant allergy, stings may be life-threatening. This reaction is called anaphylaxis. Symptoms may include itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness. Anaphylaxis is a medical emergency and may be fatal. Anyone experiencing these symptoms after a fire ant sting should obtain emergency medical treatment immediately. After acute treatment you should also obtain a referral to an allergist/immunologist to learn about treatment options.

How can I identify fire ants?
"Fire ants build nests of dirt in the ground that may be quite tall (18 inches) in moist clay type soil," according to Theodore Freeman, MD, FAAAAI, an allergist/immunologist who has been studying fire ants for more than 25 years.

However in dry, sandy soil the mounds may be entirely flat. Since fire ants do not remove vegetation from the area around their mounds, some may be very hard to see. They also like to build their mounds in disturbed soil, so mounds often start along sidewalks or roadways or at the edge between cultivated areas and grass. How can I prevent my child being stung?

Dr. Freeman says, "Stay away!" Fire ants, like other insects, are most likely to sting if their homes are disturbed. Unfortunately, since some mounds are flat, they may be stepped on accidently resulting in hundreds of ants coming to the defense of the mound. Removing mounds requires killing the queen. Commercial products are available, but take several weeks to make the mounds disappear.

If your child encounters or accidently disturbs a mound, tell him or her to move away quickly; the longer you stay near a mound the more stings you may get. Make sure your child wears closed-toe shoes and socks outdoors; avoid letting him or her go barefoot outside. When working in the garden or yard, wear work gloves. Shoes and gloves allow you the chance to get away from the mound and remove the shoes, socks and gloves with the attached stinging fire ants before they can reach your skin.

How do I treat a sting?
"Fire ants will actually bite and hold onto you with their mandibles while they sting and may remove their stinger, rotate and sting again," notes Freeman.

"The venom fire ants inject will kill bacteria and will kill some of your skin cells. This results in the formation of a blister that fills with a cloudy white material (dead cells) in about 24 hours. While this looks like a pus-filled lesion that should be drained, it is really sterile, and needs to be left alone," advises Freeman.

The following steps can help in treating local reactions to fire ants stings:

  • Elevate the affected limb and apply a cold compress to reduce swelling and pain.
  • Gently clean area with soap and water to prevent secondary infections; do not break blisters.
  • If the blister is accidently scratched open, continue to clean the area with soap and water.
  • Use topical steroid ointments or oral antihistamines to relieve itching.
  • See your doctor if swelling progresses or if the sting site seems infected.

If your child is severely fire ant allergic, carry an auto-injectable epinephrine device. Learn how to administer the epinephrine, and replace the device before the labeled expiration date.

Remember that epinephrine is a rescue medication only, and you must still take your child to an emergency room immediately if he or she is stung. Those with severe allergies may want to consider wearing a bracelet or necklace that identifies the wearer as having severe allergies. When should I see an allergist?

Anyone who has had a serious adverse reaction to a fire ant sting should be evaluated by an allergist/immunologist, who will recommend testing to determine whether an insect allergy exists.

Your child's allergist/immunologist will help determine the best form of treatment. People who have severe allergies to fire ants should consider receiving fire ant whole body extract immunotherapy, a highly effective vaccination program.

Patients who receive appropriate treatment such as immunotherapy and who practice careful avoidance measures can still participate in regular outdoor activities.

Theodore M. Freeman, MD, FAAAAI, is a retired Air Force Colonel. He is now in private practice in San Antonio Texas, and is a Fellow within the American Academy of Allergy, Asthma & Immunology.. He has been researching and writing about fire ants for more than 25 years.

 

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