European Wasp

Overview

The European wasp is a yellow-and-black striped stinging insect, slightly longer and slimmer than a bee. It is common in many parts of Europe and has also spread to other parts of the world. A sting happens when a wasp pushes a sharp stinger into your skin and injects a small amount of venom (poison). For most people a sting is painful and annoying, but not dangerous. It settles on its own within hours to a few days. A small number of people are allergic to wasp venom and can have a serious reaction that needs emergency help.

Yes. Wasp stings are very common, especially in late summer and early autumn when wasp numbers are at their highest. Most people who spend time outdoors at this time of year will be stung at some point in their lives.

Anyone can be stung. You are more likely to be stung if you spend time outdoors eating or drinking, work in gardens or orchards, handle rubbish, walk barefoot on grass, or go near a wasp nest. People with a known wasp venom allergy, and people with certain long-term conditions that cause repeated allergic reactions, are at higher risk of a severe reaction. Children and older adults need a little extra watching after a sting.

Symptoms

Common symptoms

• A sharp, burning pain at the moment of the sting
• A red, raised lump or swelling around the sting site
• Itching and tenderness in the area
• A small white mark or tiny puncture point where the stinger went in
• Redness and swelling that may spread a little over the first 24 to 48 hours
• The discomfort usually easing within a few hours, though itching can last a few days

Symptoms in children

• Crying, distress and difficulty settling after the sting
• Swelling that can look larger than in adults, especially on the face, hands or feet
• Itchy raised patches (hives) appearing on other parts of the body
• Children may scratch the area and cause a skin infection — keep the site clean and covered
• Watch closely for breathing changes, drowsiness, floppiness or repeated vomiting, which need emergency help

Symptoms in older adults

• Thinner, more fragile skin, so the sting may bleed or bruise more easily
• Swelling that takes longer to settle
• A higher chance of the sting site becoming infected
• Medicines that thin the blood can make bruising and bleeding at the site more noticeable
• Some heart medicines can make a severe allergic reaction harder to treat, so tell the emergency team which medicines you take

Causes

Main causes

• Being stung by a European wasp, usually when the insect feels trapped or threatened
• Accidentally disturbing a wasp nest in the ground, a wall, a roof space or a hedge
• Eating or drinking outdoors, especially sweet foods, fruit, sugary drinks and ice cream
• Walking barefoot on grass or clover where wasps are feeding
• Reaching into places where a wasp has settled, such as a cup, a can, a folded towel or clothing left outside

Risk factors

• Late summer and early autumn, when wasp numbers are highest
• Outdoor eating, picnics, barbecues and bins
• Wearing bright colours, floral patterns or strong perfume
• Gardening, farming or outdoor work near nests
• Having had a previous allergic reaction to a sting
• A condition that causes repeated allergic reactions, such as mastocytosis (a rare condition with too many allergy cells in the body)
• Being very young or elderly, or having heart or breathing conditions

When to see a doctor

See a doctor urgently if:

• Any breathing difficulty, throat tightness, facial swelling, dizziness or collapse — call your local emergency number straight away
• A sting in the mouth, throat or eye
• A sting that is getting more red, hot and painful after a couple of days
• Fever, pus or spreading redness around the sting
• A very large swelling that is uncomfortable or limits movement

Book a routine appointment if:

• You have had a severe allergic reaction in the past and want to talk about an emergency plan
• You have had a large local reaction and would like advice on managing future stings
• The itch or lump is not settling after a week or so
• You are worried about wasps near your home, school or workplace and need advice on nest removal

Diagnosis

For most people, no tests are needed. A doctor or nurse can usually tell it was a wasp sting from what happened and by looking at the skin. The main job is to check how your body is reacting and to rule out a severe allergic reaction or an infection.

Tests that may be done

• No tests for a normal sting reaction
• Allergy testing, arranged by an allergy specialist, if you had a severe reaction — this may be a skin test or a blood test
• A blood test or skin swab only if infection is suspected
• A review of your medicines if you take blood thinners or heart medicines

What to expect at your appointment

The doctor or nurse will ask what happened, when it happened and how you felt afterwards. They will look at the sting site and check your breathing, blood pressure and heart rate if there is any concern. If you had a severe reaction, you may be referred to an allergy clinic, where testing and a personal emergency plan can be arranged. This is usually done as an outpatient appointment.

Treatment

Most wasp stings can be looked after at home. The aim is to ease pain and itching, keep the skin clean and watch for signs of a severe reaction or infection. Severe allergic reactions need emergency treatment, which is given by paramedics or in hospital and works quickly.

Self-care at home

• Move away from the area calmly to avoid more stings
• If a stinger is still in the skin, scrape it out sideways with a fingernail or the edge of a card — do not squeeze it
• Wash the area gently with soap and water
• Put a cold compress or wrapped ice pack on the site for short periods to reduce pain and swelling
• Keep the area clean and avoid scratching; a plaster or light dressing can help, especially for children
• Ask your pharmacist about suitable over-the-counter options for pain and itch — always check they are safe for you, and never give medicines to children without advice
• Raise the limb if the sting is on an arm or leg and swelling is uncomfortable
• Watch for the next hour or two for any signs of a severe reaction

Medical treatments

If you have a severe allergic reaction, emergency treatment is given straight away, usually by injection, and works to open the airways, support your blood pressure and calm the allergic response. You will be monitored in hospital afterwards. People who have had a severe reaction may be given an emergency injectable device to carry with them, along with a written plan and training for family, friends or colleagues on when and how to use it. Doctors may also recommend treatment for long-lasting itch or swelling, and antibiotics only if the skin becomes infected. Your healthcare team will explain which medicines are right for you.

Living with this condition

Most people carry on exactly as before after a sting. If you have a known wasp allergy, day-to-day life means keeping your emergency device with you, checking it is in date, and making sure the people around you know where it is and what to do. Keep outdoor eating tidy and check drinks and food before you eat or drink.

Lifestyle tips

• Keep food and sugary drinks covered outdoors and use a straw or lidded cup
• Check cups, cans and utensils before use, especially in summer
• Wear shoes outdoors and avoid loose, bright or floral clothing in wasp season
• Avoid strong perfumes and scents when eating outside
• Keep bins closed and clear up fallen fruit
• Stay calm and move away slowly if a wasp comes near — swatting makes stings more likely
• If you are allergic, tell friends, family, school or workplace about your emergency plan

Diet and exercise

There is no special diet needed after a wasp sting. Eat and drink normally, and keep well hydrated. You can return to normal activity as soon as you feel comfortable. If you have had a severe reaction, follow your allergy team's advice about when to resume exercise. Take extra care with outdoor eating and drinking, as these are the times wasps are most likely to come close.

Mental health and emotional wellbeing

It is very common to feel anxious or jumpy around wasps after a sting, especially if the reaction was severe or if a child was stung. This fear usually fades over time. If worry about stings is stopping you from going outdoors, eating outside or letting your child play, talk to your doctor — talking therapies and a clear emergency plan can help a lot. If you are feeling very distressed or overwhelmed, contact your local mental health service or crisis line, or your local emergency number if you feel unsafe.

Prevention

You cannot remove all risk, but you can greatly reduce your chances of being stung. Most stings happen when a wasp is trapped or feels threatened, so the key is to stay calm, avoid swatting, and keep food and drink covered when you are outdoors. If there is a nest near your home, keep people and pets away and ask a professional pest control service to deal with it.

Vaccines

There is no vaccine against wasp stings. For people with a severe allergy, allergy specialists sometimes offer treatment that gradually reduces sensitivity over time; ask your doctor whether this might be suitable for you.

Complications

If left untreated

• Most stings need no treatment and heal without problems
• A skin infection can develop if the site is scratched or dirty, causing spreading redness, pain, heat and fever
• A large local reaction can cause big, uncomfortable swelling that lasts a few days
• A severe allergic reaction (anaphylaxis) can develop within minutes, and needs emergency treatment
• Multiple stings from a disturbed nest can cause serious illness in anyone, even without an allergy
• Rarely, a sting inside the mouth or throat can cause swelling that makes breathing difficult

Long-term outlook

The outlook is very good. The great majority of wasp stings are painful for a short time and then heal fully without any lasting effects. Even if you have had a severe reaction, having a clear plan, an emergency device if prescribed, and knowing the warning signs means you can live a full and active life. Most people who are stung go on to enjoy the outdoors as before.

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