Chapter 27ENVENOMATIONS

James A. Palmier*

ARTHROPOD ENVENOMATIONS

HYMENOPTERA

Common names: Apoidea (bumblebee, honeybee), Vespoidea (wasp, hornet, yellow jacket), Formicoidea (fire ants)

Occupational setting

Gardeners, orchard workers, farmers and agricultural workers, florists and workers in the flower industry, forestry workers, and sanitation workers are potentially at risk.

Exposure (route)

Exposure occurs through physical trauma to the skin and occasionally the oral mucosa as a result of a bite or sting.

Pathobiology

Bees have a barbed stinger that becomes attached to the human skin after a sting, when it deposits its venom. In honeybee stings, the stinger apparatus becomes disengaged from the bee with its venom sac intact. Wasps also have a stinging apparatus but it does not contain barbs; therefore, they are able to withdraw the stinger and sting again. Ants have powerful jaws that grasp the skin and cause the release of venom locally; they are capable of inflicting multiple bites.

The Hymenoptera venom of the bee (Apoidea) consists of histamine, dopamine, enzymes (phospholipase A1 and hyaluronidase), and peptides, including neurotoxins and hemolysins.1 The Vespoidea venom is very similar to the bee venom, except that both wasp venom and hornet venom contain serotonin, and the venom of the hornet also contains acetylcholine.1 The Formicoidea venom contains alkaloids and a small amount of proteins. Histamine is released when these alkaloids come in contact with ...

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