Insect Stings: What's Bugging You?

If the thought of a spider bite or bee sting makes your skin crawl, then preventing a painful encounter is the key.
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If the thought of a spider bite or bee sting makes your skin crawl, then preventing a painful encounter is the key.

Cries from Susan's tent brought a rush of concerned friends to her side. They found the young woman lying in a fetal position, screaming in pain, and complaining of agonizing cramps in her abdomen and lower back. Her pulse grew fast and weak and her fever rose. She was drenched in sweat when the vomiting started. Fearing appendicitis or some life-threatening gastrointestinal illness, the group decided to cut the trip short and

carry their ailing friend back to the trailhead for a speedy drive to the nearest hospital.

The emergency room doctor discovered a red, hardened bump on Susan's right lower leg: a spider bite, probably from a black widow. Exactly when the bite occurred was not known, since black widow envenomations cause no initial pain. That comes later. Although Susan made a full recovery, she came away from the experience with a distinct fear and loathing for all little critters that bite and sting.

Our planet is full of creepers and crawlers to dislike. Within the class arachnida there are more than 60,000 kinds of eight-legged creatures, including 30,000 species of spiders. In prime habitat areas, experts estimate the number of scurrying arachnids may run as high as 265,000 per acre. There are 2,700 species of snakes slithering around. The order hymenoptera, which includes bees and their winged relatives, claims around 3,500 different insects.

The unpopularity of these lowly creatures generally arises from the fact that most are equipped with fangs or stingers and have the ability to inject poison into their victims. It's a survival mechanism they use to feed and protect themselves in the competitive animal kingdom. Unfortunately, they occasionally come crosswise with humans, and the result can be quite painful and, in rare instances, even fatal.

Because it's better to know how to recognize and deal with these critters, instead of merely disliking them, here's a look at some of the ones you're most likely to encounter while wandering through the backcountry.

RECLUSIVE WIDOWS

The bad news is that almost all spiders on the planet carry venom, and they inject it with piercing fangs. The good news is that only a few dozen species are harmful to humans, either because the spiders inject too little venom or because their fangs cannot penetrate human skin. Of those that can do you harm, one of the most venomous is the female black widow, a tiny, common spider that packs more poison in every drop of venom than any other creature in North America. She's about an inch in length and is easily identified by the hourglass mark on her abdomen. You're likely to find her secreting her tattered web under logs and large pieces of bark, in stone crevices, in trash heaps and outbuildings, and deep in clumps of heavy vegetation. Rarely aggressive, she may be uncharacteristically defensive during spring mating and egg-tending season.

Humans almost never feel the bite, although some have reported immediate sharp pain. There may be little or no redness and swelling at first, but a small, red, slightly hard bump may form later. Although, as in Susan's case, you may feel like you're going to die, such a fate is rare. Fortunately, the black widow's drop of poison is tiny, and the spider claims an average of only two to four people a year in the United States. The victims are almost always the very young, the very old, or the very allergic.

The bite of the black widow should, nevertheless, be taken very seriously. Getting someone who's been bitten to the nearest medical facility is the most prudent course of action, just in case complications arise. Treatment usually includes painkillers and 8 to 12 hours of observation. Youngsters and seniors may be admitted for longer. Antivenin is used when needed.

While its name may not sound as forbidding as the infamous black widow, the solitude-seeking recluse (a.k.a. fiddleback) spider poses as much, if not more of a risk to humans. The recluse is generally pale brown to reddish in color, a quarter to a half inch in length, has long slender legs, and the front portion of its body is shaped like a violin. Unlike the black widow, the recluse is dangerous no matter if it's male or female.

The recluse prefers the South and southern Midwest, but can be found throughout the United States. It doesn't mind the company of humans, and it sets up housekeeping underneath furniture, within hanging curtains, and in the shadowed corners of closets. The recluse also resides in plentiful numbers in forests across America, hiding during daylight hours beneath rocks, dead logs, and pieces of bark. It attacks more readily in the warmer months, usually at night, and only when disturbed.

Like most spiders, the bite of the recluse is often painless, but within 1 to 5 hours, a painful red blister appears where the relatively dull fangs did their damage. Watch for the characteristic "bull's-eye" lesion to develop-a bluish circle around the blister with a red circle around that. Often the lesion heals without a trace after a week or two, but sometimes it spreads irregularly when an enzyme in the spider's venom destroys the cells of the victim's skin and subcutaneous fat. This ulcerous tissue heals slowly and leaves a lasting scar. Death has occurred in children when recluse venom caused fatal complications in the circulatory system.

Initially, there is little you can do for a spider bite victim other than calming him and applying cold to the bite site to reduce pain. The best treatment is prevention, so look before poking your hands into dark places. Set up camp and gather firewood (if allowed) while there's still plenty of light. When you move around after dark, wear boots and use a flashlight. And always look in your boots before putting them on in the morning.

VIPERS ARE THE PITS

An estimated 200 species of snakes worldwide carry venom that's potentially lethal to humans. A best guess by experts places the number of snake bite deaths each year at more than 50,000, although few occur in the United States (none in 1990, one in 1991, and one in 1992). Just about all poisonous snake bites recorded in the United States are the result of a run-in with pit vipers, more commonly known as rattlesnakes, copperheads, and water moccasins.

All pit vipers have distinctly triangular heads, catlike pupils, and heat-sensitive pits between eyes and nostrils. When provoked to strike, their jaws open alarmingly wide and bite, then venom is ejected down canals within the fangs and into the victim. The amount and toxicity of the venom depends on the type of viper you're dealing with. For instance, the Mojave rattlesnake's poison is about 44 times more potent than that of the southern copperhead.

The other family of potentially lethal slitherers is coral snakes, although they pose little threat. All coral snakes found in the United States can be identified by a particular color sequence: "Red on black, venom lack; red on yellow, kill a fellow." In other words, red bands bordered by yellow bands equals danger. The short, fixed fangs in the front of the snake's small mouth make it all but impossible for this reptile to bite anything other than a finger, toe, or fold of skin, and it usually has to hang on and chew to inflict damage.

In general, your level of risk after being bitten depends on a bunch of variables, including your age, size, health, emotional stability, whether or not you're allergic to the venom, location of the bite (near vital organs is the most dangerous), depth of the bite, the species and size of the snake, and first-aid measures taken after the bite. Because it's so difficult to determine the seriousness of a snake bite in the backcountry, the best course of action is to evacuate the person either by carrying him, or if he appears fairly stable, let him slowly walk to the trailhead. Get him to a medical facility as quickly as possible so antivenin can be administered if needed.

Under no circumstances should you cut the bite area and try to suck the venom out with your mouth. This can cause infection and is ineffective. There are snake bite kits on the market that come with a suction cup, which when placed over the bite, literally sucks venom out. The key is to start suction within the first five minutes, and keep it up for about half an hour.

Don't give painkillers unless the person is calm and rational. Don't apply ice or immerse the wound in cold water. Above all, don't apply a tourniquet, give alcohol to the victim, or administer electric shock. Most old-time remedies actually do nothing except inhibit recovery.

When camping in snake habitat, avoid walking around at night. If you must wander after dark, carry a flashlight and wear boots. Don't put your hands and feet in places you haven't visually inspected first. Stay away from wood and rock piles, caves, swampy areas, and sunwashed rock ledges. Snakes just want to be left alone, so don't bother them.

BEE IT EVER SO PAINFUL

Bees, yellow jackets, hornets, and fire ants (all of the order hymenoptera) have a nasty habit of injecting venom when they sting. Most humans find the pain extremely annoying, and that's the end of the story. Some folks are severely allergic to venomous insects, however, and a sting can mean death. An estimated 50 to 100 people die every year in the United States from anaphylaxis, which is a severe allergic reaction brought on by an insect sting.

The nonaggressive honeybee leads the swarm of stinging insects that pose a threat to some. In fact, as many as 15 percent of us are allergic in varying degrees (often it's mild) to bee venom. Unlike other hymenopterans, the bee has a barbed stinger that rips out of the insect and stays in your skin, continuing to pump venom for up to 20 minutes. That's why if a bee nails you, remove the stinger as soon as possible by scraping it out; never try to squeeze or pull it out.

As for the infamous Africanized "killer" bees, close relatives of honeybees, they are edging into the extreme southern United States from Latin America, where they've attacked hundreds of people with fatal results. Killer bee venom is no more potent than honeybee venom, but the "killers" are more aggressive and engage in mass attacks. Human deaths from killer bee swarms have been reported in recent years in southern Texas and Arizona.

Wasps (including hornets and yellow jackets) are predators and scavengers who, unlike bees, are attracted to meat and decaying matter. Their dirty stingers can cause an infection in human skin if the sting site isn't thoroughly cleaned. One wasp is capable of multiple stings, but deaths in humans rarely result.

When it comes to earth-bound insects, none is more vicious en masse than the fire ant. Step on one of their beds, which typically contains about 25,000 residents, and 30 seconds later you'll be covered with hundreds of ants. Just about all species of ants bite, but fire ants do it with a vengeance. While holding on to your flesh with their mandibles, fire ants arch their backs and jab in their stingers. After venom is released, they pull out the stinger, rotate, then jab it in again. Unless you intervene, each ant will create a ring of burning stings. The venom causes tissue destruction and produces a fluid-filled bump that itches horribly for a week or more. Fire ants are commonly found in at least 11 southern states, and mounds have been discovered as far north as Virginia. The number of victims seeking medical attention in recent years has soared to as high as 85,000 in one recent year, and deaths from stings have topped out at 30 per year.

With any of these hymenopterans, 10 or more stings can cause vomiting, diarrhea, headache, fever, muscle spasms, difficulty breathing, and convulsions. More than 100 stings can result in cardiac arrest. Ice packs generally ease the pain and swelling in the sting area, as do over-the-counter products such as StingEze. Mild to moderate allergic reactions characterized by hives, facial swelling, or dizziness can be treated with an oral antihistamine. If the person experiences difficulty breathing, signaling the onset of anaphylactic shock, an injectable drug called epinephrine (available by prescription in pre-loaded syringes) is essential. If you've ever had an allergic reaction to an insect sting, consult your physician about the possibility of taking an epinephrine kit or other medication with you on trips.

When confronted by bees or wasps, stay calm and back away slowly. These insects don't like rapid motion, especially swatting movements. If attacked by a swarm, run for dense cover, lie face down and cover your head with your hands. Running and swatting are both approved methods for warding off fire ants. When it comes to sting prevention, keep in mind that bright-colored clothing seems to attract winged insects, while tan, light brown, white, and light green colors appear to have no special appeal. Food left uncovered around camp is an open invitation to stinging things. And bug repellents do work.