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Summer is nearly upon us, and that means baseball, beaches, barbecues — and bee stings. To be sure, the warm season is time to beware of the Hymenoptera sting, that prickly zap inflicted by bees, as well as wasps, hornets, yellow jackets, and some other flying insects. But while the ache and swelling of a sting might spoil an outing for most of us, people who are allergic to insect venom live with a serious — even deadly — threat.

For the average person, a bee sting causes temporary skin inflammation, which can be treated with hydrocortisone cream and a cold compress; if the stinger remains in the skin, it should be scraped away (avoid trying to pluck out a stinger with tweezers, which can squeeze more venom into the wound).

However, those allergic to bee or wasp poison develop a hypersensitivity after the first sting. The immune system reacts to subsequent stings with a massive production of antibodies. Although antibodies are needed to fight off foreign proteins that invade the body — such as bacteria or viruses — the allergic reaction to insect venom is excessive and dangerous. Once you develop those antibodies, you’ll react every time, says Bierman. And with each following sting, the reactions tend to get worse.

In a typical case, the victim will break out in hives, often within minutes of the sting. If left untreated, the symptoms get scarier; the victim might experience anaphylactic shock, which causes a dramatic drop in blood pressure, swollen throat, and difficulty breathing. “Death is always a possibility,” says Bierman, stressing that anyone who experiences these symptoms following an insect sting should report to an emergency room immediately.

Doctors treat the sting victim with adrenaline, intramuscularly and at the site of the sting, which slows the absorption of venom. Patients are sent home with emergency kits which include a syringe preloaded with adrenaline. Because many people are uneasy about giving themselves shots, Bierman favors an EpiPen, a spring-driven device that works with a simple tap against the thigh.

For the most serious cases of venom allergy, immunotherapy is used to build up the patient’s resistance to the poison. By giving the sufferer small doses of the venom over a period of time, the patient’s immune system can become desensitized, reducing the risk of strong allergic reactions. Immunotherapy is an effective treatment, but it takes several years of gradually increased dosing to have its full effect.

Unfortunately, no amount of bug spray will scare away a determined bee or wasp. Bug sprays repel biting insects such as mosquitos, but have little effect on stinging pests, says Bierman. But whether you’re allergic or not, he adds, there’s still plenty you can do to keep from getting stung.

* Avoid wearing bright colors — stinging insects, especially bees, might mistake you for a flower. Perfume can attract their interest, too. If you insist on wearing flowers in your hair, consider yourself warned.
* Food left out in the open attracts stinging insects, too. Keep garbage areas tidy. Children who spill watermelon or other summer foods on their clothes should be changed into clean togs before being allowed to play outside.
* Wear shoes when outdoors (in case you step on an insect, or even a nest).
* If you’re with someone who gets stung, get away. After they strike, bees and yellow jackets give off a chemical that angers other stinging insects, as far as a block away.