Insect bites and stings usually cause little harm unless there is a severe allergic reaction.

Summary

Insect bites and stings usually cause little harm unless there is a severe allergic reaction, multiple stings or stings to the head and neck area - these require immediate medical help. Remove a tick by grasping it with tweezers as close to the skin as possible. All scorpion stings, and any spider bite where you aren't sure if the spider is dangerous, should be treated as a medical emergency. Avoid bites and stings with measures like wearing shoes and protective clothing outdoors.

Insect bites and stings

Mosquito, bedbug and flea bites are the most common insect bites, and, although bothersome, usually cause little harm. Note that in certain endemic areas, mosquitoes can transmit malaria. Bee and wasp stings are common during summer.

Symptoms and signs of insect bites and stings

These include itching or stinging, redness and mild swelling generally confined to the bite or sting site and that disappears within a day or so. For some, especially children, the swelling and redness may extend beyond the sting site, be more pronounced, and last two to three days.

A few people are allergic to insect bites or stings, and may experience additional symptoms such as itchy bumps or swelling in other parts of the body. Severe symptoms include difficulty breathing, swelling of the face and tongue, dizziness, confusion, nausea, cramps, rapid heartbeat.

First aid for insect bites and stings

Get immediate medical help if:

  • Symptoms of a severe allergic reaction develop.
  • There is a history of previous severe reaction to the insect's bite - don't wait for the reaction to occur.
  • The face, neck or throat is stung. This may cause rapid swelling which could obstruct the airway.
  • There are multiple stings.

For minor bites and stings:

  • Relieve itching with an ice cube or cold compress. Calamine lotion or a baking soda paste or hydrocortisone cream can also be helpful.
  • Oral antihistamine can be given to reduce severe itching, and paracetamol for pain.
  • Remove a bee stinger by gently scraping the skin with the blunt edge of a knife, or similar (e.g. a credit card), or your fingernail.
  • Do this as quickly as possible to avoid further injection of venom. Don't grasp the stinger or rub the skin.
  • Wash the bite area with soap and water.

Call a doctor if:

  • There are signs of infection.
  • There are multiple bites causing swelling.
  • You think you may have developed an allergy to insect bites or stings.
  • You have been in a malarial area and flu-like symptoms develop.

Tick bites

Ticks are arachnid parasites that embed their heads in the skin to feed on blood. They range are usually found in the veld and on domestic animals. Tick bites are more common during spring and summer. They seldom lead to serious problems but some ticks may transmit organisms which could lead to illnesses, such as tick bite fever.

First aid for tick bites

If you've been outdoors, check your whole body for ticks. If a tick is found, remove it immediately: grip it with fine-tipped tweezers as close to the skin as possible and pull it out in a straight line - don't jerk or twist. Make sure the head is also removed. If the head remains behind, it could cause a small necrotic ulcer ('veld sore'). Save the tick in a container in case you develop a tick-borne illness and tests need to be done. Wash your hands and the bite site. Apply an antiseptic cream.

Call a doctor if:

  • There are signs of infection
  • A whole tick could not be removed.
  • Flu-like symptoms develop: tick bite fever.

Spider bite

Only a few species of spiders are dangerous. In South Africa, the button, sac, violin, six-eyed crab, black widow and brown widow spiders cause the most harmful reactions. Spider bites may produce a reddened wheal and an ulcer and in serious cases could lead to intense pain around the bite, sweating, muscle cramps, fever and difficulty breathing.

Scorpion sting

All scorpions found in South Africa are venomous but only the stings from the Buthidae family (thick tails and thin pinchers) can be fatal. Symptoms include intense, burning pain, numbness and tingling across the body, nausea, vomiting, stomach pain, blurred vision, slurred speech, difficulty breathing or swallowing and shock.

First aid for spider bites and scorpion stings

  • Call emergency services for any scorpion sting, and any bite from a dangerous spider.
  • Keep the affected limb lower than the heart.
  • If breathing stops, perform CPR.
  • Treat for shock if necessary.
  • Clean the wound and apply an ice pack to reduce swelling and spread of venom.
  • Do not use a tourniquet.
  • Give paracetamol for pain.

Prevention of bites and stings

  • Sleep under a mosquito net with a fan next to you and wear protective clothing after dusk.
  • Keep pets free of fleas by regular use of anti-flea preparations.
  • Avoid stinging insects' nests. If you encounter a flying stinging insect, stay calm and move slowly. Don't swat at it.
  • Many insects are attracted by flower smells, so avoid perfume when outdoors. Wear pale clothing if you are visiting an area where bees are common.
  • Wear closed-toe shoes outdoors and don't go barefoot.
  • Keep food covered when eating or drinking outdoors. Remember: stinging insects sometimes crawl into open cold drink cans.
  • If you are allergic to bee or wasp stings, ask your doctor about carrying an emergency kit containing an adrenaline syringe. Wear a Medic Alert tag.
  • When camping, shake out shoes before putting them on.
  • Wear gloves when working in the garden.
  • Don't go barefoot outdoors.
  • Be careful when lifting rocks and pieces of wood in the veld.

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