Social and health impact of flying Hymenoptera stings: experience in a region of central hill country of Sri Lanka

Abstract

Envenomation by flying hymenoptera species especially Asian Giant Bee (Bambara) and Hornet (Debara) sting are common environmental hazard in Sri Lanka. This is a descriptive retrospective study and data were collected from bed head tickets of the patients. Eighty patients presented following attacks by the above insects during year 2011/2012 to District Base Hospitals of Rikillagaskada and Teldeniya which are situated in two banks of Victoria reservoir were studied. The number of insects involved in an attack ranged from single to as high as 100 with a mean of 15 insects per victim. Majority had local reactions with an uncomplicated recovery except one, known to be allergic to Bee venom, developed Acute Coronary Syndrome (Kouni’s Syndrome). Cases presented with Asian Giant Bee and Hornet attacks were 54 (68 %) and 26 (32 %) respectively. Sixty three incidents (78.75%) were reported during windy seasons; May/ June 32 (40%) and August/ September 31 (38.75%). Six (7%) incidents were following provocation of Giant Asian honey Bees by eagles attacking their combs. All the patients had been exposed to attacks while in outdoor activities and male: female ratio was 1:1. The age of the victims was between 5 to 89 years (mean- 45.39 years). None of them had taken protective measures. The time lag between the incident and hospitalization was from 5 minutes to 7 hours (mean- 1.95 hours). Head and neck region was the primary target in 72 (90 %) victims and 55 (69%) incidents happened during morning hours. No deaths were reported during the study period. The most common reactions to these stings are transient pain and redness at the site lasting a few hours (Local reaction). Most serious complication reported in this study was Kouni’s syndrome. Risk factors for stings included day-time outdoor activities and period of year. Education of the public and facilitation of medical staff working in prevalent regions is a current need.