Most people suffer only momentary discomfort when stung by a bee: a pin prick of pain: a red welt at the site of the sting surrounded by a paler, whitish area; and maybe a fierce itch. In a couple of days, all is forgotten. Allergic people (and 1 out of 250 people is allergic to insect bites or stings) don't get off so easily.

The area around the sting may swell and remain swollen for up to a day. That’s no real cause for concern unless the swelling persist or the whole arm or leg swells. Than you need to se a doctor – if for no other reason than to determine whether or not you are at risk for a reaction that involves your whole body (doctors call it ”systemic”) and may even be life threatening.

That type of reaction can begin mildly enough: a dry cough, itching and swelling around the eyes, sneezing, wheezing and wide spread hives. And if you’re lucky, that’s where the symptoms stop. But in 4 out of 1,000 people, the pulse becomes rapid, the skin pale or flushed, and blood pressure falls – followed by constricted breathing, and possibly abdominal cramps, diarrhea, nausea, vomiting, chills, fever and loss of consciousness – all within 15 minutes of the sting.

That’s anaphylactic shock; unfortunately, it kills 40 people a year. So, even the first mild symptoms should be treated as an emergency if you’ve had a severe reaction at any time in the past. A few individuals suffer not only an immediate reaction but a second, delayed reaction 10 to 14 days later. Symptoms can include a headache, general malaise, fever, lymph gland discomfort and painful joints.

Know Thy Enemy

Insects that cause allergy are of two general sorts: stingers and bitters. Stingers include bees, hornets, wasps and yellow jackets. The females of the species are the troublemakers. Equipped with stingers mounted on their hind sections, they inject their venom much as a doctor injects you with a hypodermic needle. Stinging insects produce more severe reactions than biting insects.

Biters include ants, mosquitoes, flies and spiders (scientifically, spiders don't belong to the insect family, but since most people think of them as insects, allergy doctors, too). Biters dispense venom through their saliva. As the victim, however, you probably won’t know what bit you, let alone notice what end it used. Still, it's helpful to know something about the habits and habitats of these perky creatures, in order to keep out of their way.

Bees

Bees differ not only in appearance but in temperament. Honey bee are mild mannered and usually will not sting unless stepped on or otherwise disturbed, or unless their hive is threatened. Yellow jackets, in contrast, may sting without provocation. If you’re approached by a solitary bee, your first reaction is probably to flail your arms wildly to shoo it away.

Don't. That will only get it excited. Instead, slowly walk to the nearest building or automobile for cover. Incidentally, do not crush a bee near it's nest. Doing so many release an odor that signals the colony to swarm out in revenge. And if one sting is bad, many are disastrous. If you inadvertently disturb a nest while trimming brush or painting the house, make a fast beeline for cover.

Ants

Of the 15,000 different kinds of ants, the fire ant, found in the southeastern part of our country, is the biggest problem for allergic people (they're no picnic for non-allergic people, either). Fire ants are usually red, but they can blend into the surrounding soil like chameleons.

When disturbed, fire ants can literally explode from their mounds, which they build in farm field, ballparks, schoolyards, parks and lawns. Their stings burn like fire and cause symptoms that are decidedly different from the symptoms caused by stings of other insets. A welt rises at the site and then expands.

Within four hours or so, the wound is surrounded by small blisterlike sacs filled with a thin, clear fluid. As the fluid drains, it is displaced by cloudy pus. Twenty four hours after the sting, the wound is surrounded by a thin, red circle or painful swelling. The lesions can remain for three to eight days.

Crusts develop. Scar tissue forms. All in all, an unsightly affair. And in highly sensitive people, fire ant stings can be fatal. Immunotherapy (which we’ll get to a little later) is 90 to 95 percent effective. Not bad, but nor 100 percent. So if you live in fire ant country, it's important to know what to do if you’re stung.

Mosquitoes

It's hard to believe that anything so small can cause so much misery. You might assume the discomfort of a mosquito bite is from the bite itself. And that’s certainly part of it. But for allergic people, the real problem is the saliva the mosquito injects with the bite to dilute the victim’s blood and more easily suck it up through the tubelike proboscis.

Allergic substances in the bug’s saliva can cause nausea, dizziness, hives, swelling, headache and lethargy. Not as severe as those reactions produced by stinging causing, to be sure. But more than a mere nuisance, nonetheless.

Flies

In the United States, the flies that commonly cause allergic reactions are biting midges, deerflies and black flies. Biting midges are also known as sand flies, moose flies, gnats and no see ums (because of their infinitesimal size). A good steady breeze can cart them off, but they return the minute the wind dies down.

While deerflies usually dine on horse, cattle and deer, they are not averse to human fare. And they’re vicious biters. Systemic reactions are rather frequent. Nothing clears the beach like black flies, though (they're also known as buffalo gnats or turkey gnats in some areas).

Black flies are so bloodthirsty they’ll bite through clothing if they have to. And they can cause shock. Aside from allergy, infection from scratching a bite is a serious concern, since flies are well known for their filthy habits. Be wary of any signs of inflammation, redness, swelling, fluid leaks and pain from a fly bite. An try not to scratch.

Spiders

Spiders bite by accident or when provoked. Either way, all spiders produce venom and are capable of causing allergic reactions. Like fly bites, all spider bites should be washed and disinfected – you don't know where that bug has been. The apply an ice pack to reduce swelling. Be alert for systemic reactions.

If you are bitten by a black widow or brown recluse spider, both of which are highly poisonous, don't wait for symptoms to develop – seek medical help immediately. Many brown spiders are alike, so if you can, kill the spider and take it to your doctor for identification.