Dealing with a wasps nest - not really bee related

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"Every year in the UK there are 2–9 deaths due to anaphylaxis from bee or wasp stings"

National Institute for Health and Clinical Excellence (NICE)


Any evidence for your c1,000 deaths and c5,000 hospitalisations figure?

Extrapolation of Sinkewicz et al looking at coronary admissions due to stings. Work done by Professor Kounis and others on Kounis syndrome both frank and silent.

Mast cell mediated heart attacks caused by innate activation and degranulation by wasp toxins through toll like receptors as opposed to allergically mediated stimulation of high affinity receptors means that heart attacks from wasp stings go largely undiagnosed not least because of their delayed nature. This is recognised in the literature and to be honest paramedics and A&E crews don't go looking for wasp sting causality because they are too busy trying to save the patient.

Circa 5000 is down to a host of sources most of which are plauged by the paucity of causal reporting in the NHS. Cellulitis is recorded as cellulitis as opposed to wasp sting induced cellulitis etc. Just fortunate enough to have colleagues working at the coal face who have reported wasp sting admissions and extrapolating their experience provides a useful indication as to the extent of the problem.

The 200,000 to 400,000 comes from another host of sources including dozens of visitor attraction incident books. If one theme park reports 2000 first aid centre visits and 6 anaphylaxis cases based on 400,000 visitors over the said period, it's easy to see how that ramps up to 200,000 to 400,000 per annum and circa 1000 admissions for anaphylaxis.

Bear in mind that anaphylaxis only accounts for a minor proportion of hospital admissions for wasp stings but because of the immediacy and serious nature of anaphylaxis it gets attributed and reported more accurately.
 
Extrapolation of Sinkewicz et al looking at coronary admissions due to stings. Work done by Professor Kounis and others on Kounis syndrome both frank and silent.

Mast cell mediated heart attacks caused by innate activation and degranulation by wasp toxins through toll like receptors as opposed to allergically mediated stimulation of high affinity receptors means that heart attacks from wasp stings go largely undiagnosed not least because of their delayed nature. This is recognised in the literature and to be honest paramedics and A&E crews don't go looking for wasp sting causality because they are too busy trying to save the patient.

Circa 5000 is down to a host of sources most of which are plauged by the paucity of causal reporting in the NHS. Cellulitis is recorded as cellulitis as opposed to wasp sting induced cellulitis etc. Just fortunate enough to have colleagues working at the coal face who have reported wasp sting admissions and extrapolating their experience provides a useful indication as to the extent of the problem.

The 200,000 to 400,000 comes from another host of sources including dozens of visitor attraction incident books. If one theme park reports 2000 first aid centre visits and 6 anaphylaxis cases based on 400,000 visitors over the said period, it's easy to see how that ramps up to 200,000 to 400,000 per annum and circa 1000 admissions for anaphylaxis.

Bear in mind that anaphylaxis only accounts for a minor proportion of hospital admissions for wasp stings but because of the immediacy and serious nature of anaphylaxis it gets attributed and reported more accurately.

So in summary, you pretty much made the figures up to suit your argument.
 
So in summary, you pretty much made the figures up to suit your argument.

Whatever.

As a healthcare professional I have had to respond to emergency anaphylaxis and my colleagues both in healthcare and pest control have witnessed and experienced the personal tragedies of wasp sting fatalities.

Everyone is at liberty to roll the dice the way they want. There's a big difference however in rolling the dice wittingly or unwittingly.
 
Apparently wasps don't have the right to live their lives?
Yes they do. I don't advocate eradication. I advocate management. When it comes to social hymenopterans I would imagine that beekeepers above most understand that the future of the species is predicated on the success of the hive rather than the individual worker. Integrated wasp management is about managing nuisance wasps specifically where they represent a direct threat to human health and doing so in a way that also happens to reduce individual wasp worker mortality.
 
Whatever.

As a healthcare professional I have had to respond to emergency anaphylaxis and my colleagues both in healthcare and pest control have witnessed and experienced the personal tragedies of wasp sting fatalities.

Everyone is at liberty to roll the dice the way they want. There's a big difference however in rolling the dice wittingly or unwittingly.

Being a hospital porter doesn't make you an authority on wasp stings.

The NHS is one of the most analysed bodies in the UK. You stated some very large figures. I asked you for anything, even a single quote from a press release, to back them up. You have failed to provide anything which quotes figures anything like the ones you mention. As such, your demand that we "follow the evidence" is laughable. Essentially, you know someone who treated someone with a wasp sting, and have extrapolated an entire nation's statistics from that.
 
It's about 5,000 hospitalisations per annum (mainly over a 6-8 week period) for various complications some more serious than others. Wasp sting induced delayed heart attacks potentially account for circa 1000 deaths per annum and circa 200,000 to 400,000 people seek medical attention at the primary care level for wasp stings.

Make light of it as you will but it is a bigger problem than people realise.
I accept it is a problem, but also some people make a real fuss about nothing. In the days when GP's did their own night calls, I worked in a seaside town. I would often get calls in the middle of the night about stings that had been inflicted during the day!
 
I also work at the sharp end of healthcare and have never (knowingly) seen a Kounis reaction. However they may well be massively under-diagnosed.
 
I also work at the sharp end of healthcare and have never (knowingly) seen a Kounis reaction. However they may well be massively under-diagnosed.

It is massively under diagnosed. More so in siluent Kounis syndrome where there isn't an immediately obvious allergic reaction. In the case of wasp venom it seems that wasp venom has evolved to specifically target mast cells to cause degranulation via innate stimulation so what occurs is the vasospasm and vasoconstriction which results in a broad spectrum of effects ranging from mild palpitations and feelings of anxiety to angina to full blown heart attacks. One of the complications of mast cell degranulation is that it undermines atherscleromatous plaques and together with vasospasmic rupture causes thromboembolism as a delayed sequellae with a high fatality rate. Given that mast cells coalesce around stents as foreign objects wasp stings in patients with stents is of particular concern.

When I first encountered Kounis and googled it back in late 2009 there were only 10 hits on google. Now it's in the hundreds of thousands so it gives one an indication of how new this area of understanding is. This might be of interest.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636655/
The above link does work but for some reason is giving an error message. This is the link: www.ncbi.nlm.nih.gov/pmc/articles/PMC6636655/
 
It is massively under diagnosed. More so in siluent Kounis syndrome where there isn't an immediately obvious allergic reaction. In the case of wasp venom it seems that wasp venom has evolved to specifically target mast cells to cause degranulation via innate stimulation so what occurs is the vasospasm and vasoconstriction which results in a broad spectrum of effects ranging from mild palpitations and feelings of anxiety to angina to full blown heart attacks. One of the complications of mast cell degranulation is that it undermines atherscleromatous plaques and together with vasospasmic rupture causes thromboembolism as a delayed sequellae with a high fatality rate. Given that mast cells coalesce around stents as foreign objects wasp stings in patients with stents is of particular concern.

When I first encountered Kounis and googled it back in late 2009 there were only 10 hits on google. Now it's in the hundreds of thousands so it gives one an indication of how new this area of understanding is. This might be of interest.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636655/
The above link does work but for some reason is giving an error message. This is the link: www.ncbi.nlm.nih.gov/pmc/articles/PMC6636655/

Interesting! Thanks for posting - I'll look out for it!
 
Interesting! Thanks for posting - I'll look out for it!

No problem. Kounis can be a bit of a pig when it presents with anaphylaxis because the treatment protocols have to be different particularly around vasodilation vs vasoconstriction.
 
The above link does work but for some reason is giving an error message. This is the link: www.ncbi.nlm.nih.gov/pmc/articles/PMC6636655/

The linked article indicates that Kounis syndrome can occur as a result of a multitude of causal factors. For example, they state that

"Commonly used drugs, such as aspirin, antihypertensives, and corticosteroids as well as antibiotics and nonsteroidal anti-inflammatory drugs, constitute some of the main offenders."

Presumably users of these medications are far more common in the general population than are victims of wasp stings.
 
The linked article indicates that Kounis syndrome can occur as a result of a multitude of causal factors. For example, they state that

"Commonly used drugs, such as aspirin, antihypertensives, and corticosteroids as well as antibiotics and nonsteroidal anti-inflammatory drugs, constitute some of the main offenders."

Presumably users of these medications are far more common in the general population than are victims of wasp stings.

There's a subtle but important distinction. Almost anything can cause an allergic reaction where there is an overload of the immune system which causes Kounis including wasp stings. This is by accident so occurs 'relatively' infrequently. Wasp venom on the other hand and for want of a better way of describing things, 'intentionally' causes Kounis type reactions because the venom targets the immune cells in the body responsible for Kounis on purpose even without a visible 'allergic' reaction.
 
You've got me a bit concerned now.The little darlings got me three times today on the leg and goodness knows how many wasp stings I've had over the years.
 
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You've got me a bit concerned now.The little darlings got me three times today on the leg and goodness knows how many wasp stings I've had over the years.
Just to put your mind at rest. Repeated bee stings are likely to build immunity and reduce the chance of reacting either allergically or innately so without being complacent you should rest easy viz your little darlings. Bit like being on a natural desensitisation program. 😁

Wasps are a different story and should be treated with respect. The chances of reacting are still small but not rare and the combination of mast cell degranulating peptides in wasp venom and the infrequency of wasp stings priming for a potential allergic reaction shouldn't be dismissed lightly. The immunity built up with frequent bee stings is not transferrable to wasps because IMHO there are sufficient differences between the venoms.
 
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