Deaths by Africanized Bee Attacks Associated with Anaphylaxis or Angioedema

Are Killer Bees Killers? A Case Series of Massive Africanized Bee Envenomation
Journal of Medical Toxicology, Volume 4, Number 1, March 2008

Background: “Killer bees” (Africanized honey bees) have been established in the southern US for over 17 years. The incidence of multiple bee stings has been on the rise. The patients at the extremes of age have been proposed to be at highest risk of organ failure and death.

Case Reports: Here we describe three cases of massive bee envenomation, two of which were in geriatric patients. All patients were documented to have over 100 stings, with the highest one being a case of an 83 year old envenomated by over 400 Africanized honey bees (AB). All patients seemed to do well with supportive medical care, and were discharged from the hospital after 3­6 days of observation. The two geriatric patients were given epinephrine in the field and both had an increase in their Troponin I levels. It was not clear if this rise in Troponin I was an effect of epinephrine itself or a direct effect of the bee venom. Both geriatric patients were observed the longest in their Troponin I, and were released without any sequelae. Except for cases of anaphylaxis, we believe that these three cases show that supportive care is sufficient for patients with massive bee envenomation (over 100 stings).

Discussion: Bee venom contains melittin, phospholipase A, histamine, degranulating peptides, and hyaluronidase. The LD50 for AB is similar to the LD50 reported for the European honey bee. It is the defensive nature of AB that results in a greater number of stings, and consequently a greater venom load potentially resulting in failure of various organ systems…