A worker bee will rarely sting when out foraging, except when stepped on or roughly handled. However, if you manipulate the hives poorly and/or there are other contributing factors that upset the bees, they will actively seek you out and sting you if they perceive the hive to be threatened.

When a honey bee stings a person, it typically cannot pull the barbed stinger back out. It leaves behind not only the stinger, but also part of its abdomen and digestive tract, plus muscles and nerves which allow the venom sack to continue pumping the venom into the victim. You should therefore scrape the sting off as soon as you can, usually with your fingernail or with the edge of your hive tool. A study has shown however that the amount of venom delivered does not differ whether the sting is pinched or scraped off and even a delay of a few seconds leads to more venom being injected, so being swift is more important!

The stinger consists of three parts: a stylus and two barbed slides (or lancets), one on either side of the stylus. The bee does not push the stinger in but it is drawn in by the barbed slides. The slides move alternately up and down the stylus so when the barb of one slide has caught and retracts, it pulls the stylus and the other barbed slide into the wound. When the other barb has caught, it also retracts up the stylus pulling the sting further in. This process is repeated until the sting is fully in and even continues after the sting and its mechanism is detached from the bee’s abdomen.

The main component of the venom that causes pain is melittin. Histamine and other biogenic amines may also contribute to pain and itching; typically the swelling and itching appears a few hours later and last for a few days. The sting’s injection of apitoxin into the victim is accompanied by the release of alarm pheromones, a process which is accelerated if the bee is fatally injured. This release of alarm pheromones will almost certainly attract other bees to the sting’s location, encouraging more bees to attack and sting in the same place. As these pheromones do not dissipate quickly you can try and mask them by using your smoker on the stung areas. In addition to general cleanliness to prevent transmission of diseases, washing your bee suit after each apiary visit will remove these “sting me here” pheromones. Not doing so could encourage your bees to seek you out on arrival!

Drone bees do not have stings. Although the Queen does have a sting she will not use this when you are handling her.

Treatment

Once the sting is removed, pain and swelling should be reduced with a cold compress. A topical anesthetic containing benzocaine will kill pain quickly and menthol is an effective anti-itch treatment. Itching can also be relieved by antihistamine or by a steroid cream. Bee venom is acidic; however, topically applied alkali is unable to reach it due to the venom being under the skin, so putting an alkali on the skin is unlikely to neutralise the venom. The sting may be painful for a few hours. Swelling and itching may persist for a week. The area should not be scratched as it will only increase the itching and swelling. If swelling persists for over a week or covers an area greater than 7–10 cm (3–4 inches), medical attention should be sought.

Doctors often recommend a tetanus immunization.

For about 2 percent of people, a hypersensitivity can develop after being stung, creating a more severe reaction when stung again later. This sensitisation may happen after a single sting, or after a series of stings where they reacted normally. A highly allergic person may suffer anaphylactic shock from certain proteins in the venom, which can be life-threatening and requires emergency treatment. People known to be highly allergic may carry around epinephrine (adrenaline) in the form of a self-injectable EpiPen for the treatment of anaphylactic shock.

Mild allergic reactions may cause extreme redness and increased swelling at the sting site.

Severe allergic reactions may cause:

• hives (urticaria), red, itchy welts
• pale skin
• severe itching
• swelling of the tongue and throat
• difficulty breathing
• rapid pulse
• nausea and vomiting
• diarrhoea
• dizziness
• loss of consciousness

Bee sting anaphylactic shock is rare and you may never see it. However, it is wise to be prepared.

If you / they feel they may be having a severe reaction move the person away from the hives and scrape out the sting/s as quickly as possible in order to stop any further injection of venom, and ring for an ambulance (999 and/or 112 on a mobile).

Calm the person, sitting them down. If there are signs of difficult breathing, light headedness or general reaction to the sting you need to take action.

If they are conscious:

• Loosen tight clothing at the waist and neck. 
• Sit him/her on the ground, leaning against a wall, tree or the side of a car. 
• Make the person as comfortable as possible to help breathing. 
• The person may be short of breath, feeling sick or feeling faint and may be very frightened so stay with the person, talk quietly and encourage him/her to breathe in and out regularly. 

If they have become unconscious:

• Loosen tight clothing and place him/her in the recovery position on his/her side. 
• Tilt the head back for a good airway. 
• Put underneath arm behind the back. 
• Check that s/he is breathing. 
• Check that s/he has a pulse in the side of the neck. 
• If there is another person, send them to flag down the ambulance. 
• Do not try to give the person who has been stung any food or drink. 
• If the person’s heart stops or the breathing stops, resuscitation should be provided by a trained person.

Remember – Anaphylactic shock is very rare, but it does happen, quick and calm help is essential.