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Massive Bee Envenomation

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Critical Care Toxicology

Abstract

Hymenoptera is a large order of the class Insecta and comprises the social honeybees (family Apoidea), wasps, hornets, yellow jackets (Vespoidea), and ants (Formicidae). Honeybees (Apis species) are social insects that live in well-organized communities and have received more attention due to the massive attacks these insects can provoke. The species mellifera includes several subspecies, with A. m. mellifera and A. m. ligustica being the most common in Europe and A. m. scutellata in Africa [1].

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References

  1. Smith DR. African bees in the Americas: insights from biogeography and genetics. TREE. 1991;6(1):17–21.

    CAS  PubMed  Google Scholar 

  2. Kerr WE. The history of the introduction of African bees in Brazil. S Afr Bee J. 1967;2:3–5.

    Google Scholar 

  3. Schumacher MJ, Egen NB. Significance of Africanized bees for public health. A review. Arch Intern Med. 1995;155(19):2038–43.

    Article  CAS  PubMed  Google Scholar 

  4. Winston ML. The Africanized ‘killer’ bee: biology and public health. Q J Med. 1994;87(5):263–7.

    CAS  PubMed  Google Scholar 

  5. Michener CD. The Brazilian honeybee – possible problems for the future. Clin Toxicol. 1973;6(1):125–7.

    Article  CAS  PubMed  Google Scholar 

  6. Rindener TE, Oldroyd BP, Sheppard WS. Africanized bees in the U.S. Sci Am. 1993;269:52–8.

    Google Scholar 

  7. Reisman RE. Insect stings. N Engl J Med. 1994;331(8):523–7.

    Article  CAS  PubMed  Google Scholar 

  8. Ferreira Jr RS, Almeida RA, Barraviera SR, Barraviera B. Historical perspective and human consequences of Africanized bee stings in the Americas. J Toxicol Environ Health B Crit Rev. 2012;15(2):97–108.

    Article  CAS  PubMed  Google Scholar 

  9. Vetter RS, Visscher PK, Camazine S. Mass envenomations by honey bees and wasps. West J Med. 1999;170(4):223–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Kim KT, Oguro J. Update on the status of Africanized honey bees in the western states. West J Med. 1999;170(4):220–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Schumacher MJ, Tveten MS, Egen NB. Rate and quantity of delivery of venom from honeybee stings. J Allergy Clin Immunol. 1994;93(5):831–5.

    Article  CAS  PubMed  Google Scholar 

  12. Schumacher MJ, Schmidt JO, Egen NB, Dillon KA. Biochemical variability of venoms from individual European and Africanized honeybees (Apis mellifera). J Allergy Clin Immunol. 1992;90(1):59–65.

    Article  CAS  PubMed  Google Scholar 

  13. Hider RC. Honeybee venom: a rich source of pharmacologically active peptides. Endeavour. 1988;12(2):60–5.

    Article  CAS  PubMed  Google Scholar 

  14. Dotimas EM, Hider RC. Honeybee venom. Bee World. 1987;68(2):51–70.

    Article  Google Scholar 

  15. Habermann E. Bee and wasp venoms. Science. 1972;177(4046):314–22.

    Article  CAS  PubMed  Google Scholar 

  16. Moreno M, Giralt E. Three valuable peptides from bee and wasp venoms for therapeutic and biotechnological use: melittin, apamin and mastoparan. Toxins. 2015;7(4):1126–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Gajski G, Domijan AM, Zegura B, Stern A, Geric M, Novak Jovanovic I, et al. Melittin induced cytogenetic damage, oxidative stress and changes in gene expression in human peripheral blood lymphocytes. Toxicon. 2016;110:56–67.

    Article  CAS  PubMed  Google Scholar 

  18. Peiren N, Vanrobaeys F, de Graaf DC, Devreese B, Van Beeumen J, Jacobs FJ. The protein composition of honeybee venom reconsidered by a proteomic approach. Biochim Biophys Acta. 2005;1752(1):1–5.

    Article  CAS  PubMed  Google Scholar 

  19. de Graaf DC, Aerts M, Danneels E, Devreese B. Bee, wasp and ant venomics pave the way for a component-resolved diagnosis of sting allergy. J Proteomics. 2009;72(2):145–54.

    Article  PubMed  Google Scholar 

  20. Li A, Zhang L, Fang Y, Han B, Lu X, Zhou T, et al. Proteome and phosphoproteome analysis of honeybee (Apis mellifera) venom collected from electrical stimulation and manual extraction of the venom gland. BMC Genomics. 2013;14:766.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Resende VMF, Vasilj A, Santos KS, Palma MS, Schevchenko A. Proteome and phosphoproteome of Africanized and European honeybee venoms. Proteomics. 2013;13(7):2638–48.

    Article  CAS  PubMed  Google Scholar 

  22. Danneels EL, Van Vaerenbergh M, Debyser G, Devreese B, de Graaf DC. Honeybee venom proteome profile of queens and winter bees as determined by a mass spectrometric approach. Toxins. 2015;7(11):4468–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Prado M, Solano-Trejos G, Lomonte B. Acute physiopathological effects of honeybee (Apis mellifera) envenoming by subcutaneous route in a mouse model. Toxicon. 2010;56(6):1007–17.

    Article  CAS  PubMed  Google Scholar 

  24. Azevedo-Marques MM, Ferreira DB, Costa RS. Rhabdomyonecrosis experimentally induced in Wistar rats by Africanized bee venom. Toxicon. 1992;30(3):344–8.

    Article  CAS  PubMed  Google Scholar 

  25. Grisotto LS, Mendes GE, Castro I, Baptista MA, Alves VA, Yu L, et al. Mechanisms of bee venom-induced acute renal failure. Toxicon. 2006;48(1):44–54.

    Article  CAS  PubMed  Google Scholar 

  26. Sitprija V. Animal toxins and the kidney. Nat Clin Pract Nephrol. 2008;4(11):616–27.

    Article  CAS  PubMed  Google Scholar 

  27. dos Reis MA, Costa RS, Coimbra TM, Teixeira VP. Acute renal failure in experimental envenomation with Africanized bee venom. Ren Fail. 1998;20(1):39–51.

    Article  PubMed  Google Scholar 

  28. Franca FO, Benvenuti LA, Fan HW, Dos Santos DR, Hain SH, Picchi-Martins FR, et al. Severe and fatal mass attacks by ‘killer’ bees (Africanized honey bees – Apis mellifera scutellata) in Brazil: clinicopathological studies with measurement of serum venom concentrations. Q J Med. 1994;87(5):269–82.

    CAS  PubMed  Google Scholar 

  29. Kumar C, Sapeco SD. Death due to multiple honeybee stings – a case report with review of literature. J Indian Soc Toxicol. 2008;4(2):36–40.

    Google Scholar 

  30. Almeida RA, Olivo TE, Mendes RP, Barraviera SR, Souza Ldo R, Martins JG, et al. Africanized honeybee stings: how to treat them. Rev Soc Bras Med Trop. 2011;44(6):755–61.

    Article  PubMed  Google Scholar 

  31. du Toit-Prinsloo L, Morris NK, Meyer P, Saayman G. Deaths from bee stings: a report of three cases from Pretoria. South Afr Forensic Sci Med Pathol. 2016;12(1):81–5.

    Article  Google Scholar 

  32. Shetty M, Rao CPS. Death due to massive bee injury – a case report. J Punjab Acad Forensic Med Toxicol. 2012;12(1):33.

    Google Scholar 

  33. Nittner-Marszalska M, Kopec A, Biegus M, Kosinska M, Obojski A, Pawlowicz R, et al. Non-ST segment elevation myocardial infarction after multiple bee stings. A case of “delayed” Kounis II syndrome? Int J Cardiol. 2013;166(3):e62–5.

    Article  PubMed  Google Scholar 

  34. Nisahan B, Selvaratnam G, Kumanan T. Myocardial injury following multiple bee stings. Trop Doct. 2014;44(4):233–4.

    Article  PubMed  Google Scholar 

  35. Bousquet J, Coulomb Y, Robinet-Levy M, Michel FB. Clinical and immunological surveys in bee keepers. Clin Allergy. 1982;12(4):331–42.

    Article  CAS  PubMed  Google Scholar 

  36. Hiran S, Pande TK, Pani S, Gupta R, Vishwanathan KA. Rhabdomyolysis due to multiple honey bee stings. Postgrad Med J. 1994;70(830):937.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Daher Ede F, da Silva Junior GB, Bezerra GP, Pontes LB, Martins AM, Guimaraes JA. Acute renal failure after massive honeybee stings. Rev Inst Med Trop Sao Paulo. 2003;45(1):45–50.

    PubMed  Google Scholar 

  38. Betten DP, Richardson WH, Tong TC, Clark RF. Massive honey bee envenomation-induced rhabdomyolysis in an adolescent. Pediatrics. 2006;117(1):231–5.

    Article  PubMed  Google Scholar 

  39. Mejia VG. Acute renal failure due to multiple stings by Africanized bees. Report on 43 cases. Nefrologia. 2010;30(5):531–8.

    Google Scholar 

  40. Bresolin NL, Carvalho LC, Goes EC, Fernandes R, Barotto AM. Acute renal failure following massive attack by Africanized bee stings. Pediatr Nephrol. 2002;17(8):625–7.

    Article  PubMed  Google Scholar 

  41. Ceyhan C, Ercan E, Tekten T, Kirilmaz B, Onder R. Myocardial infarction following a bee sting. Int J Cardiol. 2001;80(2–3):251–3.

    Article  CAS  PubMed  Google Scholar 

  42. Mytas DZ, Stougiannos PN, Zairis MN, Tsiaousis GZ, Foussas SG, Hahalis GN, et al. Acute anterior myocardial infarction after multiple bee stings. A case of Kounis syndrome. Int J Cardiol. 2009;134(3):e129–31.

    Article  PubMed  Google Scholar 

  43. Viswanathan S, Muthu V, Singh AP, Rajendran R, George R. Middle cerebral artery infarct following multiple bee stings. J Stroke Cerebrovasc Dis. 2012;21(2):148–50.

    Article  PubMed  Google Scholar 

  44. Bindu CB, Manuprakash SK, Srinivasa BS. Acute myocardial injury in multiple bee stings – a case report. Int J Med Sci Pub Health. 2013;2(4):1107–9.

    Google Scholar 

  45. Boz C, Velioglu S, Ozmenoglu M. Acute disseminated encephalomyelitis after bee sting. Neurol Sci. 2003;23(6):313–5.

    Article  CAS  PubMed  Google Scholar 

  46. Schiffman JS, Tang RA, Ulysses E, Dorotheo N, Singh SS, Bahrani HM. Bilateral ischaemic optic neuropathy and stroke after multiple bee stings. Br J Ophthalmol. 2004;88(12):1596–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Jain J, Banait S, Srivastava AK, Lodhe R. Stroke intracerebral multiple infarcts: rare neurological presentation of honey bee bite. Ann Indian Acad Neurol. 2012;15(2):163–6.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Yoder J, Lloyd A, Tilney PV, McKenna DP. Intracerebral hemorrhage following multiple bee stings. JAAPA. 2013;26(7). pii: 01720610–201307000-00017. doi: 10.1097/01.

    Google Scholar 

  49. An JY, Kim JS, Min JH, Han KH, Kang JH, Lee SW, et al. Hemichorea after multiple bee stings. Am J Emerg Med. 2014;32(2):196 e1–2.

    Article  Google Scholar 

  50. Hommel D, Bollandard F, Hulin A. Multiple African honeybee stings and acute renal failure. Nephron. 1998;78(2):235–6.

    Article  CAS  PubMed  Google Scholar 

  51. Gabriel DP, Rodrigues Jr AG, Barsante RC, dos Santos Silva V, Caramori JT, Martim LC, et al. Severe acute renal failure after massive attack of Africanized bees. Nephrol Dial Transplant. 2004;19(10):2680.

    Article  PubMed  Google Scholar 

  52. Bridi RA, Balbi AL, Neves PM, Ponce D. Acute kidney injury after massive attack of Africanised bees. BMJ case reports. 2014;2014. doi: 10.1136/bcr-2013-201381.

    Google Scholar 

  53. Silva GAR, Pires KL, Soares DCS, Ferreira MR, Ferry FRA, Motta RN, et al. RRH: envenoming syndrome due to 200 stings from Africanized honeybees. Rev Inst Med Trop Sao Paulo. 2013;55(1):61–4.

    Article  PubMed  Google Scholar 

  54. Ramanathan M, Lam HS. Acute renal failure due to multiple bee stings – case reports. Med J Malaysia. 1990;45(4):344–6.

    CAS  PubMed  Google Scholar 

  55. Nag SS, Ghosh N, Singh AK, Nayek K, Mitra P. Nephritic syndrome following multiple bee stings: a late hypersensitivity reaction. Paediatr Int Child Health. 2015;35(2):157–9.

    Article  PubMed  Google Scholar 

  56. Islam F, Taimur SD, Kabir CMS. Bee venom induced acute renal failure in an 8 year old child. Ibrahim Med Coll J. 2011;5(1):34–6.

    Google Scholar 

  57. Guassemi K, Esteghamati M, Moayedi AR, Alavi SA. Acute renal failure after multiple honeybees’ stings (case report). Asian J Med Pharm Res. 2013;3(4):148–9.

    Google Scholar 

  58. Patra P, Nayak U. Delayed onset renal failure following multiple bee stings. Int J Med Sci Pub Health. 2012;1(1):14–5.

    Google Scholar 

  59. Daher Ede F, Oliveira RA, Silva LS, Silva EM, Morais TP. Acute renal failure following bee stings: case reports. Rev Soc Bras Med Trop. 2009;42(2):209–12.

    Article  PubMed  Google Scholar 

  60. Dechyapirom W, Cevik C, Nugent K. Concurrent acute coronary syndrome and ischemic stroke following bee stings. Int J Cardiol. 2011;151(2):e47–52.

    Article  PubMed  Google Scholar 

  61. Lovecchio F, Cannon RD, Algier J, Ruha AM, Curry SC, Wallace KL, et al. Bee swarmings in children. Am J Emerg Med. 2007;25(8):931–3.

    Article  PubMed  Google Scholar 

  62. Prado M, Quiros D, Lomonte B. Mortality due to Hymenoptera stings in Costa Rica, 1985–2006. Rev Panam Salud publica = Pan Am J Pub Health. 2009;25(5):389–93.

    Article  Google Scholar 

  63. Visscher PK, Vetter RS, Camazine S. Removing bee stings. Lancet. 1996;348(9023):301–2.

    Article  CAS  PubMed  Google Scholar 

  64. Díaz-Sánchez CL, Lifshitz-Guinzberg A, Ignacio-Ibarra G, Halabe-Cherren J, Quinones-Galvan A. Survival after massive (>2000) Africanized honeybee stings. Arch Intern Med. 1998;158:925–7.

    Article  PubMed  Google Scholar 

  65. Ling Z, Yan K, Ping F, Yu C, Yunying S, Fand L, et al. Myoglobin clearance by continuous venous-venous haemofiltration in rhabdomyolysis with acute kidney injury: a case series. Inj Int J Care Injured. 2012;43:619–23.

    Article  Google Scholar 

  66. Jones RG, Corteling RL, Bhogal G, Landon J. A novel Fab-based antivenom for the treatment of mass bee attacks. Am J Trop Med Hyg. 1999;61(3):361–6.

    CAS  PubMed  Google Scholar 

  67. Santos KS, Stephano MA, Marcelino JR, Ferreira VM, Rocha T, Caricati C, et al. Production of the first effective hyperimmune equine serum antivenom against Africanized bees. PLoS One. 2013;8(11):e79971.

    Article  PubMed  PubMed Central  Google Scholar 

  68. WHO. WHO guidelines for the production, control and regulation of snake antivenom immunoglobulins. Geneva: WHO; 2010.

    Google Scholar 

  69. Funayama JC, Pucca MB, Roncolato EC, Bertolini TB, Campos LB, Barbosa JE. Production of human antibody fragments binding to melittin and phospholipase A2 in Africanized bee venom: minimising venom toxicity. Basic Clin Pharmacol Toxicol. 2012;110(3):290–7.

    Article  CAS  PubMed  Google Scholar 

  70. Pessenda G, Silva LC, Campos LB, Pacello EM, Pucca MB, Martinez EZ, et al. Human scFv antibodies (Afribumabs) against Africanized bee venom: advances in melittin recognition. Toxicon. 2016;112:59–67.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Instituto Butantan, São Paulo, Brazil

    Hui Wen Fan & Jorge Kalil

  2. Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Jorge Kalil

Authors
  1. Hui Wen Fan
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  2. Jorge Kalil
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Corresponding authors

Correspondence to Hui Wen Fan or Jorge Kalil .

Editor information

Editors and Affiliations

  1. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Jeffrey Brent

  2. Office of New Drugs Drug Evaluation and Research, FDA, Silver Spring, Maryland, USA

    Keith Burkhart

  3. Clinical Toxicology, St Thomas' Hospital, London, United Kingdom

    Paul Dargan

  4. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Benjamin Hatten

  5. Med & Toxicological Intensive Care Unit, Lariboisière Hospital Paris-Diderot University, Paris, France

    Bruno Megarbane

  6. University of Colorado School of Medicine, Toxicology Associates, Denver, Colorado, USA

    Robert Palmer

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

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Fan, H.W., Kalil, J. (2016). Massive Bee Envenomation. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_122-1

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  • DOI: https://doi.org/10.1007/978-3-319-20790-2_122-1

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