Bee Sting Injuries in Thailand’s High Apicultural Area: Outcome, Risk and Treatment Patterns

Abstract

Objective

This study aims to assess the clinical outcomes and risk factors associated with severe systemic reactions following bee stings, focusing on patients treated at Pa-Sang Community Hospital, located in Lamphun Province, Thailand, which is recognized as one of the country’s largest apicultural areas.

Methods

A retrospective review was conducted, utilizing electronic medical records with ICD-10 coding, of patients treated for bee sting injuries at the Emergency Department of Pa-Sang Hospital from January 2015 to December 2019.

Results

This analysis included a total of 591 bee sting events involving 533 patients. The average incidence of bee sting injuries was 31.3 per 10,000 Emergency Department visits, with 55% being male. A significant majority (86%) of events occurred outside the patients’ home area. Notably, the head or extremities (49%) were the most common anatomical sites stung. Systemic reactions were observed in 44% of cases, with 96 visits (16%) diagnosed as anaphylaxis. Epinephrine injection was administered in 77% of these cases, and fortunately, no fatal anaphylactic reactions were recorded. Protective factors for anaphylaxis and severe systemic reactions after bee stings included age less than 15 years old and stings on extremities. Conversely, having more than ten bee stings and seeking Emergency Department treatment within 60 minutes of being stung were identified as significant risk factors.

Conclusion

Bee sting injuries were a common presentation at the hospital situated in the high apicultural area, and severe systemic reactions were observed. This study highlights the need for comprehensive interventions to mitigate the increased risk of bee-related accidents in communities with thriving apicultural industries.

Keywords:

• bee sting
• venom
• anaphylaxis
• bee keeping
• Thailand

Data Sharing Statement

The datasets generated during the current study are available from the corresponding author upon reasonable request.

Ethics and Consent Statements

This study adheres to the principles outlined in the Declaration of Helsinki and was conducted with prior approval from an ethics committee. This approval was granted by the Research Ethics Committee of the Faculty of Medicine, Chiang Mai University (Reference Number: 107/2020, Date: March 20, 2020). Due to the retrospective nature of the study, informed consent was not required from participants. Access to the data was restricted to authorized investigators who are bound by anonymization, confidentiality, and data processing regulations.

Acknowledgments

This study was supported by the Faculty of Medicine Research Fund, Chiang Mai University. We thank Mr. Chunyapasth Kanthatham and Mr. Poom Suvanarat for their assistance with data collection and statistical analysis, respectively. We also thank Pasang District Hospital for providing patient data.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

This study was supported by the Faculty of Medicine Research Fund, Chiang Mai University (grant number: 117/2563).