Versione Italiana


Luciano Schiazza M.D.
c/o InMedica - Centro Medico Polispecialistico
Largo XII Ottobre 62
cell 335.655.97.70 - office 010 5701818

It is necessary to differentiate stings such as those of wasps, bees and hornets, provoked as an act of defense, and mosquitoes, horse flies, ticks, bedbugs, lice, caterpillars, that feed themselves on blood.


These insects normally sting for self defense when disturbed.


Honey Bees (Apis mellifera)

Ape mellifera Ape mellifera

They live where there are flowers to pollinate: vegetable and flower gardens. The characteristic that differ bees from wasps and hornets is the stinger. In fact, when the stinger is in the skin it can’t be taken off. Being the stinger linked to the last tract of the intestine, the bee will die a couple of days after stinging.

Bees sting when provoked and this usually occurs a few meters from the beehive. (Reference is made to Italian bees)

The bees poison is described as liquid, watery, it has a bitter taste and a smell similar to the one of ripe bananas.

Wasps (Germanic wasp – common wasp, paper wasp)

vespa germanica vespa germanica vespa germanica

They are easy to spot because of the black and yellow stripes, they can be found everywhere, as they build up in large populations and scavenge for human food (carbonated beverages, cider, juices, ripe fruits and vegetables, candy, ice cream, fish, ham, burgers, etc.
Wasps have a lance-like stinger without barbs and can sting repeatedlywhereas honey bees have a barbed stinger and sting only once.

It is dangerous when they sting your mouth: be careful when you drink carbonated beverages, especially if left unattended outdoor. A wasp may have entered the can.

If a wasp enters in your car do not panic: move slowly and get the insect out.

Hornets (Vespa Cabro)

Vespa crabro Vespa crabro

The biggest of the group (their length can reach 35 mm). They love flowers and sting for self defense or to protect the nest. They live preferably under the roofs and in the cavity of trees, (if you travel to Italy mind the cavities in olive trees) in the ground or walls or in bird’s nests. They eat juicy fruits such as peaches, apricots and plums. The stinger is 3-4 mm long. It isn’t barbed as the one of honey bees, so they can sting repeatedly.
It is recommended to seek professional help to destroy nests.

The most common consequence of the sting is redness and edema. The red area has a white spot in the center. However painful and itchy, it  is not life threatening.
In fact, to be at life risk a adult human should be stung simultaneously one hundred times and a child 50.

Severe can be the allergic reaction, that may affect hyper-sensitive subjects. In this case a single sting might trigger a deadly anaphylactic reaction.

It may  manifest 10-20 min after being stung with itching, swollen face, eye lids tongue  and larynx. These symptoms may severely evolve in chest constriction, urticaria and excessive swelling.

While we can expect to be stung by wasps, which have their nests in well know places, we may unexpectedly encounter a hornet, for its nest may be either on the ground, or on trees.

First aid

To reduce swell and inflammation a cortisone cream might be applied.

In the case of multiple stings and severe itch, systemic treatment with antistamine may be prescribed.

The risk of death by asphyxiation is high in the case of stings to the tongue or larynx, due to mucosal swelling. It’s fundamental to immediately seek medical treatment. Sucking ice cubes or drinking very cold beverages slow the swelling process.

Only the poison of 100 bites can be deadly.

However, if in the case of a single sting you experience :


In this case you are having an anaphylactic reaction and you should immediately seek medical treatment.

Hypersensitive subjects should always carry a kit containing adrenaline or cortisone.

Home remedies:



Culex pipiens Larva di zanzara Culex pipiens

We know very well these annoying insects that disturb our summer evenings (Culex pipiens), that feed on human and pets’ blood. It colonizes stagnant water and stings at sunset.

How to avoid stings

It’s important to wear adequate clothing:

It is important to :

You may use natural repellents such as citronella (never in the sun because it is photosensitive) or geranium. Chemical repellents should not exceed 10% DEET)  should be sprayed on clothing and not on the skin.

In the case of the Asian tiger mosquito (aedes albopictus) in Italy since 1990 (probably arrived on cargo ships containing disposed tyres). It is smaller than common mosquito, black and white striped legs and small, black and white body.

Tiger mosquito breeds in small quantities of stagnant water in places such as:

Eggs are laid on the surface of stagnant water and hatch in spring-summer. They are very resistant : in fact, eggs laid at the end of summer resist throughout the winter.

The adult female lives in areas with low vegetation. It stings at leg height.

In Italy they are not dangerous, (while in Asia they  are vectors of dengue, yellow fever and several kinds of encephalitis), but their bite gives itch and local reaction. It normally bites in the morning and at sun down  (the coolest hours of the day), while common mosquitos bite at sundown and during the night.

What environmental measures should be adopted ?

Nei cimiteri:

Mosquito bites can be treated with cortisone creams, to used under medical supervision.


Zecca Zecca

Ticks are acari that mainly develop in hot-humid climate. Ticks sting and attach to the skin, (thanks to the hypostome) to suck our blood. This may occur in every season, but they are more active during the summer. Children on camp holidays in the country side are more at risk.

It has to be considered that : 

Tick sting doesn’t always mean infection or sickness.

Among the transmissible illness there is rickettsiosis (Mediterranean spotted fever) and Lyme borreliosis


This last takes days to weeks (3 to 30 days after tick bite) to develop the classic sign of at the site of the tick bite: erythema migrans (also called erythema chronicum migrans). It’s a circular erythema that progressivaly enlarges with a outer edge red and a clear inner area.

Parents have to daily check for 30-40 days  the area where the tick was attached. If erythema appears, immediately consult a physician, who will prescribe antibiotics for 3-4 weeks.

In the case that the child, for any other reason during the observation period needs antibiotic treatment, parents should  inform the doctor about the tick sting, so that he can prescribe antibiotics effective on Lyme borreliosis as well.

If not treated, it may lead to more serious problems that may include the skin, joints, nervous system and heart. Symptoms can last for weeks or, if untreated, for years.

The most dangerous is the wood tick that lives in the hill woods. It is very small, 2-8 mm, dark color, difficult to spot.

In what kind of environment the risk to be stung ?

However, if the climate is mild and warm, they breed all the year around. Since tick do no fly, or jump, they wait for their host at the extremity of plants. They  are attracted to body heat of animals and humans.

Ticks inject anesthetic when they bite, so you don’t feel them biting.

How to avoid to be bitten in areas which might be infested with ticks.:

While in tick’s infested areas:

Back home:

To remove a tick :

Come rimuovere una zecca

Avoid folks remedies such as:

Environmental prevention in residential areas:



You find may in hot, sunny and non windy days. The female sucks from 20 to 200 micrograms of blood. The sting provokes a itchy papule. Topic treatment with cortisone cream is recommended.


cimice Cimici

Bed bugs are small flat insects of the family Cimicidae. They are attracted to beds or dirty mattresses. You can recognise them from the smell or their escrements in the bed.
They are attracted to a temperature around 35° C. This is why man is its favourite victim. Its small stings, come in a raw on face, neck hands and arms.
Topic treatment with cortisone cream is recommended.



The kind of flea that man comes in contact with is the cat flea (Ctenocephalides felis) that lives in cats and dogs. Less frequent is the man flea (Pulex irritans) and the poultry flea (Echidenofaga gallinacea). They don’t have wings: instead they have  strong jumping legs. They  are attracted to warm bloodded animals (including man) who can become their mean of transportation till they reach a specific host where they will mate. They move quickly and are often difficult to catch.

In order to better understand their infestation capacity, it is necessary to know their life cycle. Once a flea acquires a host, generally cats and dogs, it initiates feeding with its blood. After its first blood meal it mates and starts to lay eggs (up to 46 per day), till they die (they generally live two weeks).  Eggs fall from the haircoat of the host in the surroinding environment (they prefer warm and humid areas) where they develop. The place may be your house or garden, causing a huge unfestation, you may not be aware of.  The adult fleas on your pet only represent 5% of the total amount; 95% is represented by eggs in the environment.

Fleas may cause:

They can carry  bubonic plague and murine typhoid, transmitted by the rat flea (Xenopsylla cheposis).

The most affected areas are those non covered by clothing: you may observe small erythematous papula lesions in a row, as a trace of the flea walk on your skin.

Fleas control guide.

You may find fleas also in mammals other than cats and dogs, bird nests, hen-pens, uninhabited houses, cracks in old buildings, barns,  trunks of trees and sheds.


Processionaria Processionaria

Caterpillars that mey cause problems to the man are larval form of nocturnal butterfly.
They crawl at night in single file, head to tail in large processions to feed on foliage in the crowns of trees, later to return in the same
The contact with the caterpillar, in particular with its urticans hair (they may also be transported by the wind) may cause dermatitis (erucism or caterpillar dermatitis) with red and itchy papules. More serious consequences if incontact with eyes, nasal mucosae, mouth or respiratory and digestive tracts.

In the case of contamination:

Ice cubes may be applied to the affected area. However, steroid creams (consult your phisycian) may be used for a more effective treatment.