Health Threats to School Children from
Jerome Goddard, Ph.D.
Wasp, bee, yellowjacket, and fire ant stings are serious health
considerations for school children in two primary ways: 1) the
direct effects of stings -- pain, itching, swelling, etc., and 2)
the indirect effects such as allergic reactions to the venom.1
Direct effects are bad enough, with many children experiencing
severe pain and localized swelling after an insect sting.2,3
In others, the direct effect may be even worse with extensive
swelling that may be debilitating for days or weeks (termed a large
local reaction). Indirect effects of stings -- primarily allergic
reactions -- vary from mild systemic (all over the body) reactions
such as hives, itching, runny eyes and nose, and wheezing, to severe
systemic reactions such as sudden swelling of the respiratory tract,
crash in blood pressure, collapse and death within 15-30 minutes.4,5
Contrary to what people think, there are more deaths each year in
the U.S. from bee and wasp stings than from snake bites.6
In addition, fire ants have increasingly become a costly medical
threat to adults and children in institutions, schools, and day care
For example, in 1998, there were an estimated 660,000 cases of fire
ant stings in South Carolina, of which approximately 33,000 sought
medical treatment for an estimated cost of $2.4 million.12
Biology of the Pest Species Involved.
Paper wasps (including yellowjackets and hornets) build their nests
in protected places such as hollow trees, thick bushes, holes in the
ground, and the like. The problem is they often build them under the
eaves of human dwellings, in wall voids or in attics. Paper wasps
begin their nests in the spring with a single mated female wasp
(queen), and gradually enlarge the nest, producing more and more
worker wasps until winter kills most of them. Accordingly, the worst
problems with paper wasps occur in late summer and early fall
(unfortunately, this coincides with the start of school). Paper
wasps will aggressively defend their nest when disturbed, stinging
repeatedly (honey bees sting only once; paper wasps can sting
Honey bees (including both the European variety and the newly
arrived "killer bee") build their nests in hollow trees, but may
also build nests in wall voids. They do not construct a paper nest,
instead making a waxy, comb-like structure. In addition, honey bees
can overwinter -- cold weather does not kill the hive. Accordingly,
a honey bee hive could remain inside a wall for several years.
Honeybees also aggressively defend their nest when disturbed.
Interestingly, killer bees are no bigger in size or more poisonous
than regular honey bees -- only more aggressive. They are more
easily alarmed, more of the hive emerges to chase intruders, and
they chase intruders much further.
Fire ant stings can even be more serious than bee stings. There are
some native fire ants in the U.S., but the imported ones are the
worst pests. At least 300 million acres in the U.S. are now
infested. Imported fire ant sting aggressively and inject a
necrotizing venom to paralyze or kill their prey. The ants
characteristically boil out of their mounds in great numbers at the
slightest disturbance. Worker imported fire ants attach to the skin
of their victim with their mandibles and lower the tip of their
abdomen to inject the stinger forcefully; therefore, fire ants both
bite and sting, but their stings cause the subsequent burning
sensation and wheal. As is the case with any stinging insect,
hypersensitivity to fire ant venom may result in severe allergic
reactions from just a few stings.
Outdoors, fire ants are best recognized by the appearance of their
mounds, which are elevated earthen mounds 3 to 36 inches high
surrounded by relatively undisturbed vegetation. In some areas,
there are as many as 300-400 fire ant mounds per acre of land,
greatly interfering with any outdoor activity. But fire ants may be
present in an area even in the absence of visible mounds, because
some soil types make mound building difficult. In addition, foraging
tunnels 50 to100 feet long are used by workers to collect food for
the colony. Children at play may not see these feeding trails and
inadvertently get into them. Foraging tunnels are excavated just
below the soil surface and extend outward from the mound in all
directions. Worker ants travel through these tunnels, emerge from an
opening, and search for a food source. Once a food source is
located, the foraging worker returns to the tunnel laying a trail of
pheromone for other worker ants to follow.
Control Options and Health Effects from Non-use of Pesticides.
Paper wasp nests can be mechanically removed (knocked down),
especially early in the spring. However, there are obviously some
health risks to the person doing the nest removal. A few of the
"green" pesticides or other products may also work on paper wasp
nests. For example, a soap/water mixture does effectively kill wasps
and bees. Nonetheless, there are many instances in which traditional
pesticides are needed. Some of the synthetic pyrethroids, packaged
as long-range sprays, provide instant knockdown of wasps, hornets,
yellowjackets, and bees. In addition, insecticidal dusts are
extremely effective tools in controlling hard-to-reach wasp or bee
nests in wall voids. Fire ants pose a different problem, being
extremely difficult to control without a combination of insecticidal
baits (broadcast in the school yard) and individual mound treatments
using traditional, residual insecticides. In a recent study of
health effects from fire ant stings, the authors (all physicians)
recommended pesticidal control of fire ants according to Clemson
University Cooperative Extension Service guidelines.12
Alternative, non-pesticidal control measures were mentioned in the
official Extension Service guidelines, but were said to be "not very
If traditional pesticides are not available to pest control
personnel for the removal of wasp, ant, or bee nests in/around
schools, then successful elimination of the nests -- and their
associated health risks -- will be extremely difficult, if not
impossible. Pesticides should be considered as important "public
health tools" in the removal of such pests. Failure to have such
tools available will ultimately lead to children being exposed to
stinging insects, and possible liability on the school's part for
not having provided a safe, pest-free environment.
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Alexander JO: Arthropods and Human Skin. Berlin: Springer-Verlag,
Kunkel DB: The sting of the arthropod. Emerg Med 1996; (May 1996
Reisman RE: Insect stings. N Engl J Med 1994; 331: 523-527.
Parrish HM: Analysis of 460 fatalities from venomous animals in the
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deShazo RD, Williams DF, Moak ES: Fire ant attacks on residents in
health care facilities: a report of two cases. Ann Intern Med 1999;
deShazo RD, Butcher BT, Banks WA: Reactions to the stings of the
imported fire ant. N Engl J Med 1990; 323: 462-466.
deShazo RD, Banks WA: Medical consequences of multiple fire ant
stings occurring indoors. J Allergy Clin Immunol 1994; 93: 847-850.
Levy AL, Wagner JM, Schuman SH: Fire ant anaphylaxis: Two critical
cases in South Carolina. J Agromed 1998; 5: 49-54.
Kemp SF, deShazo RD, Moffitt JE, Williams DF, Buhner WA: Expanding
habitat of the imported fire ant: a public health concern. J Allergy
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ABOUT THE AUTHOR:
Jerome Goddard holds a Ph.D. in medical entomology from Mississippi
State University. He is a public health entomologist and a Clinical
Assistant Professor of Preventive Medicine at the University of
Mississippi Medical Center in Jackson, Mississippi. Dr. Goddard has
written a medical entomology textbook, "Physician's Guide to
Arthropods of Medical Importance" which is now in its Third Edition
and is used by physicians worldwide. In addition, Dr. Goddard has
written two other books on medically important pests, three book
chapters, and 80 scientific articles. He has been a visiting
professor in the Department of Dermatology at the Mayo Clinic, as
well as a member of a National Institute of Health panel convened to
study the future of tick taxonomy in the U.S. In 1999, he testified
before a congressional committee on the public health benefits of