<em>Hymenoptera</em> (wasps, bees and ants) envenomation; a neglected tropical disorder in Sri Lanka

Abstract

Sri Lanka is a tropical agricultural country in which a huge number of insect species have been reported. Bees, wasps, and ants belong to the order Hymenoptera mostly living in a colony, and colony members attack humans aggressively when they are disturbed. However, Hymenopterans are important in many ways such as pollination service to the agricultural and wild plants, honey production, natural pest control for crops, and being members of the food chains. Therefore, we should help to conserve Hymenopterans while safeguarding ourselves from them.Unpublished data confirm that thousands of hospital admissions and 15-30 deaths after insect stings in Sri Lanka annually. When Hymenopterans are disturbed, they sting the victims and inject venom as a defense mechanism. Immunological reactions and toxic effects are common clinical presentations after the Hymenoptera sting. Fatal anaphylaxis, rhabdomyolysis, acute kidney injury, acute myocardial infarction (Kounis syndrome), bowel gangrene, cerebral infarction, acute pulmonary oedema, multi organ failure, limb ischaemia and haemolytic anaemia have been reported in Sri Lanka.