Clinico-epidemiology of Hymenoptera Stings in and around Kaski District, Nepal.

Introduction: In Nepal, morbidity and mortality from Hymenoptera stings is mainly from three commonly encountered insects: hornets (local: aringal), wasps (local: barulo) and honey bees (local: mahuri). The present study documents the incidence of hymenoptera sting in Western Region of Nepal and explores the cause behind such unprovoked attack upon human subjects. Methods: This hospital-based study included all the patients with history of insect sting attending the Emergency Department of Manipal Teaching Hospital, Pokhara from May 2015 till November 2015. Results: Of total 16 cases during the study period three were brought dead cases. The alleged insect happened to be bee in two cases, hornet in two cases, and wasp in eight cases with a case of unidentified insect sting. Severe burning pain with swelling, redness and itching were the common presenting symptom in all the admitted patients (n=13). Conclusion: Agricultural activity during the day was the cause of most unprovoked stings followed by deliberate destruction of the insect hive. Immediate medical attention in the nearby health care facility to the victims will save mortality. The health care facility also needs to have surplus lifesaving medication to counteract the life-threatening anaphylaxis reactions from such stings.