Q&A/How dangerous are hornet attacks in Taiwan?

Taipei, Aug. 28 (CNA) A 41-year-old man died after being attacked by hornets in Taitung County, southeastern Taiwan, last week. He had been guiding a group of students on a hike on Jinshuiying Old Trail when a swarm descended on him and stung him more than 50 times.

The prospect of getting stung by this buzzing insect might discourage someone from tackling one of Taiwan's countless hiking trails. But how common are hornet attacks in Taiwan? And what should you do if you find yourself in the middle of an angry swarm?

Yang Chen-chang (楊振昌), director of the department of clinical toxicology and occupational medicine at Taipei Veterans General Hospital, talked to CNA last Friday, sharing his knowledge about the phenomenon of hornet attacks from a public health perspective.

Q1: How common are hornet attacks?

Fatal hornet attacks are rare.

According to data from the Ministry of Health and Welfare and the General Clinical Research Center at Taipei Veterans General Hospital, of the 611 hornet sting cases reported to the poison control center at the hospital, about 4.7 percent resulted in serious toxicosis and around 2.8 percent resulted in death.

Yang said that there are two worst-case scenarios in a hornet attack.

First, the stings can cause a serious allergic reaction known as anaphylaxis which is sometimes fatal.

In such a scenario, bronchospasms -- tightening of the airways that connect the windpipe to the lungs -- can occur 30 minutes to two hours after the initial sting. If no appropriate medical treatment such as an injection of epinephrine is applied, the person suffering the allergic reaction may die from asphyxiation.

The second life-threatening scenario, according to Yang, can occur if a large number of stings causes rhabdomyolysis, a condition in which muscles rapidly disintegrate leading to kidney failure or pulmonary edema.

However, rhabdomyolysis can only be caused by a high number of stings, around at least 25 hornet stings or at least 350 bee stings, Yang said.

Yang recommended that in the unlikely event that a person is stung by a large number of hornets, they should go to the hospital and remain under medical observation for 6-12 hours.

Q2: What season are hornet attacks most frequent?

Hornet attacks are more likely in summer and autumn, with the highest number of monthly cases reported in September, Yang said.

Stings are most frequent during this period because hornets are typically busy building their nests and storing food, so are prone to react angrily if disturbed, Yang added.

Q3: What is the best way to avoid hornet attacks?

When engaging in outdoor activities, avoid perfumes and brightly-colored clothing, Yang suggested.

If you see hornets nearby, leave as soon as possible -- but avoid running away as this can be perceived as aggressive by the hornets.

Q4: What should I do if hornets attack me?

If you find yourself being attacked by hornets, it is imperative to leave the area, Yang said. This is because hornets become aggressive in response to perceived threats to their hive and will likely not continue to attack when away from their nest.

Once you are at a safe distance, use clean water to wash the affected areas of your body.

If the hornets' tails or stingers are embedded in your skin, use your hands or scissors to pull them out, the doctor advised.

Redness and swelling usually subside within a day or two, provided the wounds do not become infected, Yang said.

Although some people believe that urine or taro juice should be applied to the sting areas, Yang advised against using such liquids since they have no clinical benefit and may instead cause infection.