BehindTheMedspeak: The most dangerous animal in the U.S.

It's the bee.

Bees kill more people in this country every year than any other animal (except, of course, for humans).

A study published in the September issue of the Journal of Allergy and Clinical Immunology notes that most insect sting victims, even those with potentially fatal reactions, are undertreated in hospitals and discharged without proper follow–up.

Only 13% of patients who should have received epinephrine shots got them.

Of the 259 patients who had systemic reactions, only 6 — that's 2.3% — received all the recommended interventions.

Dr. Carlos A. Camargo, one of the paper's co–authors, said that anyone with a history of systemic allergic reactions to bee or insect stings should never be without a self–injectable epinephrine syringe.

Here's Nicholas Bakalar's story from Tuesday's New York Times Science section.

Safety: Most Dangerous Animal? Hint: They Make Honey

Bees are deadly.

More people in the United States are killed by them than by any other animal - and some of those people may not be getting the right emergency room treatment.

A study published in the September issue of The Journal of Allergy and Clinical Immunology suggests that most insect sting victims, even those with potentially fatal reactions, are undertreated in hospitals and discharged without the proper follow-up.

The researchers reviewed the charts of 617 patients with insect sting allergies treated at 15 hospital emergency rooms in the United States and Canada.

Almost one-third of patients had anaphylactic reactions, the more severe, multisystem responses that can be fatal.

Guidelines call for patients with anaphylaxis or less severe systemic reactions - for example, a sting in one place and a rash or hives in another part of the body - be given immediate treatment with epinephrine, a prescription for self-injectable epinephrine for future prevention and a referral to an allergist.

But only 13 percent of these patients actually received the drug in the emergency room, 27 percent left with the proper prescription, and 20 percent got referrals.

Of the 259 patients with systemic reactions, only 6 received all the recommended interventions.

Dr. Carlos A. Camargo, a co-author of the paper and an associate professor of medicine and epidemiology at Harvard, said that self-injectable epinephrine is essential equipment for anyone with a history of systemic allergic reactions.

Sunday Clark, an epidemiologist and the study's lead author, said: "One way we can improve is to increase discussion and collaboration between emergency physicians and allergists. The more these groups talk to each other, the better the situation will become."

You want to know why almost no one who has the need for an epinephrine auto–injector has one?

Look here.

$86 for a drug that is generic and costs about 1 cent.

Why the huge markup at this Canadian website?

You're paying for not having to deal with the cost and inconvenience of getting a prescription for it (in the U.S. it can only be dispensed with a doctor's prescription).

Even with a doctor's prescription it's not cheap: two for $93.94 here.

And there's one other thing: it expires in a year, so you have to keep buying a new one forever.

What a rip–off.

And yet: what's your life, or that of a loved one, worth?