A recent report on the mass envenomation of a horse and foal led to me to look the subject up

According to P Kirk Visscher, Richard S Vetter, & Scott Camazine

Death from honey bee or wasp envenomation is a rare
event. Most often it is caused by IgE-mediated Type
I anaphylaxis, and the fatal incident involves a single
sting. Less commonly, death occurs from the
toxic effects of massive envenomation involving hundreds
to thousands of stings.

Most of the mass envenomation cases reported in the
medical and entomological literature involve hundreds
of stings, many resulting in toxic systemic reactions and
renal failure.

Honey bees will leave detached stings in the victim, and these
should be removed as soon as possible by whatever
method is quickest. Erroneous conventional medical
advice states that the venom sac should never be
squeezed, since this purportedly injects more venom
into the victim; however, this was shown to be incorrect


The method of removal does not seem to affect the
quantity of venom received. This finding contrasts sharply
with conventional advice on the immediate treatment of
bee stings.

Our data indicate that the advice often given to
patients—that they should be concerned about how bee
stings are removed—is counterproductive in terms of
minimising envenomisation. The method of removal is
irrelevant, but even slight delays in removal caused by
concerns about the correct procedure (or finding an
appropriate implement) are likely to increase the dose of
venom received.

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