Human Bites

Suspicion still simmers just under the surface

Human Bites | Johns Hopkins Medicine

For decades, residents of the poor neighborhood surrounding Johns Hopkins Hospital have had an uneasy relationship with the billion-dollar institution at its center. They viewed it as elitist, more interested in medical research than in their care.

While the hospital has worked to enhance relations, spending millions on community support and to serve poor patients, recent controversy over a study conducted by the Johns Hopkins Bloomberg School of Public Health and the Kennedy Krieger Institute has illuminated historical tensions.

In 2000, researchers spread fertilizer made from a combination of human and industrial wastes on the lawns of nine East Baltimore homes in an effort to help combat lead poisoning. Hopkins says the fertilizer was a common, commercially available compost that did effectively mitigate lead and that participants and the community were fully informed.

But the National Association for the Advancement of Colored People has called for state and federal officials to launch a criminal investigation, saying the study could be viewed as an experiment conducted at a cost to the health of the mostly poor, black families living in the area. Maryland lawmakers have urged the U.S. Department of Housing and Urban Development to investigate why it funded the study.

“This particular story about the sludge unfortunately adds to the continuing distrust of Hopkins,” said Michael Eugene Johnson, state director of the Black United Fund, which has joined forces with the NAACP on the issue. “This may be an honest, proper study that was done, but the shroud of secrecy, the fact that information is not being shared, it has revived this concern.”

Johnson said some people living in the shadow of Hopkins remain wary of the institution, even while recognizing it as a premier research hospital.

“It's always been known as Johns Frankenstein to a lot of us, even though we are well aware that Johns Hopkins is one of the finest research institutions in the world,” he said. “People would say, 'Don't go past there at night, you might come up missing.'”

Homer E. Favor remembers reluctantly carrying his 3-year-old son to the emergency room at Johns Hopkins Hospital.

It was 1960, and a father's fears were exacerbated by the fact that blacks and whites were treated in separate wards. Worse, were the unfounded rumors that circulated among Favor's friends and neighbors: at Hopkins they made guinea pigs black patients.

His son received life-saving surgery to remove his appendix, and over the years, Favor became good friends with some of Hopkins' most respected doctors and administrators.

But the “ghost stories” among some African-Americans about medical research at Hopkins and other research institutions in minority communities remain.

“There are still people I know who say, 'Don't take me to Hopkins. … Something bad is going to happen to me there,'” said Favor, 84, a civil rights activist and retired dean at Morgan State University, who has lived in the East Baltimore community near Hopkins for more than 40 years.

African-American skepticism of medical research was inflamed in the infamous Tuskegee Study, in which researchers for the U.S. Public Health Service allowed syphilis in black men in Alabama to go untreated.

The study, begun in the 1930s, continued for 40 years. Hopkins was not involved in that study, but the incident contributed to widespread suspicions about medical research in general.

When Dr. Levi Watkins Jr. arrived at Hopkins 38 years ago, the hospital had only recently become integrated, abandoning the practices of separate wards, blood banks, morgues and cafeterias for blacks and whites. He and other interns and residents lived in buildings encircled by a fence, designed to keep the local – mostly black – community out, he said.

It was not what Johns Hopkins himself had envisioned. In a letter to trustees upon founding the institution, Hopkins urged the hospital to be inclusive of minorities and the poor, making service to these groups a crucial part of its mission, Watkins said.

In fact, the second patient admitted to the hospital when it opened in 1889 was an African-American. That was a time when many other hospitals in Baltimore did not admit blacks.

“The problem with that was America,” said Watkins, associate dean at the Johns Hopkins University School of Medicine and a professor of cardiac surgery, who has made diversity at the institution his mantra. “We were giants in medicine, not so giant in humanitarian efforts as much as race was concerned, even though Mr. Hopkins had instructed us to be so.”

Watkins maintains Hopkins has worked to ease community discomfort. The hospital has 82 community programs designed to engage the neighborhood, examining such issues as teen pregnancy prevention, sickle cell anemia and crime and violence, he said.

Officials also noted that Johns Hopkins Hospital, as well as the School of Public Health, have devoted significant resources to East Baltimore and the city overall.

In fiscal year 2007, the institution gave $100 million in community benefits, according to Hopkins spokesman Gary Stephenson. The hospital provided $146 million in uncompensated care – typically care for poor, uninsured patients.

Stephenson said the “vast majority of this care went to Baltimore City residents.”

“Johns Hopkins is deeply committed to its community and it has supported that community with money, resources and time,” Stephenson said.

He said Johns Hopkins has never been involved in a Tuskegee- study, in which subjects were harmed or otherwise exploited. And Watkins defended Bloomberg researchers, saying he is certain they had no racial motives.

“The problem however, is the sensitivity of it,” Watkins said.

Bloomberg Dean Dr. Michael Klag agreed that the black community had historical grounds for suspicion about researchers' motives. But Klag said the institution has a “pretty good relationship with the surrounding community.”

And he said the researchers had worked closely with community groups to set up the study and make sure it was done ethically.

“It was done as it should have been done,” he said.

The study's leader author, Mark Farfel, a former associate professor at the Kennedy Krieger Institute and Bloomberg, has been the subject of favorable and unfavorable press over the years.

In 2001, the Court of Appeals ned a lead paint study Farfel had conducted years before to the Tuskegee experiments.

Farfel's study was an attempt to identify an affordable measure that could reduce the danger of lead-paint poisoning faced by children living in old homes.

The study focused on more than 100 families who were enticed to live in homes that had varying levels of partial lead abatement as part of a study of whether cheaper methods of containing lead would keep the toxin children's bodies.

In reversing a lower court decision dismissing the suit, the Court of Appeals found researchers failed to warn families that their children faced a health risk if they continued to live in the homes. The court also found that the researchers did not inform the families of the youngsters' elevated blood-lead levels in a timely way.

Klag argued that in the compost study, the researchers were actually trying to help the community, not exploit it. “It was done in East Baltimore because we were having an epidemic of lead poisoning there,” he said. “The study was done in response to the needs of the community.”

Klag said he didn't think most people in East Baltimore felt alienated from Hopkins: “By and large, people are worried about getting a good education for their kids, having a good job. I don't think they have a lot of hostility directed toward the hospital. Many people recognize that Hopkins does a lot of good things in the community.”

However, Hopkins and the East Baltimore Community Development Inc. have been criticized for clearing dozens of acres and displacing residents to make way for an $800 million biotechnology park.

Donald Gresham, president of the Save Middle East Action Committee, which represents homeowners, said the hospital has not done enough for the community.

“Most people's impression is they are really hurt and disappointed,” Gresham said. “Most people in East Baltimore were born at Johns Hopkins. Their doctor is at Johns Hopkins. The community is not happy about what Johns Hopkins is doing.”

Dr. Al Sommers, who was dean at JHSPH from 1990 to 2005, said decades-long tensions have eased significantly in recent years.

Klag, Sommers argued that Hopkins has helped East Baltimore. “Hundreds if not thousands of people in East Baltimore work there. Hopkins has been an engine for jobs, employment, education, for people bettering themselves,” he said.

Battling community suspicion is not unique to Hopkins but is an issue that research institutions nationwide face, said Watkins.

“There is distrust here as there is of most research institutions in communities of color. This is an American issue,” he said. “I don't hear the kinds of concerns I used to, but that doesn't mean that people don't still believe them.”

Staff reporters Stephen Kiehl and Dennis O'Brien contributed to this article.


Johns Hopkins faces further criticism over experiments

Human Bites | Johns Hopkins Medicine

The Johns Hopkins University Medical Center, in Baltimore, Maryland, is facing fresh criticism over its research methods and ethics—this time in relation to a study of different ways of getting rid of lead paint in homes, during which children were knowingly exposed to high levels of lead.

The centre temporarily lost its licence for research on humans recently after a previously healthy woman died in an asthma study (28 July, p 186).

Now two families have won the right to pursue a court case against the Kennedy Krieger Institute, which is affiliated to the Johns Hopkins University Medical Center, claiming that in the study it allowed their children to sustain lead poisoning and brain damage by failing to inform them that they lived in housing with dangerous levels of lead dust. The Kennedy Krieger Institute, located on the university's campus, is nationally recognised in the field of lead poisoning and childhood neurological disorders.

The study, which ran from 1993 to 1995, was conducted in 100 homes contaminated with lead paint. In Baltimore city more than 100000 homes have lead paint and over 4000 children annually test positive for raised serum lead levels.

The aim of the study was to find a cheaper and less hazardous way of removing lead paint than stripping the paint off the walls. The work was funded largely by a government grant.

Landlords were paid from $1650 (£1178) to $7000 to partially remove lead by scraping off peeling paint, to paint over existing paint, or to add coverings.

Residents were allowed, and in some cases encouraged, to remain in their homes while these removal techniques were going on.

Lead levels of children living in the homes were periodically tested to monitor the efficiency of the various techniques.

Maryland Court of Appeal ruled 7 to 1 to allow the lawsuit to move forward, using the occasion to tighten safety precautions in research involving children and to restrict such research further. They also criticised Johns Hopkins' institutional review board for allowing the study to proceed.

Judge Dale Cathell compared the Kennedy Krieger study to Nazi experiments on concentration camp victims and to the Tuskegee experiment, in which syphilis in black men with the disease was allowed to progress (rather than be treated with penicillin) so that the natural course of syphilis infection could be studied

The appeal court's indictment of the Kennedy Krieger study has also resulted in an investigation into the study by the Department of Health and Human Services' Office of Human Research Protections.

But Don Ryan, executive director of the Alliance to End Childhood Lead Poisoning, in an article in the Baltimore Sun newspaper (2001; 28 August) defended the lead research, saying: “The reality is that this research made homes safer, not only for the children in Baltimore but for hundreds of thousands of others across the nation. Children do not live in lead-burdened houses because researchers want to ‘experiment’ on them but because so much of our housing is contaminated by lead.”

Articles from The BMJ are provided here courtesy of BMJ Publishing Group


HRC Sets Sights on Johns Hopkins After Controversial Trans Report

Human Bites | Johns Hopkins Medicine

The fate of transgender Americans may now be in the hands of the U.S. Supreme Court, as it decides whether to hear the case of trans student Gavin Grimm, who is suing his school district in order to use the boys' bathroom. Those who would deny individuals Grimm their civil rights, however, hope to block not just their right to pee — but to be.

RELATED: Supreme Court Blocks Transgender Bathroom Ruling

The focus of many in the anti-trans movement is to erase what it means to be trans, as evidenced by the position statement issued recently by the American College of Pediatricians, not to be confused with the American Academy of Pediatricians. The so-called College denies some children are transgender and benefit from being respected in those identities.

Paul R. McHugh, M.D (left) and Lawrence S. Mayer, M.B., M.S., Ph.D. (right)NBC News

The movement’s latest effort is a controversial 143-page report that LGBTQ advocates consider an early Christmas gift to religious conservatives. Its authors are Dr. Paul McHugh and Dr. Lawrence Mayer of Johns Hopkins University’s Bloomberg School of Public Health and School of Medicine in Baltimore, Md., who between them have never conducted independent research on LGBTQ Americans.

McHugh, a retired professor at Johns Hopkins and a psychiatrist who considers being trans a “mental disorder,” collaborated with Mayer to change what people think about sexuality and gender through science.

This is an opponent of transgender rights who made a name for himself by declaring homosexuality a choice, lending his expertise to legal efforts to block same-sex marriage in California.

The self-described cultural conservative and strict Catholic once compared the practice of administering hormone therapy to children as akin to performing “liposuction on an anorexic child.”

Mayer, a biostatistician and epidemiologist, recently served as a $400-an-hour expert witness in North Carolina Gov. Pat McCrory’s defense of House Bill 2, the Republican-sponsored state law that restricts transgender people to bathrooms matching their birth certificates.

Their report is titled “Sexuality and Gender: Findings From the Biological, Psychological and Social Sciences” and is billed as “a careful summary and an up-to-date explanation of research — from the biological, psychological, and social sciences — related to sexual orientation and gender identity.”

Among the report's claims:

  • LGBTQ people are not “born this way,“ yet biological sex is innate.
  • Gender identity is an “elusive concept,” and so transgender people do not exist.
  • It is harmful to so-called “confused” children to offer them transgender treatment and societal accommodations. Instead, they need non-surgical intervention.

Who's Behind the Report?

The paper was published in The New Atlantis, which is not a peer-reviewed medical journal, where reports by members of the Johns Hopkins team might normally be found. Instead, it’s the product of the Ethics and Public Policy Center (EPPC), a Christian-focused conservative think tank “dedicated to applying the Judeo-Christian moral tradition to critical areas of public policy.”

Even if you’ve never heard of EPPC, their stance on some key issues in LGBTQ life will be familiar. The group supported the now-defunct Defense of Marriage Act, objected to the elimination of Don’t Ask, Don’t tell and supports efforts by conservative states to enact religious freedom restoration acts.

Although it might appear unusual that Johns Hopkins healthcare professionals would publish a paper of this kind in a religious publication with a political agenda, Mayer shrugged it off. He conceded in an email to ThinkProgress that the report “may be politically biased but it is not scientifically biased.”

To the religious right wing of American politics, and in particular its leaders in the anti-gay and anti-transgender movement, the report is seen as “groundbreaking.

” That’s what Brian Brown, president of the National Organization for Marriage, called it: a study that will “expose the lies of the media and LGBT activists, that contradict not only common sense but also the best scientific knowledge.”

Human Rights Campaign Takes Action

But all that knowledge is going to be costly. NBC OUT has learned that unless Mayer and McHugh’s bosses at Johns Hopkins immediately disassociate themselves from what the Human Rights Campaign (HRC) considers their transphobic findings, the reputation of the university, its medical school and its hospitals may suffer.

The claims made by the authors have triggered an unprecedented review by HRC, which is the nation’s leading LGBTQ civil rights organization. The group says it has been warning the internationally respected university medical school for several months that it will remove its name from an elite classification in its Healthcare Equality Index (HEI) unless action is taken.

A person with knowledge of HRC’s leadership decisions told NBC OUT that after repeated warnings, Johns Hopkins is now on the brink of losing its perfect score on that closely-watched benchmark for LGBTQ equality. The source provided the text of a warning sent in June, prior to the release of the report by Dr. Mayer and Dr. McHugh:

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“Failure to take significant steps to distance Johns Hopkins Medicine from this line of Dr. McHugh’s personal beliefs and opinions will be considered an activity that undermines LGBTQ equality and patient care for the purposes of the Healthcare Equality Index score for Johns Hopkins Hospital.”

How important is the HEI ranking? James Page Jr., the top man in charge of diversity at Johns Hopkins Medicine, explained it best in March in a press release:

“We recognize the importance of a leader in health care also being a leader in health care equality,” Page was quoted as saying in the statement heralding their latest perfect HEI score. “We are dedicated to making Johns Hopkins Medicine a fully inclusive place to work and seek care, and we are pleased to see our efforts being recognized.”

“The ‘research’ Paul McHugh has been releasing and peddling and marketing are a weapon in the arsenal of anti-transgender politicians and extremists.”

So, one would suspect it matters to Johns Hopkins that it would continue to be selected for this honor, to be one of fewer than 150 institutions chosen from more than 2,000 health care facilities nationwide.

It’s a sought-after recognition that follows a rigorous, independent evaluation of an institution's policies and practices that is, as HRC states on its website, “related to the equity and inclusion of their LGBTQ patients, visitors and employees.”

NBC OUT reached out to spokespersons for both Johns Hopkins Medicine as well as the university, in hopes of getting their reaction to its endangered perfect score, and to ask whether anyone would endorse or would condemn the controversial report on transgender Americans.

A spokeswoman for Johns Hopkins Medicine, representing both institutions, addressed the issue via email, but refused to directly address the report:

“The Johns Hopkins University and the Johns Hopkins Health System are deeply committed to inclusiveness, including respect and support for our LGBTQ students, patients, employees and other members of the Johns Hopkins community.

“As one of the world’s leading research institutions, we value scientific integrity and academic freedom. While members of our faculty are free to share their views and opinions, it is important to understand that those do not necessarily represent the views and opinions of our institution.”

In other words, they’re not endorsing Mayer and McHugh and “not necessarily” distancing themselves, either. On Monday, HRC sent another warning letter to Johns Hopkins, mentioning the report in the New Atlantis, according to the HRC official who requested anonymity.

Sarah McBride, HRC's national press secretary and the first-ever transgender speaker at an American political convention, talked to NBC OUT on the record and said she believed the report by Mayer and McHugh posed “dangerous consequences for transgender people, in particular transgender young people.”

McBride noted that in contrast to what is popularly viewed as a year of tremendous acceptance and progress for transgender Americans, the stark reality is that trans people and their allies nationwide are on the defensive. “This year in particular, trans people have experienced pretty significant and harmful political and legislative attacks,” she said in a phone interview.

“The ‘research’ Paul McHugh has been releasing and peddling and marketing are a weapon in the arsenal of anti-transgender politicians and extremists.”

Kim Hoppe, a Johns Hopkins spokeswoman, issued a subsequent statement to NBC OUT, expressing pride for its HEI ranking and “inclusiveness.” But first and foremost, Hoppe defended Johns Hopkins' dedication to providing its staff with “academic integrity and freedom of expression,” which seems to suggest a resolution to this standoff may not be reached:

“This means both that the university will not penalize faculty for statements made in public debate and that we are committed to a strong principle of academic freedom in teaching and research. This is true even when a faculty member is expressing views that provoke controversy and others may consider wrong.“

Although Hoppe did not directly answer NBC OUT's questions about its HEI ranking, she remained firm in deflecting the impact Mayer’s and McHugh’s opinions would have on the university:

“At times, the views of individuals are imputed to the university for which they work, and that may unfortunately affect others’ views of the institution. I can assure you that as health care providers, we have taken steps across all of our hospitals to live up to the policy requirements to qualify as a leader in LGBT health care equality.”

Not so fast, implied McBride. “There’s no question that the public narrative is that this is a Hopkins study,” and unless the institution were to take action there will be “consequences,” she added. As to what those might be, McBride later emailed a statement to NBC OUT to shed a few new details.

“We are deeply troubled by the continued use of Johns Hopkins' name and reputation to back up the unscientific, unfounded, and harmful personal prejudices of a few of their doctors.

We have repeatedly reached out to Johns Hopkins to express our disappointment and anger with the ongoing use of their credibility to back up discredited theories.

The next version of our HEI will include criteria regarding institutional support for similar anti-LGBTQ actions, which means that unless Johns Hopkins addresses this situation, their score will be significantly impacted. We have made and will continue to make that fact clear to Johns Hopkins as we work to end this practice.”

The Science Behind the Report

Ideology can be debated, but what of science? The Advocate invited Dean Hamer, PhD., to investigate Mayer and McHugh’s report. Hamer, who is scientist emeritus at the National Institutes of Health, took a scalpel to Mayer and McHugh’s claims in a scathing review titled New 'Scientific' Study on Sexuality, Gender Is Neither New nor Science.

Hamer did not mince words in his article, writing in conclusion: “When the data we have struggled so long and hard to collect is twisted and misinterpreted by people who call themselves scientists, and who receive the benefits and protection of a mainstream institution such as John Hopkins Medical School, it disgusts me.”

Johns Hopkins to Offer 'Gender-Affirming Therapies'

The affiliation of Mayer and McHugh with Johns Hopkins is even more relevant considering Johns Hopkins Medicine, according to a Pride letter it released in June, “will join a growing number of leading academic medical centers this fall in offering gender-affirming therapies for transgender patients, including sex reassignment surgery and hormonal treatment as part of a range of support options available.”

“Members of our Sexual Behaviors Consultation Unit are deeply engaged in offering affirming care to our transgender patients,” Hoppe told NBC OUT. “We have established two steering committees related to continuously improving the competency of our workforce in the care of LGBT patients, and this work will further our ongoing expansion of services to the transgender and LGBT community.”

“Johns Hopkins Medicine fully recognizes that gender transition services can be medically necessary for patients, as determined through evaluation by a qualified medical provider, and we will continue to treat each of our patients with the highest level of care and respect,” Hoppe added.

While that speaks to the medical branch of the university as a whole, it leaves open the door to McHugh, Mayer and others to potentially influence individual treatment.

The End Game

The real test of Mayer and McHugh's controversial report will be whether it is largely ignored, as Dr. Hamer believes it will be, or whether it will find its way into the hands of the U.S. Supreme Court justices as they consider what could be a precedent-setting case on trans civil rights.

Dawn Ennis is an award-winning journalist who was the first to transition in a network TV newsroom. She is now a freelance writer, producer and editor, as well as a widow, a single parent of three children, and the subject of an award-winning documentary, Before Dawn/After Don. Ennis is also on , on and blogging at

Follow NBC OUT on , and Instagram.

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Bites and Stings: Insects

Human Bites | Johns Hopkins Medicine

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Fleas, mites, and chiggers often bite humans, but are not poisonous. It is sometimes difficult to assess which type of insect caused the bite, or if the rash is caused by poison ivy or other skin conditions.

What are the symptoms of a flea, mite, or chigger bite?

The following are the most common symptoms of a flea, mite, or chigger bite. However, each individual may experience symptoms differently. Symptoms may include:

  • Small, raised skin lesions
  • Pain or itching
  • Dermatitis (inflammation of the skin)
  • Allergic-type reactions in hypersensitive people with swelling or blistering

The symptoms of a flea, mite, or chigger bite may resemble other conditions or medical problems. Always talk with your healthcare provider for a diagnosis.

Treatment for bites caused by fleas, mites and chiggers

Specific treatment for these insect bites will be discussed with you by your healthcare provider. Some general guidelines for treatment may include the following:

  • Clean the area well with soap and water.
  • Use an antihistamine, if needed, for itching.
  • Take acetaminophen, if needed, for discomfort.

When should I call my healthcare provider?

Call your healthcare provider if any, or all, of the following symptoms are present:

  • Persistent pain or itching
  • Signs of infection at the site, such as increased redness, warmth, swelling, or drainage
  • Fever

Call 911 or your local emergency medical service (EMS) if the individual has signs of a severe allergic reaction such as trouble breathing, tightness in the throat or chest, feeling faint, dizziness, hives, and/or nausea and vomiting.

Tick bites

Ticks are small insects that live in grass, bushes, wooded areas, and along seashores. They attach their bodies onto a human or animal host and prefer hairy areas such as the scalp, behind the ear, in the armpit and groin, and also between fingers and toes. Tick bites often happen at night and happen more in the spring and summer months.

What to do if you find a tick on your child

Recommendations for removing a tick include the following: 

  • Do not touch the tick with your bare hand. If you do not have a pair of tweezers, take your child to your nearest healthcare facility where the tick can be removed safely.
  • Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head as close to your child's skin as possible.
  • Pull up slowly and steadily without twisting until it lets go. Do not squeeze the tick, and do not use petroleum jelly, solvents, knives, or a lit match to kill the tick.
  • Save the tick and place it in a plastic container or bag so it can be tested for disease, if necessary.
  • Wash the area of the bite well with soap and water and apply an antiseptic lotion or cream.
  • Call your child's healthcare provider to find out about follow-up care.

Regardless of how careful you are about animals in your home, or how many precautions you take when your child is outdoors playing, animal and insect bites and stings are sometimes unavoidable.

By remaining calm and knowing some basic first aid techniques, you can help your child overcome both the fear and the trauma of bites and stings.

Facts about insect stings

Bees, wasps, yellow jackets, and hornets belong to a class of insects called Hymenoptera. Most insect stings cause only minor discomfort. Stings can happen anywhere on the body and can be painful and frightening for a child.

Yellow jackets cause the most allergic reactions in the U.S. Stings from these insects cause 3 to 4 times more deaths than poisonous snake bites, due to severe allergic reaction.

Fire ants, usually found in southern states, can sting multiple times, and the sites are more ly to become infected.

The 2 greatest risks from most insect stings are allergic reaction (which can sometimes be fatal if the allergic reaction is severe enough) and infection (more common and less serious).

What are the symptoms of an insect sting?

The following are the most common symptoms of insect stings. However, each child may experience symptoms differently. Symptoms may include:

  • Local skin reactions at the site or surrounding the sting, including the following:
    • Pain
    • Swelling
    • Redness
    • Itching
    • Warmth
    • Small amounts of bleeding or drainage
    • Hives
  • Generalized symptoms that indicate a more serious and possibly life-threatening allergic reaction, including the following:

    • Coughing
    • Tickling in the throat
    • Tightness in the throat or chest
    • Breathing problems or wheezing
    • Nausea or vomiting
    • Dizziness or fainting
    • Sweating
    • Anxiety
    • Itching and rash elsewhere on the body, remote from the site of the sting

Treatment for stings

Specific treatment for stings will be discussed with you by your child's healthcare provider. Large local reactions usually do not lead to generalized reactions. However, they can be life-threatening if the sting happens in the mouth, nose, or throat area. This is due to swelling that can close off the airway.

Treatment for local skin reactions only may include:

  • Calm your child and let him or her know that you can help.
  • Remove the stinger, if present, by gently scraping across the site with a blunt-edged object, such as a credit card or dull knife. Do not try to pull it out, as this may release more venom.
  • Wash the area well with soap and water.
  • Apply a cold or ice pack wrapped in a cloth to help reduce swelling and pain (10 minutes on and 10 minutes off for 30 to 60 minutes).
  • If the sting happens on an arm or leg, elevate the limb to help reduce swelling.
  • To help reduce the itching, consider the following:
    • Apply a paste of baking soda and water and leave it on for 15 to 20 minutes.
    • Apply a paste of nonseasoned meat tenderizer and water and leave it on for 15 to 20 minutes.
    • Apply a wet tea bag and leave it on for 15 to 20 minutes.
    • Use an over-the-counter product made to use on insect stings.
    • Apply an antihistamine or corticosteroid cream or calamine lotion.
    • Give acetaminophen for pain.
    • Give an over-the-counter antihistamine, if approved by your child's healthcare provider. Be sure to follow dosage instructions carefully for your child.
    • Observe your child closely for the next hour for any signs of allergic reaction that would warrant emergency medical treatment.

Call 911 or your local emergency medical service (EMS) and seek emergency care immediately if your child is stung in the mouth, nose, or throat area, or for any signs of a systemic or generalized reaction.

Emergency medical treatment may include the following:

  • Intravenous (IV) antihistamines
  • Epinephrine
  • Corticosteroids or other medicines
  • Lab tests
  • Breathing support

Prevention of insect stings

Some general guidelines to help reduce the possibility of insect stings while outdoors include:

  • Avoid perfumes, hairsprays, and other scented products.
  • Avoid brightly colored clothing.
  • Do not let your child walk or play outside barefoot.
  • Spray your child's clothing with insect repellent made for children.
  • Make sure your child avoids locations of hives and nests. Have the nests removed by professionals.
  • Teach your child that if an insect comes near to stay calm and walk away slowly.

Some additional preventive measures for children who have a known or suspected allergy to stings include the following:

  • Carry a bee sting kit (such as EpiPen) at all times and make sure your child knows how to use it. These products are available by prescription.
  • Make sure your child wears long-sleeve shirts and long pants when playing outdoors.
  • See an allergist for allergy testing and treatment.


East Baltimore Campus Photo I.D. Office

Human Bites | Johns Hopkins Medicine

Johns Hopkins Hospital600 N. Wolfe StreetHarvey/Nelson 108

Baltimore, MD 21287

Phone: 410-955-5325
Fax: 410-502-3907

Office hoursMonday – Friday

8:00 a.m. – 4:00 p.m.

How can we help you?

New badges
Replacement badges
Temporary badges
Name or information change

New badges

The Photo Identification Office will accept new employees, faculty, house staff, contractors and students after officially being hired by their department.

All new personnel and students must bring a completed JHMI badge request form with you when you come for processing. This form may be obtained from the HR or I.D. office.

This form must be filled out completely and have a valid, authorized signature from the Human Resources (Personnel) Department or Registrars Office. For identity verification, each individual must present a valid picture ID along with the JHMI badge request form.

A photo ID badge will be issued at no cost to the new personnel or student at this time.

Note: the name used on the I.D. badge will be the legal name of the individual requiring the badge. No nicknames will be used.

Replacement badges

Lost badge replacement
Any employee who has lost their I.D. badge must go to their office of record (e.g., Personnel, Registrar, etc.) to obtain a completed JHMI badge request form. School of Medicine personnel must see the Human Resources/Payroll Coordinator for their department. This provides the I.D.

staff verification that the individual requesting a replacement is in fact still employed, enrolled or in some way associated with the JHMI. The individual will then proceed to the Admitting Cashier and pay a $15.00 lost badge fee.

The individual must present the completed badge request form, the cashier's receipt and a valid photo ID for identity verification prior to receiving their replacement badge.

The lost badge fee will be refunded to the individual if they find and return their lost badge to this office within 10 business days from the date of replacement. When badges are found and returned to this office, the I.D. staff will try to locate the owner to:

  • Return the lost badge to its proper owner.
  • Notify the owner of the returned lost badge so they can collect their $15.00 refund. All returned lost badges are destroyed.

Stolen badge replacement
Any employee who has had their I.D. badge stolen must go to their office of record (e.g., Personnel, Registrar, etc.) to obtain a completed JHMI badge request form. This provides the I.D.

staff verification that the individual requesting a replacement is in fact still employed, enrolled or in some way associated with the JHMI. The individual must present proof that the badge was stolen (i.e., police report number, incident report taken by a security officer, etc.) and a valid photo I.D.

for identity verification prior to receiving their replacement badge. If proof of the badge's theft is presented, the $15.00 replacement fee will be waived.

If no proof that the badge was stolen can be presented, the “Lost Badge Replacement” protocol (above) must be followed and the $15.00 replacement fee will apply.

Damaged badge replacement
Any employee who brings a damaged badge to the ID Office will have the badge replaced at no charge. The individual will need to complete a JHMI badge request form for our records. The damaged badge will provide verification for the issue of a new badge.

Temporary badges

All temporary employees, contractors, vendors, volunteers, temporary students and visiting professionals who will be at our facilities over 30 days but not more than one year may be issued a temporary I.D. badge if the following condition is met:

  • A completed JHMI badge request form from the Human Resources, Registrars or Facilities Office, or a memo on departmental letterhead from the staff member responsible for the vendor or visiting professional must be provided. The memo will contain the individual's name, SSN, employer, reason for the badge to be issued and duration of their stay at the JHMI.

All temporary badges will expire on or before March 31. On April 1 of each year, the color of the “T” placed on temporary badges will be changed.

On April 1, only temporary badges with the color “T” assigned for that 12 month period will be valid for admittance and use in the JHMI facilities.

All temporary badges printed with a color “T” previously assigned will be confiscated by security and returned to the I.D. Office.

Name or information changes

Any employee needing a new badge to reflect a change in name, employer, department or title must present a completed JHMI badge request form from their office of record along with the badge that is being replaced. There is no charge for this badge reissuance.

Note: The name used on the I.D. badge will be the legal name of the individual requiring the badge. No nicknames will be used.