Fire Ant Mound Swarms and Mass Hornet Stings: Brushing Off Ants Dry and Rhabdomyolysis Triage¶

Hymenoptera mass envenomations, spanning imported fire ant mound swarms (Solenopsis invicta and Solenopsis richteri), aggressive Africanized honeybee attacks (Apis mellifera scutellata), and giant hornet or yellowjacket swarms (Vespa mandarinia, Vespa velutina, and Vespula species), pose two distinct, time-critical threats to human life: immediate IgE-mediated anaphylactic shock within 5 to 30 minutes of even a single sting, and direct systemic venom toxicity (rhabdomyolysis, intravascular hemolysis, and acute kidney injury) evolving over 6 to 72 hours when a non-allergic person suffers more than 30 to 50 hornet or wasp stings (or hundreds of bee or fire ant stings). Equally critical are the mechanical behaviors of the insects themselves during the first 10 seconds of an attack: when someone steps onto a disturbed fire ant mound, thousands of worker ants swarm silently up the ankles and calves before releasing an alarm pheromone that triggers simultaneous stinging. Jumping into a swimming pool or spraying a garden hose onto legs covered in live fire ants is a classic mistake: water does not wash imported fire ants off skin; instead, it triggers every ant on the limb to clamp down firmly with its mandibles and pivot in a circle to sting 5 to 8 times around that anchor point. If anyone attacked by fire ants, hornets, wasps, or bees develops throat tightness, wheezing, dizziness, widespread hives, or suffers dozens of stings across the body, call your local emergency numbers immediately and administer an epinephrine auto-injector if available (allergic reactions and anaphylaxis). Also review our sibling guides on bee and wasp stings and acute kidney injury and rhabdomyolysis.

Your immediate priority is to move rapidly away from the mound or nest, briskly brush fire ants off the skin dry using a cloth or bare hand before applying any water, never pop or squeeze the white sterile pseudopustule blisters that form 24 hours after fire ant stings, and seek mandatory hospital blood and urine monitoring for delayed muscle breakdown (rhabdomyolysis) and acute renal failure after any mass hornet, wasp, or bee attack exceeding 20 to 50 stings, even if the victim feels completely stable during the first few hours.

Do this now¶

1. Assess for immediate Anaphylaxis and inject intramuscular Epinephrine (0.3 mg adult / 0.15 mg child into the mid-outer thigh) without delay if any systemic allergic sign appears, then call your local emergency number. Dial 911 in the United States and Canada, 000 in Australia, 111 in New Zealand, 112 across the European Union, 999 in the United Kingdom, 119 in Japan and South Korea, or check our global directory of emergency numbers if the person develops hoarseness, throat tightness, stridor, wheezing, shortness of breath, generalized hives, lip or tongue swelling, lightheadedness, abdominal cramping, or collapse. If symptoms do not improve within 5 to 10 minutes, inject a second epinephrine auto-injector in the opposite thigh.
2. For a Fire Ant Mound Swarm: step 5 to 10 meters (15 to 30 feet) away from the mound immediately, and BRISKLY BRUSH the ants off your skin and socks DRY with a towel, shirt, or bare hands BEFORE using any water. Imported fire ants cling to skin and fabric using tarsal claws and powerful mandibles. Spraying a hose or jumping into water causes the ants to bite down immediately and sting repeatedly while submerged. Slap and sweep them off with rapid, firm downward strokes, and strip off ant-covered shoes and socks immediately (since ants trapped inside sock weave continue stinging for minutes).
3. For a Hornet, Yellowjacket, or Africanized Bee Swarm: run in a straight line to an enclosed building or vehicle (never jump into water, and never stand still swatting at the air), protecting your face and neck with your shirt. Swatting crushes attacking hornets or bees, releasing volatile isopentyl acetate and 2-pentanol alarm pheromones that recruit hundreds more defenders straight to your face. Do not dive into a pond or swimming pool: hornets and Africanized bees hover over the water surface for 15 to 45 minutes and sting your face, eyes, nose, and mouth every time you surface for air.
4. Once all live fire ants or hornets are off the skin, wash the stung areas with soap and cool water, remove all rings and watches, and apply a wrapped ice pack (15 minutes on, 15 minutes off). Elevate swollen hands, feet, or legs above heart level to limit massive local inflammatory edema, and take an oral non-sedating H1 antihistamine (such as cetirizine 10 mg or fexofenadine 180 mg) plus ibuprofen or acetaminophen for pain.
5. NEVER pop, scratch, or lance the white pus-like blisters (pseudopustules) that appear 8 to 24 hours after fire ant stings. Those white blisters are 100 percent sterile chemical necrosis caused by non-protein solenopsin piperidine alkaloids, not a bacterial infection. Popping or scratching them strips off the sterile epidermal roof and introduces Staphylococcus aureus (MRSA) or Streptococcus pyogenes, leading to severe secondary cellulitis, lymphangitis, and permanent scarring.
6. Go straight to a hospital emergency department after ANY mass stinging event (over 20 to 50 hornet or wasp stings, over 50 to 100 bee stings, or any multi-sting attack in a child or older adult), even if the person has zero allergy symptoms. Mass hornet and wasp venom contains mastoparan, phospholipase A1/A2, and melittin that directly dissolve skeletal muscle fibers (rhabdomyolysis) and red blood cells (intravascular hemolysis), causing silent, fatal acute kidney injury (AKI) and hyperkalemia 12 to 48 hours later unless early intravenous fluid resuscitation is started.

Decision tree: fire ant swarm vs mass hornet/bee attack and rhabdomyolysis triage¶

flowchart TD
    A["Hymenoptera swarm attack: Fire Ants, Hornets, Wasps, or Bees"] --> B{"Any signs of Anaphylaxis? (Wheezing, throat tightness, hives, dizziness, vomiting)"}
    B -->|Yes: Immediate Anaphylaxis| C["Inject IM Epinephrine 0.3 mg (0.15 mg child) mid-outer thigh + Call EMS + lie flat with legs elevated"]
    B -->|No immediate allergy signs| D{"Which insect caused the attack?"}
    C --> E["Repeat Epinephrine in 5 to 10 min if no improvement; still screen for mass venom toxicity in ED"]
    D -->|Imported Fire Ants (Solenopsis invicta / richteri)| F["Step away from mound; BRUSH ANTS OFF DRY briskly; strip off shoes and socks; NEVER spray water first"]
    D -->|Hornets (Vespa mandarinia / velutina), Yellowjackets, or Paper Wasps| G["Run indoors or into closed vehicle; do NOT swat or jump in water; stingers are smooth (rarely left in skin)"]
    D -->|Honeybees or Africanized Bees (Apis mellifera)| H["Run indoors; scrape barbed venom-sac stingers out sideways within 30 seconds with credit card"]
    F --> I["Wash with soap and water; wrapped ice pack; leave 24-hr sterile white pseudopustules INTACT (never pop)"]
    G --> J{"How many stings occurred?"}
    H --> J
    I --> K{"Over 50 to 100 ant stings in infant/frail elder, or expanding redness after Day 2?"}
    K -->|Yes| L["Urgent medical evaluation for systemic toxicity or secondary bacterial cellulitis"]
    K -->|No| M["Home care: topical 1% hydrocortisone, oral cetirizine, keep pseudopustules covered and unpopped"]
    J -->|Over 20 to 30 Hornet/Wasp stings OR over 50 to 100 Bee stings (fewer in children)| N["MANDATORY Hospital ED Admission even if patient feels fine"]
    J -->|Fewer stings, mild local swelling only| O["Wash with soap and water, wrapped ice pack, oral antihistamine + NSAID"]
    N --> P["Hospital Protocol: Aggressive IV crystalloids (target urine > 100 to 200 mL/hr) + serial CK, K+, Cr, LDH, Urinalysis for 24 to 48 hrs"]

Entomological and toxicological comparison: Fire Ants vs Giant Hornets vs Yellowjackets vs Honeybees¶

Understanding how each insect attacks and what its venom is made of explains why fire ant blisters are sterile alkaloid burns whereas hornet and bee venoms are water-soluble protein cocktails that destroy muscle and kidney tissue:

Imported Fire Ant (Solenopsis) Mound Swarms and Sterile Pseudopustules¶

Why Fire Ants Swarm Silently Up Your Legs Before Stinging Simultaneously¶

Red and Black Imported Fire Ants (Solenopsis invicta and Solenopsis richteri, native to South America and invasive across the Southern US, Australia, China, Taiwan, Japan, and Southern Europe) build dome-shaped earthen mounds without a central hole:

1. Silent Ascent and Alarm Pheromone: When a person steps on a disturbed fire ant mound, thousands of worker ants pour out and climb silently up shoes, socks, and bare legs for 5 to 10 seconds without stinging. Movement or the first ant's bite releases a mandibular alarm pheromone, causing hundreds of ants to bite down with their mandibles and drive their stingers into the skin at the exact same second.
2. Circular Bite-and-Pivot Pattern: Each ant pinches a fold of skin with its toothed mandibles (jaws) to anchor itself, then arches its abdomen downward and stings 5 to 8 times in a circle around its anchored head, leaving a circular rosette of tiny stings.

Why You Must Brush Fire Ants Off DRY Before Using Water¶

The 24-Hour White Blister (Sterile Pseudopustule): Why Popping It Causes MRSA Infections¶

Because 95 percent of fire ant venom consists of water-insoluble oily piperidine alkaloids (Solenopsins A, B, and C), stings produce a unique chemical blister:

1. Formation of the Sterile Pseudopustule: Solenopsin alkaloids lyse local dermal cells and recruit neutrophils. Within 8 to 24 hours, every sting evolves into a taut, 2-to-4-millimeter (0.08 to 0.16 inch) white or yellowish-white blister (pseudopustule) on a red base.
2. Why You Must Never Pop It: Microbiological cultures prove that an intact 24-hour fire ant pseudopustule is 100 percent sterile (containing liquefied necrotic cells, zero bacteria). If left intact and unpopped, the epidermis acts as a biological dressing and dries cleanly in 5 to 10 days. If you pop or scratch it open, you inoculate Staphylococcus aureus (MRSA) or Streptococcus into necrotic tissue, causing spreading bacterial cellulitis, lymphangitis, and permanent scars.
3. Home Care: Wash gently with soap and water, apply 1% hydrocortisone cream (or prescription topical steroids), use a wrapped ice pack and an oral H1 antihistamine (cetirizine or fexofenadine) to prevent scratching, and cover foot clusters with sterile gauze. Seek antibiotics if redness expands or pus drains after Day 2 to 3.

Mass Hornet, Wasp, and Bee Envenomation: Rhabdomyolysis, Hemolysis, and Renal Failure¶

Why 30+ Hornet Stings (or 50 to 100+ Bee Stings) Are a Toxic Emergency Even Without Allergy¶

Beyond single-sting anaphylaxis, hornet, wasp, and bee venoms are potent direct cellular poisons (myotoxins, hemolysins, and nephrotoxins). Receiving dozens of stings simultaneously from yellowjackets, paper wasps, the Asian Giant Hornet (Vespa mandarinia), Yellow-Legged Hornet (Vespa velutina), or Africanized Honeybees (Apis mellifera scutellata) delivers a systemic toxin load that attacks three systems over 6 to 72 hours:

1. Direct Skeletal Muscle Dissolution (Rhabdomyolysis): Hornet/wasp Mastoparan and Phospholipase A1/B and honeybee Melittin (50% of dry venom weight) and Phospholipase A2 insert into skeletal muscle fibers, dissolving cell membranes and dumping myoglobin, creatine kinase (CK) (rising from under 200 U/L to 10,000 to over 100,000 U/L), potassium, and phosphate into the blood.
2. Direct Red Blood Cell Destruction (Intravascular Hemolysis): Melittin, mastoparan, and phospholipases lyse red blood cells, flooding plasma with free hemoglobin, raising LDH and indirect bilirubin (jaundice), and causing hemoglobinuria.
3. Triple-Hit Acute Kidney Injury (Acute Tubular Necrosis): Filtered myoglobin and hemoglobin precipitate with Tamm-Horsfall protein in acidic urine to plug renal tubules with dark-brown pigment casts, compounded by renal vasoconstriction and direct tubular cytotoxicity.

Special Danger of the Asian Giant Hornet (Vespa mandarinia) and Vespa velutina¶

The Northern / Asian Giant Hornet (Vespa mandarinia), native to Japan (o-suzumebachi), Korea, China, Taiwan, Thailand, and India (body length 4.5 to 5.5 centimeters [1.8 to 2.2 inches], 6-millimeter smooth stinger), injects 1.5 to 3.0 milligrams of dry venom per sting (10 to 30 times a honeybee dose):

• Low Toxic Threshold and Bullseye Necrosis: As few as 10 to 30 Vespa mandarinia stings trigger Multiple Organ Dysfunction Syndrome (MODS): rhabdomyolysis, hemolysis, acute kidney injury, and acute liver necrosis (AST/ALT over 1,000 U/L). Each sting develops a sunken purple-black necrotic center (3 to 10 mm) surrounded by a pale ring and swollen red plaque, predicting systemic organ injury.
• Hornet Venom Sprayed Into Eyes (Hornet Ophthalmia): Giant hornets can spray venom into human eyes from 20 to 50 centimeters (8 to 20 inches) away, causing severe chemical keratitis and corneal opacification unless irrigated immediately for 15 minutes with water or saline.

Step-by-step Hospital Protocol for Mass Hymenoptera Envenomation (Over 20 to 50 Stings)¶

When a patient arrives after a mass hornet, wasp, or bee attack (defined clinically as 20 to 30+ hornet or wasp stings, 50+ honeybee stings in an adult, or 10 to 20+ stings in a child, older adult, or patient with chronic kidney disease):

1. Immediate Resuscitation and Anaphylaxis / Toxic Shock Stabilization (Hour 0)¶

• Administer Intramuscular Epinephrine (0.3 to 0.5 mg IM mid-outer thigh) immediately if any features of anaphylaxis, bronchospasm, laryngeal edema, or hypotension are present. In massive bee or wasp envenomation, melittin and mastoparan cause direct non-IgE mast-cell degranulation (anaphylactoid massive histamine release) that clinically looks identical to IgE anaphylaxis and responds to epinephrine, H1 + H2 antihistamines (IV diphenhydramine or cetirizine + IV famotidine), and IV corticosteroids (methylprednisolone 1 to 2 mg/kg).
• Rapidly scrape out all remaining honeybee barbed stingers: If the attack was by honeybees (Apis mellifera), systematically inspect the scalp, hair, neck, ears, eyelids, and clothing folds and scrape out every remaining barbed venom sac with a plastic card edge.

2. Aggressive Intravenous Crystalloid Diuresis to Prevent Pigment Nephropathy (Hours 0 to 48)¶

• Do NOT wait for serum creatinine to rise before starting IV fluids: Start aggressive isotonic intravenous crystalloid resuscitation (0.9% Normal Saline or Lactated Ringer's) immediately at 200 to 500 mL/hour (titrated to cardiovascular status), aiming to maintain a brisk urine output of over 100 to 200 mL/hour (2 to 3 mL/kg/hour in children). High tubular urine flow dilutes myoglobin and hemoglobin and flushes pigment casts out of the nephrons before they solidify.
• Urine Alkalinization: If serum Creatine Kinase (CK) exceeds 5,000 U/L or dark brown myoglobinuria or hemoglobinuria is present without hypocalcemia or severe alkalemia, clinicians often infuse isotonic sodium bicarbonate (150 mEq sodium bicarbonate in 1 L of D5W) to keep urine pH above 6.5, which inhibits Tamm-Horsfall protein precipitation with myoglobin and hemoglobin.

3. Mandatory Serial Laboratory Monitoring Schedule (Every 6 to 12 Hours for 24 to 48 Hours)¶

Because muscle and red blood cell lysis peaks at 12 to 36 hours, obtain baseline labs and repeat every 6 to 12 hours for at least 24 hours: - Rhabdomyolysis and Electrolyte Panel: Creatine Kinase (CK), Serum Potassium (watch for lethal hyperkalemia above 6.0 mEq/L), BUN and Creatinine, Calcium, Phosphate, Uric Acid, and Blood Gas. - Intravascular Hemolysis and Liver/Coagulation Panel: CBC with Hemoglobin and Platelets, Lactate Dehydrogenase (LDH), Indirect and Total Bilirubin, Haptoglobin, AST and ALT, PT/INR, aPTT, Fibrinogen, and D-dimer. - Urinalysis (Dipstick + Microscopy): Classic finding in rhabdomyolysis and hemolysis is a urine dipstick strongly positive (3+) for Blood (heme) with ZERO or very few intact red blood cells on microscopic examination, accompanied by dark tea-colored or reddish-brown urine.

4. Early Renal Replacement Therapy (Hemodialysis / CRRT / Plasmapheresis)¶

In severe Asian Giant Hornet (Vespa mandarinia) or massive (over 200 to 500) Africanized honeybee envenomations presenting with oliguric acute kidney injury, refractory hyperkalemia, metabolic acidosis, or fluid overload, nephrology and toxicology protocols initiate early Continuous Renal Replacement Therapy (CRRT), High-Flux Intermittent Hemodialysis, or Therapeutic Plasma Exchange (Plasmapheresis) / Hemoperfusion, which clears circulating myoglobin, free hemoglobin, inflammatory cytokines, and unbound venom toxins.

Regional emergency numbers and agency protocols¶

• United States and Canada: Dial 911 immediately for any anaphylaxis symptoms or mass stinging event (over 20 to 50 stings). Contact US Poison Control at 1-800-222-1222 or a Canadian Provincial Poison Centre for guidance on rhabdomyolysis and hemolysis monitoring following Africanized honeybee or giant hornet attacks.
• Japan, South Korea, China, and Asia-Pacific: Dial 119 in Japan and South Korea, 120 in China, 119 in Taiwan, 1669 in Thailand, 995 in Singapore, or 112 / 108 in India. Across East and Southeast Asia, stings by the Asian Giant Hornet (Vespa mandarinia / o-suzumebachi) are treated as high-priority medical emergencies; any patient with 10 to 20+ stings or necrotic bullseye sting lesions is triaged immediately to a tertiary hospital with ICU hemodialysis and CRRT capability.
• Australia and New Zealand: Dial 000 in Australia or 111 in New Zealand. Follow ANZCOR Guideline 9.4.3 (Envenomation from Tick Bites and Bee, Wasp and Ant Stings): administer intramuscular adrenaline (0.3 to 0.5 mg) immediately for anaphylaxis; for Australian Jack Jumper Ant (Myrmecia pilosula) or Green-Head Ant stings (which carry an exceptionally high rate of rapid anaphylaxis in Tasmania and southeastern Australia), keep the victim completely still and call 000 immediately. Report invasive Red Imported Fire Ant (Solenopsis invicta) mounds in Queensland and NSW to the National Exotic Environmental Pest Biosecurity Hotline (13 25 23).
• United Kingdom and European Union: Dial 999 in the UK or 112 across the European Union. Across France, Spain, Portugal, Italy, Belgium, and southern England, the invasive Yellow-Legged Asian Hornet (Vespa velutina) builds large high-canopy nests that trigger aggressive mass attacks when disturbed; seek immediate A&E or ED care for multiple stings or anaphylaxis.
• Central and South America (Brazil, Mexico, Colombia, Argentina): Dial 911 in Mexico, 192 / 193 in Brazil, or local EMS. For massive Africanized honeybee (abelha africanizada) attacks (over 50 to 100 stings), proceed immediately to a tertiary hospital emergency department for ICU hydration, dialysis, and equine apilic antivenom (soro antiapilico) where available.

Frequently asked questions¶

Why should you never spray water on your legs or jump into a pool when covered in fire ants?¶

Imported fire ants evolved in South American river floodplains where they survive water by clinging tightly together and biting onto solid surfaces. Spraying a garden hose or jumping into a swimming pool does not wash fire ants off your skin; instead, the water triggers every ant on your leg to clamp down immediately with its jaws (mandibles) and sting 5 to 8 times in a circle while underwater. Always step away from the mound and briskly slap and brush the ants off your skin and clothing dry with your hands or a cloth, and pull off ant-infested socks immediately before washing with soap and water.

Why is it dangerous to pop the white pus-like blisters that form a day after fire ant stings?¶

Unlike other insect venoms that are mostly water and protein, 95 percent of fire ant venom is an oily, water-insoluble piperidine alkaloid called solenopsin. Within 8 to 24 hours, solenopsin kills a tiny pocket of skin cells and white blood cells at each sting spot, creating a taut white blister called a sterile pseudopustule. Even though it looks like bacterial pus, the fluid inside is 100 percent sterile. If you leave the blister intact, the skin roof protects it and it dries up cleanly in a week; if you pop or scratch it open, bacteria like MRSA enter the dead tissue and cause severe spreading cellulitis and permanent scars.

How can 30 to 50 hornet or wasp stings cause kidney failure a day later in someone who isn't allergic?¶

Even if you have zero allergy to hornets, wasps, or bees, their venoms contain powerful cell-dissolving enzymes and peptides, such as mastoparan, melittin, and phospholipases, that act as direct muscle and blood toxins when injected in large doses (20 to 30+ giant hornet stings, 30 to 50+ yellowjacket or wasp stings, or 50 to 100+ honeybee stings). Over 12 to 48 hours, the venom dissolves skeletal muscle fibers (rhabdomyolysis) and red blood cells (hemolysis), flooding the bloodstream with potassium and dark brown myoglobin and hemoglobin proteins that clog the microscopic filtering tubules of the kidneys and cause acute renal failure.

Why shouldn't you jump into a pond or lake to escape a swarm of hornets or Africanized killer bees?¶

Hornets, yellowjackets, and Africanized honeybees are attracted to the dark visual target of your head and the carbon dioxide and alarm pheromones on your breath. If you dive underwater, the swarm simply hovers above the water surface waiting for you, and stings your face, eyes, nose, and inside your mouth every time you come up for air, leading to airway swelling and drowning. Instead, pull your shirt up over your head to protect your eyes and neck and run in a straight line into an enclosed house, building, or vehicle with windows rolled up.

How do you tell the difference between a normal Large Local Reaction to a wasp sting and a bacterial infection (cellulitis)?¶

Timing is the single best clue. Approximately 10 percent of people develop an exaggerated allergic swelling called a Large Local Reaction (LLR) after a wasp, hornet, or bee sting, where redness, warmth, and dramatic swelling expand to 10 centimeters (4 inches) or more over the first 24 to 48 hours. Because bacteria take 2 to 3 days to multiply in skin, massive swelling that peaks within the first 24 to 48 hours without fever or red streaks is almost always sterile venom inflammation (treated with elevation, ice packs, antihistamines, and a short course of oral steroids), whereas swelling and pain that newly worsen on Day 3 to Day 7 point to secondary bacterial cellulitis requiring antibiotics.

What should I do if a hornet sprays venom directly into my eyes without stinging me?¶

Several species of hornets (including the Asian Giant Hornet Vespa mandarinia and Vespa velutina) can spray liquid venom from their stinger tip into human eyes from up to 30 to 50 centimeters away. Hornet venom in the eye causes immediate agonizing pain, severe eyelid swelling, and chemical destruction of the cornea (hornet keratitis) that can permanently damage vision. Immediately flush the open eye under a gentle stream of clean tap water, bottled water, or sterile saline for a full 15 minutes and go straight to an emergency department or ophthalmologist for slit-lamp examination.

Sources and official guidance¶

• American Academy of Allergy, Asthma & Immunology (AAAAI) and American College of Allergy, Asthma and Immunology (ACAAI, United States): Stinging Insect Hypersensitivity: A Practice Parameter Update (anaphylaxis management, epinephrine auto-injectors, fire ant Solenopsis pseudopustule care, and Large Local Reactions).
• Centers for Disease Control and Prevention (CDC / NIOSH, United States): Venomous Insects (Bees, Wasps, Hornets, and Imported Fire Ants): First Aid, Swarm Escape, and Mass Envenomation Rhabdomyolysis Triage.
• Australian Resuscitation Council (ANZCOR, Australia and New Zealand): ANZCOR Guideline 9.4.3: Envenomation from Tick Bites and Bee, Wasp and Ant Stings (adrenaline protocols, Jack Jumper ant anaphylaxis, and ice pack analgesia).
• Japanese Society for Acute Medicine and Ministry of Health, Labour and Welfare (Japan): Clinical Management Guidelines for Vespa mandarinia (Giant Hornet) Stings, Cutaneous Necrosis, and Multiple Organ Failure / Rhabdomyolysis.
• World Health Organization (WHO) and National Health Service (NHS, United Kingdom): Clinical Guidance on Hymenoptera Envenomation, Anaphylaxis, and Acute Kidney Injury from Mass Stings.

Related guides¶

• Bee, wasp, and hornet stings first aid
• Allergic reactions, anaphylaxis, and epinephrine auto-injectors
• Acute kidney injury, rhabdomyolysis, and dark urine triage
• Spreading cellulitis, red lymphangitis streaks, and skin abscesses
• Emergency numbers by country