EPIDEMIOLOGY AND ETIOLOGYĮstimates of the prevalence of subjects who have experienced immediate systemic reactions to insect stings vary from 1% to 7% of the general population. Reproduced with permission from Brown SGA, J Allergy Clin Immunol 2004 (114):371-6. *Mild reactions can be further sub classified into those with and without angioedema SBP, systolic blood pressure LOC, loss of consciousness. Grading system for generalized hypersensitivity reactions Rarely, stings can cause other unusual manifestations that are more likely to be toxic than hypersensitivity reactions. those with respiratory or vascular compromise) constitute “anaphylaxis”. Systemic allergic reactions of rapid onset with lethal potential (e.g. This may reflect the tendency of severe sting reactions to involve older subjects. Hypotension appears to be more prominent in severe reactions to insect stings than in allergic reactions to foods. Recently WAO has proposed a classification aimed at standardizing reports of reactions to subcutaneous immunotherapy (Cox, Larenas-Linnemann et al 2010), More recently, Simon Brown described a three tier system (table 1) that aimed at describing the significance of features in terms of probability of evolution of hypoxia and/or hypotension. Systemic reactions have commonly been classified with the use of the four stage system of Ulrich Mueller, a modification of the system of Harry Mueller. These include cutaneous, mucosal, respiratory, cardiovascular, gastrointestinal and/or neurological involvement (see table 1). Most of these are immediate IgE-mediated allergic reactions and show the same range of features as other such reactions. Such events only threaten life if in close proximity to the airway.Ī small percentage of the population develops “systemic” or “generalized” reactions that extend beyond areas contiguous with the sting. A minority of persons will develop excessive local swelling, which may be either “immediate” (developing and peaking within 1-2 hours) or “delayed” (developing hours after the sting, increasing for 24-48 hours and resolving after 3-10 days). Most individuals will develop limited local swelling in response to a sting that is of nuisance value.
Allergic reaction to bumble bee sting skin#
Sensitization to insect venom refers to the presence of specific sensitivity to insect venom, most commonly mediated by IgE and demonstrable by skin testing or in vitro assay.Īllergy to insect venom refers to a clinical reaction to one or more stings that is greater than would be expected in the general population and results from specific sensitization to that venom. This article does not deal with other allergic reactions to inhaled or ingested insect components or products. In most regions, the former dominate and will be the prime topic here. This article is limited to discussion of reactions to insect stings and bites. Royal Adelaide Hospital and Institute of Medical and Veterinary Science Home: Education and Programs: Education: Allergic Disease Resource Center: Professionals: Allergy to Insect Stings and Bites Allergy to Insect Stings and BitesĪssociate Professor Robert (Bob) Heddle MBBS, PhD, FRACP, FRCPA
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