Venom immunotherapy for preventing allergic reactions to insect stings
Elremeli, M., Bulsara, M. K., Daniels, M., & Boyle, R. J. (2010). Venom immunotherapy for preventing allergic reactions to insect stings. Cochrane Database of Systematic Reviews, 11. doi:10.1002/14651858.CD008838
Insect sting allergy is a common cause of anaphylaxis and may be fatal. Reported allergy to insect stings is confined to insects from the order Hymenoptera which includes bees, wasps, and ants. The population-based prevalence of a history of Hymenoptera sting systemic reactions (SRs) is approximately 0.3% to 7.5% depending on the diagnostic criteria used (Bilo 2005). In children, and based on few studies, the prevalence rate of SRs is lower than in adults, ranging from 0.15% to 0.8% (Bilo 2009). The prevalence of systemic reactions to sting exposure among beekeepers is high and ranges from 14% to 32% (Muller 2005). The relative prevalence of SRs to different Hymenoptera species varies according to the prevalence of species which deliver potentially allergenic venom in the local region. For example, in South-Eastern Australia the jack jumper ant (Myrmecia pilosula) is a common cause of SRs (Brown 2003), in the Americas imported fire ants (species of the genus Solenopsis) are common, but in both Europe and North America SRs are most commonly caused by wasps (species of the genus Vespula) or honey bees (Apis mellifera) (Bilo 2005).
Although the incidence of insect sting mortality is low, ranging from 0.03 to 0.48 fatalities per 1,000,000 inhabitants per year (Antonicelli 2002; Bilo 2005), the true number is likely to be underestimated (Graft 2006). At least 40 to 100 fatal sting reactions occur each year in the US (Pumphrey 2000).