409 Analysis of 677 death certificates and 168 autopsies of stinging insect deaths

Nall, Thomas

doi:10.1016/0091-6749(85)90545-7

Cited by 16 publications

(5 citation statements)

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“…Fatal reactions to Hymenoptera stings are rare: they range from 0.09 to 0.48 per million inhabitants and year [31,32]. However, the true number may be underestimated: in one study, specific IgE antibodies to Hymenoptera venoms were detected in 23% of postmortem serum samples from patients who died outdoors from unknown reasons [33].…”

Section: Epidemiologic Aspectsmentioning

confidence: 99%

Insect Venoms

Müller¹

2010

Chemical Immunology and Allergy

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Insect venoms applied by stings of social Hymenoptera, like honey bees, vespids or ants aretogether with foods and drugs -the most frequent elicitors of anaphylaxis in humans. Besides taxonomy, the biology of the responsible social Hymenoptera is important: guidelines based upon its knowledge allow to reduce the risk of further stings in patients with a history of venom anaphylaxis. Epidemiology of venom anaphylaxis has special aspects with regard to prevalence, fatality and natural history. An estimated 200 individuals die every year in Europe from anaphylaxis following Hymenoptera stings. Most of the relevant venom protein allergens have been identified and many of them have been expressed in recombinant form. Proof of venom sensitization is based on skin tests with venoms and serum venom-specific IgE antibodies as standard diagnostic tests. Allergenspecific immunotherapy with Hymenoptera venoms is highly effective and therefore recommended for all patients with a history of Hymenoptera sting anaphylaxis and positive diagnostic tests with the respective venom. Frequent cross-reactions to venoms of different Hymenoptera species may cause difficulties in identifying the responsible species and the selection of the respective venom for immunotherapy.Insect venoms, together with foods and drugs, are the most frequent elicitors of anaphylaxis in men. The insect venom is applied by stings which must have occurred for more than 100,000 years, since human beings exist. Conflicts between stinging insects and humans occur while fighting for food, like honey or foods consumed outdoors, or while venomous insects feel threatened by human beings, most often near their nests. Taxonomy and Biology of Responsible InsectsVenoms causing anaphylaxis or other allergic reactions originate almost exclusively from social Hymenoptera, most often honey bees and vespids ( fig. 1) [1], occasionally from bumble bees [2], in America [3] and in Australia [4], also from ants. Stings by other insects like mosquitoes, bedbugs, fleas, horse flies and midges can very rarely also cause systemic allergic reactions. These are however not due to venoms but to

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Section: Epidemiologic Aspectsmentioning

confidence: 99%

Insect Venoms

Müller¹

2010

Chemical Immunology and Allergy

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“…Between 3 and 12% of the population have a history of large local or systemic allergic reactions following insect stings (Golden et al, 1989;Settipan & Boyd, 1970;Stuckey et al, 1982). Although fatalities from insect stings are rare, the annual number of deaths arising from Hymenoptera stings is estimated to be about 40-50 in the United States (Nall, 1985). Many Hymenoptera are capable of stinging, but only species belonging to the families Apidae (bees), Formicidae (ants) or Vespidae (wasps) regularly sting humans.…”

Section: Introductionmentioning

confidence: 99%

Structure of recombinant Ves v 2 at 2.0 Å resolution: structural analysis of an allergenic hyaluronidase from wasp venom

Skov

Seppälä

Coen

et al. 2006

Acta Crystallogr D Biol Cryst

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Wasp venom from Vespula vulgaris contains three major allergens: Ves v 1, Ves v 2 and Ves v 5. Here, the cloning, expression, biochemical characterization and crystal structure determination of the hyaluronidase Ves v 2 from family 56 of the glycoside hydrolases are reported. The allergen was expressed in Escherichia coli as an insoluble protein and refolded and purified to obtain full enzymatic activity. Three N‐glycosylation sites at Asn79, Asn99 and Asn127 were identified in Ves v 2 from a natural source by enzymatic digestions combined with MALDI–TOF mass spectrometry. The crystal structure of recombinant Ves v 2 was determined at 2.0 Å resolution and reveals a central (β/α)7 core that is further stabilized by two disulfide bonds (Cys19–Cys308 and Cys185–Cys197). Based on sequence alignments and structural comparison with the honeybee allergen Api m 2, it is proposed that a conserved cavity near the active site is involved in binding of the substrate. Surface epitopes and putative glycosylation sites have been compared with those of two other major group 2 allergens from Apis mellifera (honeybee) and Dolichovespula maculata (white‐faced hornet). The analysis suggests that the harboured allergic IgE‐mediated cross‐reactivity between Ves v 2 and the allergen from D. maculata is much higher than that between Ves v 2 and the allergen from A. mellifera.

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“…Long-standing morbidity due to myocardial or cerebral infarction may, however, occur, and fatalities have been reported from many countries [3,7]. The annual number of deaths due to Hymenoptera stings is estimated to be about 40 for USA [8], 10 for Germany [9], five for England [10], three for Switzerland [3], two for the Netherlands [11] and one for Denmark [12], but may in fact be considerably higher. This was at least suggested by several authors investigating post-mortem sera from sudden unexpected outdoor deaths [13,14], where IgE Correspondence: Dr U. Muller, Chefarzt, Medizinische Klinik, Zieglerspital, Postfach 8965, CH 3007 Bern, Switzerland.…”

Section: Introductionmentioning

confidence: 99%

Emergency treatment of allergic reactions to Hymenoptera stings

Müller

Mosbech

Blaauw

et al. 1991

Clin Experimental Allergy

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Allergic reactions to Hymenoptera stings are frequently observed all over Europe. Rarely they may induce long-standing morbidity or even be fatal. Several investigations have shown that the emergency treatment given to these patients is often inadequate. Cutaneous symptoms respond well to antihistamines and also to adrenaline. Adrenaline is the mainstay for outside hospital treatment of more severe reactions involving the respiratory tract (bronchial asthma, laryngeal oedema) and the cardiovascular system (anaphylactic shock). Inhaled adrenaline is especially useful in respiratory symptoms, while parenteral application of adrenaline is prefered for shock treatment. All patients with severe respiratory or cardiovascular reactions must be hospitalized, treated under intensive care conditions and observed for at least 24 hr. Emergency medications including adrenaline for inhalation or for self-injection must be given to all patients with a history of systemic allergic reactions to hymenoptera stings. These patients must also get instructions for safety measures to avoid further stings. They should be referred to an allergist in order to evaluate the indication for venom immunotherapy.

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409 Analysis of 677 death certificates and 168 autopsies of stinging insect deaths

Cited by 16 publications

References 0 publications

Insect Venoms

Insect Venoms

Structure of recombinant Ves v 2 at 2.0 Å resolution: structural analysis of an allergenic hyaluronidase from wasp venom

Emergency treatment of allergic reactions to Hymenoptera stings

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