463 Efficacy of Immunotherapy With Allergenic Extract of Aedes Aegypti in the Treatment of Large Local Reaction to Mosquito Bites in Children

Abstract

BackgroundAllergic reactions to insects are a global problem. The objective of this study was to assess the efficacy of immunotherapy with allergenic extract of Aedes aegypti for the treatment of large local reactions (LLR) to mosquito bites in children.MethodsExperimental, comparative, prospective, longitudinal and randomized none blinded study was conducted. We included 2 to 15 year old children with a history of large local reactions to mosquito bites. Sensitization was confirmed by a positive prick test. One group was treated with subcutaneous immunotherapy with extract of Aedes aegypti during 5 months and a second group received only antihistamine as needed. Diary symptoms and medication use were recorded in each case. The presence of adverse reactions to immunotherapy was also documented.ResultsA total of 35 patients from August 2009 to September 2010. Twenty-eight patients completed the study (16 male were included, with mean 7 ± 2.5 years) 15 in the immunotherapy group and 13 in the control group. The immunotherapy group showed a decrease in the diameter of the wheal and flare as well as the duration of the reaction and the use of drugs, from the third month of treatment, compared with the control group (P < 0.001).ConclusionsOur results suggest that immunotherapy with extract of Aedes aegypti, could modify the natural history of LLR to mosquito bites in children. Additional studies are needed to determine the optimal length treatment of the scheme and its long-term effects.

Sensibilidad y especificidad de la prueba cutánea por punción con dos concentraciones del extracto estandarizado de Culex quinquefasciatus en niños alérgicos

“…Algunos autores consideran que el término alergia a la picadura de mosquito debe reservarse únicamen-te cuando el paciente tenga reacciones locales grandes, atípicas o sistémicas. [6][7][8] El diagnóstico de alergia a la picadura de mosquito se obtiene a través de una anamnesis minuciosa y un examen físico detallado, aunado a la detección in vivo o in vitro de IgE específica a los alergenos del mosquito. 1,6,7 La prueba cutánea por punción es el método menos costoso, más rápido y práctico para detectar hipersensibilidad tipo I a los alergenos del mosquito.…”

“…Los parámetros de eficacia para las dos concentraciones del extracto de Culex quinquefasciatus fueron mayores que los reportados (16 a 42%) en otros estudios, [6][7][8] lo que pudiera deberse al método diagnóstico seleccionado como referencia, que en este caso es el diagnóstico clínico basado en la aparición de síntomas relacionados con la picadura de mosquito y la determinación de IgE sérica específica a Culex quinquefasciatus. En Cuba, éste es el primer reporte de la sensibilidad y especificidad de dos concentraciones de un extracto del mosquito Culex quinquefasciatus.…”

“…No se realizaron pruebas de provocación a la picadura como patrón de referencia, lo que constituye una limitación de nuestro estudio; aunque, como otros autores, se utilizó el antecedente de alergia a la picadura de mosquito por historia clínica y la determinación de IgE sérica. 1,[6][7][8] Se obtuvo el consentimiento por escrito de los padres o tutores de los pacientes, previa información de las particularidades y riesgos del estudio. Además, se obtuvo el consentimiento de los pacientes incluidos mayores de ocho años.…”

Associations between meteorological variables, vector indices and dengue hospitalizations in Can Tho, Vietnam: a field survey

“…The larval density (LD) was defined as the number of larvae per household. To assess the productivity of different container types, relative pupal productivity was calculated by dividing the number of pupae in a given container by the total number of pupae in all containers in the study area as described in [12].…”

Omalizumab for prevention of anaphylactic episodes in a patient with severe mosquito allergy

“…The few existing studies regarding mosquito venom immunotherapy (VIT) are limited to little groups and have used whole-body extracts. [10][11][12][13] Their results were promising, but it has to be noted that their primary endpoint was reduction of local reactions and eventually even respiratory symptoms, that could depend, as previously mentioned, on mosquito body allergens. 10,11 .…”