Bee Venom Allergy in Chinese Beekeepers and Patients Under Live Bee Apitherapy

Abstract

Background: Hymenoptera stings are one of the common causes of anaphylaxis. The prevalence of systemic allergic reactions seems to be higher in highly exposed populations such as beekeepers and individuals receiving live bee acupuncture (LBA). However, there are a very few of studies on venom allergy in these populations. We performed two observational studies to describe the characteristics and risk factors of venom allergy in beekeepers and the LBA population.Methods: A total of 99 beekeepers and 127 individuals receiving live bee acupuncture were interviewed. Skin prick tests were performed on subjects with suspected bee venom allergy.Results: The prevalence of bee venom allergy was 34.3% among beekeepers and 29.0% in the LBA population. Systemic reactions occurred in 11.3% of the LBA population, and 28.3% of beekeepers. For beekeepers with exposure to 2-4 stings per year and ≥5 stings per year, the risk for developing venom allergy increased to 6.745-fold (95% CI 2.139-21.266) and 42.297-fold (95% CI 7.060-253.399) respectively, compared to the ≤1 sting per year group. Conversely, in the LBA population, compared to frequency ≤2 LBA stings per week, the adjusted OR of venom allergy was 0.281 (95% CI 0.075-1.047) and 0.166 (95% CI 0.045-0.612) for frequency 3-6 LBA stings per week and ≥7 stings per week respectively. The knowledge of adrenaline and venom immunotherapy was limited in both beekeepers and traditional doctors.Conclusion: The frequency of stings with high risk for bee venom allergy was >4/year in beekeepers and <3/week in the LBA population. The education on anaphylaxis management should be strengthened.