Prevalence of Allergy to Hymenoptera Stings

Abstract

In this study, we evaluated the prevalence of systemic reactions to hymenoptera stings in an adult general population, 20-60 years old. The protocol included a standardized questionnaire, skin tests to venom in subjects reporting a history of systemic reaction, and, in subjects reporting a history of severe local and systemic reactions, as well as in a control group, a radioallergosorbent test (RAST) to hymenoptera venoms. According to the questionnaire, 1.2% of the study population had a history of systemic reactions. Only 0.85% had both such a history and a positive skin test to venoms. RASTs were positive, for at least one venom, in 57% of subjects with a history of systemic reaction, 15.8% of subjects with a history of severe local reactions, and 6.0% of the control group. In conclusion, this study shows that systemic reactions are not uncommon in the general population. RASTs tests are not sensitive or specific enough to be considered, per se, for indications of allergy to venoms.

Epidemiology of hymenoptera allergy

“…In the Busselton Health Survey [14], RAST was carried out on 2429 sera, positive results being obtained in 16%. At a public health care centre, whilst performing routine check-ups, we observed positive RASTs in 12 of 82 subjects (14-6%) with no history of large local reactions or systemic reactions following a sting [15]. In a group of 80 beekeepers, Bousquet et al [16] detected RAST class 2 or higher in 29 (36%).…”

“…This percentage is similar to the one computed for sting-induced systemic reactions. However, other publications have indicated much lower percentages: 43% RAST class 2 or higher according to Stuckey et al [14] and 26% RAST class 1 or higher according to Charpin et al [15]. The fact that the latter two surveys were carried out in large samples of the general population using a standardized questionnaire could account for these differences.…”

“…Large local reactions The prevalence of large local reactions varies widely from study to study: 17% according to Golden [18], 7-4% according to Charpin et al [15], and 31% according to Stuckey et al [14]. One problem in evaluating this prevalence with a retrospective questionnaire lies in eliminating non-allergic local reactions which are generally less extensive and do not last as long.…”

Diagnosis of venom allergy by flow cytometry. Correlation with clinical history, skin tests, specific IgE, histamine and leukotriene C4 release

“…(0.09–0.45 deaths per million within the general population). More frequently the clinical reaction observed after an hymenoptera sting is local or loco‐regional (2 to 19% of the general population) or systemic (0.8–3.9% of the general population) [ 1, 2], these frequencies being certainly underestimated.…”

Analysis of Hymenoptera Stings Reported to the Illinois Poison Center

“…The annual incidence of allergic reactions to Hymenoptera venom in the United States population is estimated between 0.3 and 4.0% of exposed persons (Chafee 1970, Settipane and Boyd 1970, Golden et al 1989, Charpin et al 1990, Fernandez et al 1999, Navarro et al 2004, Langley 2008, although it appears to vary by geographic region (Fernandez et al 1999, Antonicelli et al 2002. Research indicates that the estimated incidence of fatalities ranges between 0.09 and 0.45 per 1,000,000 persons suffering anaphylactic reaction (Charpin et al 1994, Langley 2005.…”