+
For Patients & Caregivers
For Healthcare Professionals
Welcome! Click here for Patient or Healthcare Professional content
✕
Are you a healthcare professional?

The information in this website is intended only for healthcare professionals. By entering this site, you are confirming that you are a healthcare professional.

Enter Site
✕
Are you a laboratory professional?

The information in this website is intended only for laboratory professionals. By entering this site, you are confirming that you are a laboratory professional.

Enter Site
✕

Venom allergy: living with the fear of a sting

For patients sensitized to the venom of stinging insects, being stung can be a very severe event.

Venoms from the Hymenoptera order of insects—commonly known as bees, wasps, and some ants—may cause systemic allergic reactions in some patients. These reactions, including anaphylaxis, can be severe and fatal even upon first exposure.1 Systemic reactions occur in only about 1% of children, compared with around 3% of adults.1 For those allergic to insect venom, the fear of a sting or bite has been reported to cause emotional distress, which can actually lead to a decrease in quality of life.1-3

After an initial sting, the immune systems of affected patients may respond by producing IgE antibodies. Any subsequent stings can trigger a more rapid inflammatory response. This IgE response, though, becomes a quantifiable way to understand and identify the insect to which a patient is allergic.1,4

 

Learn more about the systems and assays available to your lab >

Data shows that 20% of documented anaphylaxis is due to venom reactions.5 

Testing results are a valuable treatment decision-making guide

Once a patient’s specific venom sensitivities are identified through information gathered from a patient’s history of sting reactions and the results of specific IgE testing, a healthcare provider can begin to develop a short- and long-term treatment plan. Patients should immediately begin to avoid the insects likely to cause a reaction, including honeybees, yellow jackets, wasps, hornets, and fire ants. Long-term management can include a variety of strategies, including the use of antihistamines, injectable epinephrine, high-dose allergy injections, or targeted venom immunotherapy (VIT).6-10

VIT is most common, due to commercial availability. For patients with a sensitization to bee and wasp venom, making a distinction between cross-reactivity and genuine double-sensitization is critical.6 Up to 50% of venom allergic patients have positive whole allergen test results to both bee and wasp venom extracts.9 Successful VIT is more likely when treatment selection is based on specific sensitization to bee and/or wasp venom informed by testing with allergen components.7

 

Learn more about testing with allergen components >

Successful management of allergies to stinging insects

Successfully managing an allergy to stinging insects long-term requires effort on the part of the provider and the patient. Educating patients on the best ways to avoid the insects to which they are allergic lays the proper foundation. Patients may need to be referred to an allergist-immunologist, especially if they are at risk for a severe systemic reaction. These specialists can educate patients on emergency and preventative treatment for severe reactions and possibly order additional testing if coexisting conditions or allergies are suspected.

Appropriately utilizing a therapy that is specific to the patient’s allergies is the best way to avoid future reactions.1 For example, when used in the appropriate patients, VIT has the potential to reduce the risk for future systemic and local reactions and improve disease-specific quality of life.5 One study that looked at deaths from insect stings in patients with a history of previous reactions found that over 50% of the deaths could have been prevented with appropriate venom immunotherapy.3 These findings underscore the importance of testing to help identify the specific insect venoms a patient is allergic to and the development of a treatment plan based on those findings.

References

  1. Golden DBK. Insect Sting Anaphylaxis. Immunol Allergy Clin North Am. 2007;27(2):261–vii. 

  2. Oude Elberink JN, de Monchy JG, Golden DB, et al. Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy. J Allergy Clin Immunol. 2002;109:162–170.

  3. Bilo MB, Bonifazi F. The natural history and epidemiology of insect venom allergy: clinical implications. Clin Exp Allergy. 2009;39:1467-1476.

  4. Children's Minnesota. Chemistry: Allergen IGE, Wasp Venom. https://www.childrensmn.org/references/lab/chemistry/allergen-ige-wasp-venom.pdf

  5. Ludman SW, Boyle RJ. Stinging insect allergy: current perspectives on venom immunotherapy. J Asthma Allergy. 2015;8:75-86.

  6. Biló BM, Rueff F, Mosbech H, et al. EAACI Interest Group on Insect Venom Hypersensitivity. Diagnosis of Hymenoptera venom allergy. Allergy. 2005;60:1339–1349. 

  7. Bonifazi F, Jutel M, Biló BM, et al. EAACI Interest Group on Insect Venom Hypersensitivity. Prevention and treatment of hymenoptera venom allergy: guidelines for clinical practice. Allergy. 2005;60:1459-1470.  

  8. Müller UR, Johansen N, Petersen AB, et al. Hymenoptera venom allergy: analysis of double positivity to honey bee and Vespula venom by estimation of IgE antibodies to species-specific major allergens Api m 1 and Ves v 5. Allergy. 2009;64:543-548. 

  9. Spillner E, Blank S, Jakob T. Hymenoptera allergens: from venom to ”venome”. Front Immunol. 2014;5:1-7.

  10. Mittermann I, Zidarn M, Silar M, et al. Recombinant allergen-based IgE testing to distinguish bee and wasp allergy. J Allergy Clin Immunol. 2010;125:1300–1307.