Abstract
BackgroundHymenoptera venom sensitization in highly exposed individuals frequently requires risk assessment for future severe sting reactions. In this study, we determined the prevalence of Hymenoptera venom sensitization in individuals who hunt and fish and analyzed possible correlations between the severity of sting reactions and the IgE sensitization profile. MethodsIn this cross-sectional study, paper-based, self-filled questionnaires about previous insect stings and sting reactions were obtained from individuals who hunt and fish in Bavaria, Germany. Blood samples were taken and analyzed for the levels of tryptase, total IgE and IgE to honey bee (i1) and wasp (13) venom, the recombinant allergens rApi m 1, rApi m 2, rApi m 3, rApi m 5, rApi m 10, rVes v 1, rVes v 5, and the CCD marker molecule MUXF3. Odd ratios (ORs) for sensitization and anaphylaxis and Pearson's correlations for the different allergens were calculated. ResultsOf 257 participants, 50.2% showed a sensitization to honey bee venom (i1), and 58.4% showed sensitization to wasp venom (i3). A total of 98.4% of participants claimed to have been stung at least once. Anaphylaxis was reported in 18.7%, and a local sting reaction was reported in 18.3%. The highest sensitization rates were found for whole venom extracts, sensitization to any of the available recombinant allergens exceeded sIgE levels to honeybee venom (i1) in 28.5% and to wasp venom (i3) in 52.9% of participants. Participants with a history of more than 5 stings showed a higher risk for anaphylaxis. ConclusionsSensitization to Hymenoptera venom and their recombinant allergens are present in the majority of individuals who hunt and fish. Sensitization to distinct recombinant allergens does not necessarily affect the severity of sting reactions including anaphylaxis. A meticulous medical history of the number of previous stings as well as systemic reactions remains essential.
Highlights
Insect stings and sensitization to Hymenoptera venom are common in the general population.[1,2,3,4,5] different methods used for assessing sensitization make it difficult to compare different populations, sting frequency and sensitization rates in warm, southern countries seem to be higher than in countries with a cooler climate[3,4]: Studies from Sweden[3] and Denmark[1] showed sensitization rates of 9% and 15% respectively, while a study from Turkey[4] reported that 29% of the general population are sensitized
Our study has shown that individuals who hunt and fish have an elevated risk for insect stings, which we expected
Sensitization against honey bee and wasp venom was found in 50.2% and 58.4%, respectively, of hunting and fishing participants and was higher than in comparable previous studies,[7,28] that found 40% Hymenoptera venom sensitization in forest workers[7] and 40% honey bee sensitization in bee keepers.[28]
Summary
Insect stings and sensitization to Hymenoptera venom are common in the general population.[1,2,3,4,5] different methods used for assessing sensitization make it difficult to compare different populations, sting frequency and sensitization rates in warm, southern countries seem to be higher than in countries with a cooler climate[3,4]: Studies from Sweden[3] and Denmark[1] showed sensitization rates of 9% and 15% respectively, while a study from Turkey[4] reported that 29% of the general population are sensitized. Individuals who spend a lot of time outside, such as those who hunt and fish, are prone to repeated stings and have a very high risk of sensitization and venom allergy.[6,7,8]. A previous study that determined the risk of systemic sting reactions in individuals with “hitherto irrelevant sensitization” suggested that “sensitization to Hymenoptera venoms is common, but systemic sting reactions are rare".2. There is no known parameter that allows the forecast of the severity and risk in regard to future allergic reactions to Hymenoptera venoms based on sensitization profiles. Hymenoptera venom sensitization in highly exposed individuals frequently requires risk assessment for future severe sting reactions. We determined the prevalence of Hymenoptera venom sensitization in individuals who hunt and fish and analyzed possible correlations between the severity of sting reactions and the IgE sensitization profile. A meticulous medical history of the number of previous stings as well as systemic reactions remains essential
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