Allergy to biting insects.

Abstract

Allergic reactions to biting insects mediated by IgE antibodies are generally considered to be relatively uncommon. There are only a handful of convincing reports in the literature of reactions to bites of mosquitoes and fleas. A small number of cases of allergy to bites of other flies have been reported as well as 2 cases of bedbug allergy. The biting insect that was most commonly cited as causing the allergic reactions reported in the literature and in the Registry of Reactions to Insect Bites run by the Committee on Insect Allergy of the American Academy of Allergy and Immunology was the kissing bug (Triatoma spp, also called reduviid bug and cone-nose bug). 1 Two recent studies performed in a community that contained prime habitat for Triatoma demonstrated a prevalence of IgE antibodies against Triatoma protracta in 6.7% of the population studied. 2 In the same population 3.3% demonstrated IgE antibodies to honeybee and/or yellow jacket venom. 3 Most of the literature on biting insect allergy consists of case reports or summaries of uncontrolled clinical experiences, so that it is very difficult to evaluate critically. There are, however, classic studies of bite reactions in animals by Feinberg et al, 4 and modern scientific investigation of true allergy to flea bites in dogs is now being initiated. 5 In this review we will examine the following: how saliva (oral secretion) antigens can be obtained from biting insects; the normal spectrum of reactions to insect bites; a critical evaluation of reports of allergy to bites from various types of insects; biting insect allergens, the relationship to stinging insect allergy; and the treatment and prevention of reactions.