Insects and arachnids as elicitors of toxic and allergic reactions in Germany

Abstract

Bees and wasps are the main culprits in terms of severe allergic reactions to insects in Germany; venoms from both insects are available for specific immunotherapy (SIT). Therefore, it is important to differentiate reactions to venom from other animals. It is also necessary for the sake of targeted prevention to assign sting reactions of any kind to their causal agents. By searching Medline, it was possible to identify relevant elicitors of sting and bite reactions particularly in Germany and Europe. Not only Hymenoptera stings, but also bites and stings from other insects, as well as skin contact with insect components, can cause allergic and/or toxic skin reactions. Mosquitoes, horseflies, and thrips cause local reactions. Contact with some beetles may lead to blister formation and skin inflammation. Bed bugs are becoming an increasing problem in Germany too, and introduction into the domestic environment via luggage is possible. Although spider bites can also cause reactions in humans in Germany, reactions to lice and flea bites are more common. Some caterpillars have hair and bristles that act as a defense mechanism and cause not only skin reactions, but also respiratory reactions, including asthma attacks. Ants, particularly in the US and Australia, are relevant triggers of anaphylactic reactions. Hymenoptera stings are the most common cause of systemic allergic reactions, while ants also need to be borne in mind in tropical and subtropical countries. Other insects rarely cause anaphylactic reactions. In this part of the world, numerous other insects may be the cause of local sting reactions.