Abstract
Allergic reactions to Hymenoptera venoms represent potentially life-threatening conditions. However, studies on their prevalence in Germany and their relation to specific IgE sensitization are rare. The aim of this study was to evaluate the prevalence of Hymenoptera venom allergy as well as the frequency of venom-specific IgE sensitization in a large population-based adult German cohort. Questionnaire data were collected from the participants of the German population-based KORA (Cooperative Health Research in the Region of Augsburg) S4 baseline study population (n = 4,261) and the follow-up F4 study population (n = 3,074), which was conducted seven years later. Moreover, sIgE antibodies to honeybee (HBV) and yellow jacket venom (HJV) as well as to common aeroallergens were measured in the S4 study population. The prevalence of systemic sting reactions ranged between 2.3 % and 2.6 %. sIgE sensitization (≥ 0.35 kUA/L) to HBV and YJV was demonstrated in 23.1 % and 31.7 % of the population, respectively (41.6 % to HBV and/or YJV). Double-sensitization to both venoms occurred in 13.2 % of the individuals. Approximately 53 % and 77 % of the individuals who reported shock symptoms after honeybee and yellow jacket stings, respectively, exhibited sIgE ≥ 0.35 kUA/L to the culprit venom. In contrast, only 2.8 % of the venom-sensitized individuals reported symptoms exceeding local reactions. Local reactions were reported by 4.4 to 4.8 % of the population. Self-reported Hymenoptera sting reactions and venom sensitization are frequent in the general German population. In many cases, sensitization and clinically relevant allergy are not observed in the same individual, indicating that comprehensive diagnostic approaches are a prerequisite for the identification of patients at risk for severe reactions.
Highlights
Stings by Hymenoptera species are very common; 56.6–94.5% of the general population have been stung at least once in their lifetime [1]
The prevalence of systemic sting reactions ranged between 2.3% and 2.6%. sIgE sensitization (≥0.35kUA/L) to honeybee venom (HBV) and yellow jacket venom (YJV) was demonstrated in 23.1% and 31.7% of the population, respectively (41.6% to HBV and/or YJV)
In this study we addressed sIgE sensitization to honeybee venom (HBV) and yellow jacket venom (YJV) of the participants of the population-based Cooperative Health Research in the Region of Augsburg (KORA) S4 baseline study (n = 4261)
Summary
Stings by Hymenoptera species are very common; 56.6–94.5% of the general population have been stung at least once in their lifetime [1]. In venom-allergic individuals already one sting can induce severe systemic reactions and even fatal anaphylaxis. The estimated number of annual mortalities ranges from 0.03–0.45 per one million inhabitants [1] This number could be underestimated as many fatal reactions following insect stings might remain undetected [3]. It was reported that in adults (>18 years) 48.2% and in children 20.2% of cases of severe anaphylaxis are caused by insect stings [4]. Of note, as these data are based on the reporting of physicians, many of whom are not familiar with the existence of such databases, this information might be strongly biased
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