General measures
- If stung, quickly remove the stinger (scrape away with fingernail).
- Please consider the preventive measures (see under prevention).
- Review of permanent medication due topossible effect on the existing disease.
Conventional non-surgical therapy methods
- Specific immunotherapy (SIT) with bee and wasp venom (hymenopteran venoms) (see “Hyposensitization” below)Subcutaneous specific immunotherapy for insect venom allergy (VIT, venom immunotherapy) is considered one of the most effective hyposensitization procedures worldwide. The average dosage of hymenoptera venom is 100 µg in children (50 µg if necessary) and adults. Indications for adults:
- Sting anaphylaxis of grade ≥ II or
- Severity I reactions and individuals from the risk group /see below increased risk of severe anaphylaxis).
It can be recommended SIT to all adult patients regardless of the severity of anaphylaxis. Indications for children:
- Repeated severe increased local reactions.
In children who developed exclusively systemic reaction of the skin (grade I), even in subsequent stings had systemic reactions again only in < 20%, without increasing the severity!Contraindications: serious immunological diseases, chronic infections or carcinomasDuration of SIT: 3-5 years (in special cases and in high-risk patients for life).
Training
- Counseling or training the patient to avoid further stings (see under Prevention) and on what to do if stung again.
