Insect venom allergy or insect allergy or sometimes wasp allergy is mostly triggered by stings from various insects in summer, late summer and sometimes still (in warm temperatures) in autumn. Not everyone is naturally allergic to these insect bites. However, those who are, expose themselves to a health risk. Since wasp venom or bee venom can cause life-threatening symptoms and discomfort in some allergy sufferers, you should take an allergy test with your doctor in time to take preventive measures to protect yourself against an insect venom allergy, if necessary.
What is insect venom allergy?
The prick test is an allergy test to check for allergic reaction to pollen or insect venom, for example. Here, possible allergic substances are dripped onto the skin, which is then lightly pricked with a lancet. After 20 minutes, the redness of the skin and the size of the wheal are assessed. In the case of insect venom allergy, the individuals in question are allergic to the sting of a bumblebee, a wasp, a bee, a hornet or other similar insects. If one of the mentioned insects feels threatened, the animals defend themselves with their sting, whereby the respective insect venom is injected under the skin and in the unfavorable case can trigger an insect venom allergy. Furthermore, there are also people who develop an insect venom allergy when bitten by an ant. An insect venom allergy is an overreaction to the ingredients contained in the venom. For normal people, a bite from the native insects is usually harmless. Usually, an insect venom allergy does not become noticeable until a repeated sting.
Causes
The cause of insect venom allergy is being stung by a poisonous insect. People who suffer from insect venom allergy are primarily allergic to the venom of wasps and bees. The stings of the great knot ant and bumblebees, on the other hand, cause a corresponding insect venom allergy much less frequently. In the case of honey bees, only the females are capable of causing an insect venom allergy through a sting. Unlike most other forms of allergy, genetic predisposition probably does not play a major role in the development of insect venom allergy. Responsible for the allergic reaction are various ingredients contained in the venom, which vary from insect species to insect species. However, there are very many people who are hypersensitive to both bee and wasp stings, since two substances responsible for insect venom allergy are found in the venoms of both insect species. Hornet venom has about the same allergenic composition as wasp venom. However, because hornets sting far less frequently, insect venom allergy is also much less common in this regard.
Symptoms, complaints and signs
In the case of an insect venom allergy, a swelling develops in the area of the insect bite, which is usually itchy and reddened around the sting. These symptoms are usually harmless and subside within a day. More serious is the body’s allergic reaction to the allergen. Allergic shock can affect the entire organism and in particular the respiratory tract, cardiovascular system and gastrointestinal tract. In the respiratory tract, there may be difficulty in swallowing and speaking, runny nose, shortness of breath and swelling. Reddened, watery and itchy eyes are also typical. In the circulatory system, heart palpitations, shortness of breath and dizziness set in, often accompanied by anxiety and panic attacks. In the gastrointestinal tract, symptoms such as nausea, vomiting and abdominal cramps occur. Exactly which symptoms and complaints occur depends on the type of allergen and the period of treatment. If the toxin is removed immediately, the symptoms subside after only a few days, while a severe course can lead to serious complications, sometimes with long-term consequences. In extreme cases, the allergy sufferer falls into a coma after a sting or suffers a heart attack. The first signs of an impending loss of consciousness are dizziness, visual disturbances and breathing difficulties.
Disease progression
In insect venom allergy, five different degrees are distinguished with regard to the course of the disease. In grade 0, a local swelling occurs that is larger than the area of a hand.Grade I insect venom allergy manifests as a mild general reaction, usually generalized hives, with nausea, anxiety, and itching. In Grade II insect venom allergy, the symptoms known from Grade I may occur, as well as lip swelling, shortness of breath, abdominal pain, vomiting, nausea, diarrhea, dizziness, and chest tightness. In Grade III insect venom allergy, severe general reactions are expected. In addition to the symptoms of grade II, the consequences of insect venom allergy may include difficulty swallowing, slurred speech, a feeling of weakness, drowsiness, hoarseness and fear of death. The most severe form of insect venom allergy is the shock reaction with an additional blue coloration of the lips, an unavoidable leakage of urine or stool, unconsciousness, drop in blood pressure and collapse (anaphylactic shock). Up to 20 people a year die from the causes of insect venom allergy in Germany alone.
Complications
In the worst case, an insect venom allergy can lead to death if it is severe and no medical treatment is given after the insect bite. If contact with insects is avoided, however, insect venom allergy does not lead to further discomfort or complications. Should a sting occur, patients suffer from various symptoms in most cases. There is swelling and burning pain at the site of the sting. Itching also occurs and the affected person may suffer from shortness of breath. It is not uncommon for circulatory shock to occur and the affected person may lose consciousness. The affected person often suffers from dizziness and anxiety, and it is not uncommon for panic attacks to occur. There is a feeling of tightness in the chest and often pain in the abdomen. For this reason, an insect bite should always be followed by treatment to prevent irreversible consequential damage. The treatment itself is carried out with the help of medication and does not lead to further discomfort or complications. With early treatment, the life expectancy of the affected person is also not affected by the insect venom allergy.
When should you go to the doctor?
Insect venom allergy can be life-threatening, so it is better for sufferers to see a doctor once too often rather than too little, especially if there are accompanying symptoms such as severe redness of the sting site, itching and wheal formation after an insect bite. An allergic reaction may also cause swelling of the face and neck, often accompanied by shortness of breath. In case of a sting in the mouth, a doctor must be consulted immediately. If, after an insect bite, the eyes water, the throat itches, the nose runs, in addition to symptoms such as dizziness, rapid heartbeat, chest tightness, nausea, vomiting, problems with swallowing and speech, and even impaired consciousness, it is imperative to call an emergency physician, as these could be signs of allergic shock. Allergic shock is life-threatening and can lead to circulatory failure with respiratory arrest. People suffering from an already diagnosed insect venom allergy usually carry an emergency kit. They should always carry this with them and inform people around them what to do in an emergency. If necessary, the doctor may also administer immunotherapy for desensitization.
Treatment and therapy
Insect venom allergy can be diagnosed by a blood and skin test. If the aforementioned symptoms occur after an insect bite, an allergist should be consulted immediately, as an insect venom allergy may be fatal. If an insect venom allergy is known, the affected person should always carry a liquid cortisone preparation, a liquid antihistamine and adrenaline as a ready-to-use syringe or spray in his or her own interest. Furthermore, insect venom allergy can be treated by immunotherapy. Such hyposensitization for insect venom allergy usually extends over three to five years. The success rate is about 90 percent. In the context of a rapid immunotherapy, however, a desired hyposensitization can be achieved after only a few days or weeks. Such a rapid method, however, requires constant monitoring by an allergist, as the risk of anaphylactic shock in the case of insect sting allergy is very high.
Aftercare
Individuals suffering from insect venom allergy require appropriate follow-up care. Immediately after treatment of the shock, various measures can be taken, depending on the type and severity of the allergy. Following an allergic shock that occurs as a result of an as yet undiagnosed insect venom allergy, referral is usually made to an allergist who will provide treatment and initiate further measures. The physician observes the course of the disease and can issue an allergy passport for newly diagnosed allergy sufferers. Based on the passport, a suitable medication can be administered to the patient quickly in an emergency. This emergency medication must be prescribed as part of the follow-up care. The allergist will also inform the patient about immunotherapy. The so-called VIT treatment makes the body tolerant to insect venom. Finally, a change in lifestyle is also part of the aftercare. Allergy sufferers should strictly avoid contact with insects and ensure that the emergency medication and allergy passport are always to hand. Affected children should be educated by parents about the risks and safety measures. Secondary and tertiary prevention will minimize the risk of recurrence of allergic shock. Follow-up care should be provided by the allergist, primary care physician, or other appropriate specialist.
Outlook and prognosis
The prognosis of insect venom allergy is usually favorable. The intensity, the extent of the insect venom allergy and the health of the affected person are decisive for the further course. In the case of very mild symptoms of poisoning, self-help measures are often sufficient to bring about relief from the symptoms. Removal of an insect sting and aspiration of the poison can already be sufficient to bring about relief from the symptoms. Recovery in these cases can be expected after the wound has healed. With increasing severity of physical impairments and health disorders, the need for medical care is necessary. With prompt and professional treatment, improvement occurs within a short period of time. In most cases, complete freedom from symptoms occurs within a few days. Medical care should be provided immediately, since it is difficult to predict, especially in the case of allergy sufferers, what physical reactions the allergy will lead to. In individual cases, an allergic shock reaction may occur. This potentially endangers life and therefore indicates a particularly unfavorable course of the disease. Since there is a possibility of a life-threatening development, it is necessary to consult a physician already at the first stronger irregularities or the increase of the complaints. If the affected person is subject to hyposensitivity, the risk of anaphylactic shock increases. Without special protective measures and adequate precautions, an emergency situation is imminent.
What you can do yourself
With an insect venom allergy, the first step should be to see a doctor. The medical professional will first diagnose the allergy and then issue the affected person with an allergy card. This should always be carried – as well as the emergency kit with cortisone, adrenaline and co. First and foremost, however, an attempt should be made to avoid contact with insects. Patients who are exposed to an increased risk of insect bites due to their occupation or circumstances are recommended to undergo hyposensitization. When walking outdoors, it is important to avoid “tempting” places for wasps, bees and co. In addition, long, light-colored, tight-fitting clothing and closed shoes should be worn. At home, it is best to install an insect screen. Special scents from the pharmacy that drive away the insects can be placed on the doors and windows. If, despite all precautions, an insect bite should occur, first aid must be administered immediately. First of all, the sting must be removed, then the puncture site should be cooled and covered. Anyone with a severe allergy should call the emergency doctor and use the emergency medication they brought with them. Further helpful tips are offered by the German Allergy and Asthma Association (Deutsche Allergie- und Asthmaverbund e.V.).