Insect venom allergy

Summer is the time of year when insecticide allergy sufferers most often come into contact with allergens that cause allergies. The most common allergies to insects are honey bee allergy, wasp allergy and bumblebee allergy. As the name already indicates, honey bee allergy is an allergy to the honey bee, which is widespread in our latitudes, and wasp allergy is usually an allergic reaction to certain folds of wasps. Of course, allergies to other insects are also possible, but these are rather rare in our latitudes.

The blooming time of summer is also the most allergenic time for allergy sufferers, because when everything is blooming and sprouting outside, the allergy-causing insects are also on the move and therefore late spring, summer and early autumn are the most dangerous times of the year for insect venom allergy sufferers.

The sting of a wasp, a bumblebee or a bee is already not particularly pleasant in general. It becomes even more unpleasant if you also suffer from an insect allergy. The sting alone causes itching, swelling and redness in all people, because the insect injects a poisonous mixture into our skin during the sting, which is not tolerated. This completely normal immune defense of humans without allergy increases exponentially in allergy sufferers - in some cases this can even be life-threatening. In German-speaking countries, up to 5% suffer from an insect venom allergy.

As in numerous other cases, a genetically determined allergy is most likely. This means that one is particularly allergic to insect venom if the predisposition for it is already embedded in our genes. If your father, mother or siblings suffer from an allergy to insect venom, then you should definitely consult a doctor and get tested.

The cause of the allergic reaction is the sting of the insect itself. The allergens (the substances that trigger the allergy) are found in the poison cocktail that insects secrete under the skin when they sting. The venom enters the bloodstream directly during the sting. The body immediately reacts to these foreign substances with its immune defence. In a non-allergic person, this immune defense is recognized by the fact that the site of the sting begins to itch, that it reddens and that small wheals form. The allergy sufferer, however, shoots with cannons at sparrows, so to speak, in the case of an insect bite. This can lead to serious symptoms such as shortness of breath and asthmatic attacks. The life of the allergy sufferer can be in danger.

Which allergens trigger the allergic reaction?

• The allergens that enter the bloodstream during a bee sting are phospholipase A, mellitin and hyaluronidase.
• In wasps, the allergens hyaluronidase, phospholipase A, and wasp-specific phospholipase B trigger the allergy.

As you can see, bees and wasps share two allergens, so people with insect venom allergies can be allergic to bee stings and to wasp stings.

The venom of hornets, to which people can also be allergic, is very similar to that of wasps.

The first insect sting does not have to be accompanied by noticeably severe symptoms. An allergy to insect venom may also become apparent after the second or third sting.

In the case of a second or third insect bite, however, the antibodies of our immune system recognize the allergens immediately. The so-called IgE antibodies (immunoglobulins antibodies, these are special proteins with which the immune system fights off foreign pathogens) cause the body to release histamine and other signal substances. The histamine released in the body is the main trigger for the allergic inflammatory symptoms. Swelling and redness occur at the injection site. Symptoms can occur within a few seconds, but also after up to 30 minutes.

We already know that our body should react harmlessly to the substances of the poison cocktail, which are harmless in and of themselves. However, in the case of an allergy, it does not. With allergy sufferers, everything from a compensated "normal" reaction of the body, such as a stronger swelling of the injection site and stronger itching, to respiratory distress and allergic shock (which can have serious consequences) can occur. The severity of the reaction can be divided into the following categories:

• Grade 0: Here there is a severe local reaction at the injection site. The swelling can spread and become as big as the palm of your hand. There is severe itching and redness.
• Grade I: In a Grade I reaction, the body reacts with severe itching, nausea, hives, and possibly anxiety.
• Grade II: In a Grade II reaction, the same reactions occur as in a Grade I reaction, except that swelling develops on the lips and eyelids. In addition, there is a feeling of pressure in the chest and there may be shortness of breath, nausea, vomiting, dizziness, abdominal pain and diarrhea.
• Grade III: Grade III reaction combines the above symptoms with difficulty swallowing, hoarseness, drowsiness and severe weakness.
• Grade IV: Grade IV reaction is an allergy shock reaction in which collapse may occur. Blood pressure drops, lips turn blue, you are no longer in control of your bodily functions, which can lead to unconsciousness.

It can be particularly dangerous if you are experiencing allergic shock, which can cause life-threatening symptoms: Anaphylactic shock forms the strongest reaction in an insect venom allergy, because the venom spreads throughout the organism within a very short time.

In case of an allergic shock, it is essential to take the affected person to hospital as soon as possible.

Tingling and burning sensations in the throat and on the tongue can be a first indication of an allergic shock, then the symptoms progress to the classic signs. One suffers from shortness of breath, nausea, headache, dizziness and cardiovascular problems. This is immediately followed by more severe general reactions, manifested by convulsions, racing heart, drop in blood pressure, feeling of weakness, increased anxiety and narrowed airways with shortness of breath, nausea, vomiting, eventually leading to unconsciousness.

Do not hesitate to call the rescue - the allergy sufferer must receive medical treatment as soon as possible.

After a detailed anamnesis of the patient, the diagnosis is made. This involves a so-called severity classification, so that it can be determined whether an insect venom allergy is actually present. The allergy test reveals which insect venom triggers the allergy in the allergy sufferer.

The so-called prick test has proven to be particularly suitable. In this test, the doctor applies insect venom to the forearm of the person affected and observes the reaction of the skin. If symptoms occur, one can assume that one is suffering from an allergy.

If one is still not sure after the medical history and the prick test, then a RAST test (Radio Allergo Sorbent Test) can be used. The blood of the allergy sufferer is examined in this test to determine exactly which substances trigger the allergy.

If you have an insect allergy, it is essential to find out what to do if you have been stung and what long-term measures you can take.

In the form of hyposensitisation, the symptoms of an allergy can be reduced. It is also important to try to avoid a sting in the first place. In case of an allergy, it is always nice to have an emergency kit at hand in order to be able to react quickly to a possible sting.

The kit contains, among other things, a fast-acting antihistamine, which is supposed to regulate the histamine output in the case of an allergic reaction. The active ingredients cortisone and adrenaline, in the form of sprays and pre-filled syringes, are also available in such a kit. Ask your doctor or pharmacist about the correct use of the emergency kit, so that you can use it correctly and, above all, quickly in the event of an insect bite.

What can you do if you have been stung by an allergy-causing insect?

First and foremost, keep your cool! Even if you do not have an allergy, an insect sting (bee, wasp or bumblebee sting) is a serious matter. If children have been stung, try to calm them down with explanatory words and immediate action.

• Remove the sting as quickly as possible with clean tweezers. Be careful not to destroy the venom gland that may still be attached, or more venom will be released into the bloodstream.
• Cold water or ice should keep the swelling down.

Long term ways to contain an allergy!

Hyposensitization is the best long-term way to manage an insect allergy. This allergy treatment, also known as specific immunotherapy, aims to contain and minimize the effects of certain allergens in your body.

The insect venom is injected under the skin of your upper arm during hyposensitization to create immunity to the insect venom. The duration of a treatment varies with the intensity of the allergy. In the case of a stronger allergy, the insect venom allergy therapy takes longer than in the case of a rather weak allergy: the effectiveness of the standard treatment is up to 95 percent. Especially in children, hyposensitization is often performed because it leads to a long-lasting protection against allergic reactions. However, one must definitely reckon with a treatment period of at least 3 years.

Take preventive measures if you suffer from an insect venom allergy. There are some things you can do to prevent an allergic reaction. You should always explain these measures, especially to children.

What can you do to prevent an insect bite - here are some helpful tips:

• When playing, doing chores or working in the garden, take extra care when in the immediate vicinity of flowers and shrubs. Wear long-sleeved clothing and a head covering. You should avoid intensely scented perfume or holding a fruit in your hand.
• Walking barefoot is the new trend, but you should avoid it at all costs. Footwear is an ideal protection for you!
• Don't forget to put insect repellent on yourself and your children when doing outdoor activities.
• If you sweat after exercising or sunbathing, shower thoroughly right away, as sweet sweat attracts insects.
• Don't leave unwrapped food out in the open - this is a prime target for insects, and you'll defend it with your life if you have to. The same goes for the garbage can, it should always be kept tightly closed.
• Hairspray, perfume and creams should be applied sparingly on balmy summer days.
• Refrain from wearing clothes that are too colourful, as these can also attract insects.
• An absolutely important point is that if you come into contact with a wasp, bee or bumblebee, you should remain calm. Just like that, insects do not sting in and of themselves. They only sting when you feel attacked. So no waving, jumping, screeching and running away when a bee comes near you.