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Insect venom desensitization treatments save lives. That is why we must not forget about them even during the coronavirus threat. Who can a sting have a tragic ending? When is desensitization indicated?
Not every reaction after a wasp, bee or hornet sting is allergic, emphasizes prof. Marita Nittner-Marszalska from the Department and Clinic of Internal Diseases, Pneumology and Allergology at the Medical University of Wroclaw. In people who are not allergic to the venom, a typical reaction is pain, itching and a slight swelling at the site of the sting. Similar symptoms accompany a local allergic reaction.
Life-threatening allergic systemic reaction
A systemic allergic reaction is much more serious and may be mild (hives all over the body, reddening of the skin and itching), but it can also be dramatic and life-threatening.
In the latter case, there may be swelling of the lips, eyelids, neck, and the entire face, even though the site of the sting was distant, such as a foot or a finger. There may also be symptoms that are not associated with a sting at all, such as restlessness, abdominal pain or bronchospasm.
As prof. Nittner-Marszalska, people who have experienced such symptoms, should contact an allergist who will recommend observation of further reactions and determine what medications should be administered in the event of a sting.
Severe systemic reactions are deadly for allergic persons. “There is a feeling of obstruction in the throat, shortness of breath, coughing with wheezing, fainting, abdominal pain and even loss of consciousness” – says the allergist. In the most severe cases, anaphylactic shock may develop, requiring immediate specialist treatment.
- See also: Pollen allergy – how to deal with it?
Who is desensitization for?
According to the guidelines of scientific societies, both European and American, those people who developed very severe symptoms after an insect sting – breathing disorders due to swelling of the upper respiratory tract, bronchospastic dyspnoea, cardiovascular symptoms, should undergo specific allergen immunotherapy, i.e. desensitization.
“The decision in this case is unequivocal: such a patient should be immediately subjected to immunotherapy, because he has a very high risk that the next sting will cause an equally severe or more severe allergic reaction, threatening his life” – explains Prof. Nittner-Marszalska.
It is an inappropriate reaction of the human immune system to allergens that are quite abundant in the environment. This ailment is considered to be the most common in the modern world. In healthy people, allergens do not cause any symptoms or sensitization. The immune system is responsible for controlling whether foreign particles can adversely affect health and takes measures to protect the body.
As the allergist explains, specific allergen immunotherapy consists in administering a minimal amount of the allergenic substance in vaccines. As a result, the patient’s immune system slowly learns to tolerate the components of the venom.
Prof. Nittner-Marszalska points out that during the pandemic, desensitization to insect venom continues, because its discontinuation poses a very serious threat to the patient.
«In our center, immunotherapy with insect venom is performed regularly and its schedule has not changed. We have introduced a number of restrictions: we make an appointment with each patient for a specific time – so that patients do not meet in the waiting room as before. Everyone is wearing masks, and the staff additionally wear helmets and double gloves »- emphasizes the specialist.
Death after an insect sting
There is currently no precise data on how many people lose their lives as a result of a severe allergic reaction to an insect sting. The mortality rate is not high, but experts point out that the statistics based on documented cases may be understated, as the actual cause is not established for some deaths.
Severe allergic systemic reactions may mimic cardiovascular reactions, infarction, and stroke.
He explains that the most severe reaction, i.e. anaphylactic shock, is characterized by the fact that sometimes without skin symptoms, e.g. swelling, there is a sudden drop in blood pressure, which entails such consequences as, for example, heart problems, loss of consciousness, breathing disorders. . “So if the blood pressure has already dropped and the patient is unconscious and we do not know what happened, then we have to differentiate this situation from many other health situations” – he adds.
Another problem is that the onset of a severe allergic reaction is difficult to predict. Occasionally, the patient may not have had any symptoms of allergy after a sting in the past, and may develop a life-threatening reaction as a result of another.
“So if the patient is unaware of his predisposition and the stings develop fatal symptoms of anaphylaxis, it is difficult to associate their cause with the sting” – admits prof. Nittner-Marszalska.
Patients of all ages, both children and seniors, are eligible for immunotherapy. It is important to perform detailed tests not only for allergies, but also for additional diseases that may affect the safety of immunotherapy.
Desensitization has two stages: initial and maintenance. The first stage may last several hours or several weeks, but always results in tolerance to the venom dose, which is then administered every 4-6 weeks during the maintenance phase for three to five years.
According to prof. Nittner-Marszalska, the initial phase of immunotherapy is the most difficult stage of treatment and should be carried out in a hospital specialized center that provides immediate help in the event of complications. «Any side effect that occurs after an injection must be recorded and controlled. After a few hours the initial desensitization process is completed »- describes the specialist.
As he emphasizes, allergen immunotherapy is an effective and safe treatmentprovided that it is used by an experienced allergist. Full protection against a dangerous reaction to wasp venom can be obtained in 90–100 percent. patients, and in the case of bee venom allergy – in more than 80%.
“It is worth emphasizing that the world has not yet reported a single death due to immunotherapy” – emphasizes prof. Nittner-Marszalska.
Hospital treatment with insect venom vaccines is reimbursed in Poland. We have a well-developed network of venom immunotherapy centers with allergists who specialize in diagnosing and treating children and adults with allergies to stinging insects. “The patient should have no problems getting to the center close to his place of residence” – sums up prof. Nittner-Marszalska.
The campaign “Break with allergy – choose health” is conducted under the patronage of the Polish Society of Allergologists and the Polish Federation of Associations of People with Asthma, Allergies and COPD.
See also:
- What is an indication for allergy testing?
- What is an allergy?
- Throat protection in spring and summer
Author: jjj/ zan/ PAP
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