In allergic subjects, the stings of bees, wasps and hornets can lead to anaphylactic shock with loss of consciousness: the treatment to reduce the risks
The throat that tightens, the heart that struggles, the eyes that are clouded. And then, the loss of consciousness. Sometimes, after a hymenoptera sting, for some people there is the risk of an excessive reaction, which goes far beyond the local pain and swelling.
Those at risk should speak to the allergist, knowing that there is the possibility of protecting themselves with a specific immunotherapy treatment. This is remembered by the experts who offer their advice in the “Punto nel vivo” campaign, sponsored by FederAsma and Allergie Onlus-Italian Patients Federation.
How to protect yourself
Bee, wasp and hornet stings are a more common problem than you think, especially in summer. In fact, in Italy, over 5 million people are stung by a bee, a wasp or a hornet every year.
Depending on the living environment and the type of activity, it is estimated that 56-94% of the adult population has been stung by a hymenoptera at least once during their life. Extensive local reactions, generally the alarm bell for allergy, are the mildest allergic reactions, characterized by intense and extensive swelling, with a wheal of at least 8-10 cm in diameter and lasting more than 24 hours. Systemic allergic reactions can affect various systems, such as the cutaneous-mucous system (e.g. hives hives spread throughout the body, swelling of the lips, eyelids), the respiratory system (e.g. difficulty breathing, bronchospasm) up to to anaphylactic shock with loss of consciousness.
The only real "life-saving" therapy for people allergic to hymenoptera venom is specific immunotherapy. At the present time, specific immunotherapy by injection is the only therapeutic device capable of effectively preventing systemic allergic reactions in the event of a new sting, with a protective efficacy of over 90% (for Vespidi venom even around 95% ). If performed for a minimum of 5 consecutive years, it remains effective even for many years after its discontinuation. Its importance is such that both European and International Guidelines have confirmed the need to continue it even during the Covid-19 pandemic.
Sars-CoV-2 virus vaccine can be made
For those being treated, the anti-Covid vaccination is not contraindicated. “Subjects with an allergy to hymenoptera venom can receive the anti-Covid vaccine – reassures Maria Beatrice Bilò allergist and campaign referent – because allergic reactions, even severe, from hymenoptera stings are not a contraindication to the vaccine.
However, it is important to provide patients with an allergy questionnaire that helps the clinician to stratify the risk of a reaction. From a concrete point of view, in the event that the subject has presented an allergic reaction from hymenoptera sting, other than anaphylaxis, the risk of developing an allergic reaction to the anti-Covid vaccine is comparable to that of the general population, therefore not it is necessary to implement any particular procedure and it is sufficient to keep the subject under observation for 15 minutes after vaccination. ". A previous stinging anaphylaxis of hymenoptera is also not a contraindication to the administration of the anti-Covid vaccine.
Vaccination can be performed as per standard procedure (in a normal vaccination environment), but with prolonged observation of 60 minutes. "Since there is a preferential association between severe anaphylactic reactions from allergy to hymenoptera venom and indolent systemic mastocytosis – continues Bilò – it is important, in subjects who have experienced a severe anaphylactic reaction, to exclude a possible clonal disease of mast cells. In the presence of both diseases, in addition to prolonged observation, it is advisable to perform premedication with an antihistamine and suggest that the patient take self-injecting adrenaline with him.
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