Abstract | BACKGROUND: The jack jumper ant (Myrmecia pilosula) is responsible for greater than 90% of Australian ant venom allergy. However, deaths have only been recorded in the island of Tasmania. OBJECTIVES: We sought to determine the prevalence, clinical features, natural history, and predictors of severity of M pilosula sting allergy in Tasmania. METHODS: We performed a random telephone survey supported by serum venom-specific IgE analysis, review of emergency department presentations, and follow-up of allergic volunteers. RESULTS: M pilosula, honeybee (Apis mellifera), and yellow jacket wasp (Vespula germanica) sting allergy prevalences were 2.7%, 1.4%, and 0.6% compared with annual sting exposure rates of 12%, 7%, and 2%, respectively. Similarly, emergency department presentations with anaphylaxis to M pilosula were double those for honeybee. M pilosula allergy prevalence increased with age of 35 years or greater (odds ratio [OR], 2.4) and bee sting allergy (OR, 16.9). Patients 35 years of age or older had a greater risk of hypotensive reactions (OR, 2.9). Mueller reaction grades correlated well with adrenaline use. During follow-up, 79 (70%) of 113 jack jumper stings caused anaphylaxis. Prior worst reaction severity predicted the likelihood and severity of follow-up reactions; only 3 subjects had more severe reactions. Venom-specific IgE levels and other clinical features, including comorbidities, were not predictive of severity. CONCLUSIONS:
Sting allergy prevalence is determined by age and exposure rate. M pilosula sting exposure in Tasmania is excessive compared with that found in mainland Australia, and there is a high systemic reaction risk in allergic people on re- sting. Prior worst reaction severity (Mueller grade) and age predict reaction severity and might be used to guide management.
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Authors | Simon G A Brown, Rodney W Franks, Brian A Baldo, Robert J Heddle |
Journal | The Journal of allergy and clinical immunology
(J Allergy Clin Immunol)
Vol. 111
Issue 1
Pg. 187-92
(Jan 2003)
ISSN: 0091-6749 [Print] United States |
PMID | 12532117
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Allergens
- Ant Venoms
- Myr p I
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Topics |
- Allergens
(immunology)
- Ant Venoms
(immunology)
- Humans
- Hypersensitivity
(epidemiology)
- Prevalence
- Severity of Illness Index
- Tasmania
(epidemiology)
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