Anaphylaxis from insect stings: an underestimated problem

Morbidity caused by anaphylaxis from Hymenoptera venom allergy is notable, as 1-3% of the general population has systemic reactions to stings by honeybees and vespids. Insect stings seem associated to a fatal outcome in less than 100 cases per year in the world, however these numbers are likely to be underestimated, as suggested by the detection of venom-specific IgE in blood from victims of sudden death of unknown origin. Also anaphylactic reactions appears, at least in some countries, undertreated. By retrospective analysis of 2244 cases of systemic reactions to insect stings we noted that epinephrine, the drug of first choice for anaphylaxis, was administered to only 15% of patients.