Insects, 20 deaths a year from stings: how to prevent anaphylactic shock

Summer and autumn are the risk periods

Insect bites can lead to anaphylactic shock. The summer and autumn months are the riskiest periods of the year for insect bites with stingers: wasps (including the oriental one, increasingly common in Italy), hornets, bumblebees and bees. For allergy sufferers, there is the risk of death as sadly testified by the most recent news events. It is possible, however, to avoid the worst consequences.

“Thanks to desensitizing immunotherapy it is possible to prevent anaphylactic shock and therefore also the deaths linked to insect bites”, explains Alessandro Fiocchi, head of Allergology at the Bambino Gesù pediatric hospital in Rome, where – reports a nora – it is possible to undergo the desensitizing procedure dedicated to children and young people diagnosed with a serious allergy to the venom of these insects. In the last year and a half, there have been 625 visits to the emergency room of the Roman hospital due to hymenoptera bites.

It is important to be able to distinguish a normal reaction from an allergic reaction, reads a note. Different insects with sting when they sting inject harmful substances that cause burning, redness, pain and itching. These are completely normal reactions if localized at the site of the sting and if limited in extent, severity and duration. Instead, we speak of allergy to insect venom when the local reaction is excessive: too extensive, severe and lasting. In some cases, a large part of an arm or leg is affected, the swelling reaches a maximum peak within 48 hours and can last up to 7-10 days. Sometimes fever (slight rise in body temperature), fatigue and nausea also occur.

Hymenoptera stings trigger allergic reactions in about 2 out of 100 people. Fortunately, the phenomenon is much less frequent among children than in adults. However, 5 to 20 people (adults and children) die every year in Italy precisely because of insect venom. From January last year to July of this year – recalls the note from the Child Jesus – the last hospital ward recorded 625 accesses for insect bites with stingers: 386 in 2022 and 239 in the first 7 months of 2023.

What to do in case of an insect bite? It is important – experts recommend – to remove the sting immediately (within 20 seconds), if it is visible, with a quick and dry movement (using nails or tweezers). After the first 20 seconds the operation will be less useful because all the poison will have now been released into the body. After the sting, it is advisable to apply something cold (ice, cold packs) to the affected area and possibly an analgesic (pain reliever). It is also possible to give an antihistamine by mouth and apply a cortisone ointment topically. Your doctor will prescribe oral cortisone-based anti-inflammatory therapy for 3-7 days if necessary.

In the event of a suspected allergic reaction, it is essential to contact a doctor or emergency room as soon as possible and, subsequently, plan a specialist visit to the allergist. He will carry out an interview and a series of tests with the aim of verifying whether it is really an allergic reaction, identifying the insect that caused it and verifying the existence of allergic sensitization towards the the venom of one or more insect species. Subsequently, the specialist will prescribe ready-to-use drugs to be used in case of further allergic reactions triggered by insect bites.

Desensitizing immunotherapy, which must be carried out exclusively in a highly specialized allergy center and under strict medical observation – the paediatricians continue – is a sort of ‘vaccination’, it is a life-saving therapy for all children and young people at high risk of anaphylactic shock or of medium-high intensity allergic reactions. It consists in the subcutaneous inoculation of increasing doses of the poison of the insect to which one is allergic, starting from extremely low doses. In this way the organism progressively ‘gets used’ to the poison until it reaches a tolerance threshold which prevents serious reactions in the event of an accidental sting. “The vaccine must be continued for at least 3 years and the effect is usually maintained for many years, but the treatment is fully effective as early as the 12th month: if the child is stung accidentally, he no longer risks anaphylactic shock”, warns Fiocchi. At the Bambino Gesù – concludes the note – there is a clinic dedicated to the diagnosis and treatment of allergies to insect venom which can be accessed by your pediatrician. There are 20 patients currently being followed by the hospital for desensitizing immunotherapy.