Insect Allergy

Insect allergy has been observed with an increase in insect bites with warmer weather. However, there are also insects that are very common in homes and buildings throughout the year. They do not need to bite or sting to cause an allergic reaction, it can trigger allergies and asthma in many people even though there is no contact or bite.

There are many different types of insects and “pest-like bugs” that can cause an allergic reaction. These types of insects are as follows:

Stinging insects

Bees, wasps, yellow jackets, and fire ants are the most common stinging insects that cause an allergic reaction. Most people stung by these insects can recover within hours or days, but in some people, this venom can trigger life-threatening allergic reactions.

Biting insects

Mosquitoes, kissing bugs, bedbugs, fleas and some flies are the most common biting insects known to cause an allergic reaction. Most people who have been bitten by insects complain of pain, redness, itching, soreness and minor swelling in the area around the bite. Rarely, insect bites can trigger life-threatening allergic reactions.

House pests

Insects that do not sting or bite, especially like cockroaches and insect-like dust mites, can also cause allergic reactions. These two bugs can be the most common cause of year-round allergies and asthma. Unlike a cockroach, a dust mite is too small to be seen with the naked eye. The waste and bodies of cockroaches and dust mites cause allergic reactions. It can also trigger asthma symptoms and asthma attacks.

Symptoms and Signs in Insect Allergies

Most people stung or bitten by insects suffer from pain, redness, itching and minor swelling in the area around the bite or sting. This is a normal reaction. Most people recover within hours or days.

The allergic reaction to insects that do not sting or bite, such as cockroaches or dust mites, is different. Symptoms may include sneezing, coughing, runny or stuffy nose, itching in the eyes, nose, mouth or throat. These symptoms can be confused with the common cold, but can last for weeks or months at a time. If you have asthma, an allergic reaction can trigger asthma symptoms or an asthma attack.

People can have a severe allergic reaction to insect bites or stings. A life-threatening allergic reaction (anaphylaxis) produces signs and symptoms that require immediate medical attention. Without immediate treatment, anaphylaxis can result in death. Symptoms usually include the skin or multiple organ systems (part of the body) such as the mouth, lungs, heart, and intestines. Some of the symptoms are:

  • Skin rash, itching or hives
  • Swelling of the lips, tongue, or throat
  • Shortness of breath, difficulty breathing, or wheezing (whistling when breathing)
  • Dizziness and / or fainting
  • Stomach pain, vomiting, bloating or diarrhea

Other serious but non-allergic reactions include:

  • It is a toxic reaction that occurs when the body reacts to insect venom like a normal poison. A toxic reaction can cause symptoms similar to an allergic reaction. Other symptoms include nausea, fever, fainting, seizures, shock, and even death.
  • Serum sickness is an unusual reaction to a foreign substance in the body. It can cause symptoms hours or days after the sting or bite. Symptoms include fever, joint pain, other flu-like symptoms, and sometimes hives.

Diagnosis in Insect Allergy

In a person with a known insect allergy, the presence of signs and symptoms of an allergic reaction following a sting or bite is typically sufficient to establish the diagnosis of an allergic reaction.

Anyone who is unsure whether they are allergic to stinging insects may consult an allergist / immunologist for testing. Skin tests and blood tests can be used to determine if you have a specific type of stinging insect allergy. Skin testing involves placing a sample of the insect venom above or below the top of the skin and observing the area for signs of an allergic reaction. The blood test involves a test called a radioalibororbent test (RAST) to determine the amount of IgE antibodies in the blood to a particular substance.

Treatment and Prevention in Insect Allergies

The top priority for the medical team is to maintain respiratory and blood pressure.

  • If you have difficulty breathing, oxygen can be given through a tube or face mask in your nose.
  • In cases of severe respiratory distress, a mechanical ventilator can be worn. This is temporary until the reaction becomes less effective.
  • If your blood pressure is too low, a vascular line will be placed.
  • Saline solution can be given intravenously to increase blood pressure.
  • If necessary, you can take medication to make your breathing easier and / or increase your blood pressure.
  • H1-type antihistamine like diphenhydramine is usually given by mouth or injection to reduce the histamine reaction. This will relieve itching.
  • Corticosteroids such as prednisone or methylprednisolone are usually given to reduce swelling and suppress the immune response.

Take precautions to prevent future insect bites.

  • Avoid nests or hives of stinging insects.
  • Do not use bright clothes or perfumes that can attract bees and wasps.
  • Stay calm and quiet around flying insects. Move slowly.
  • Use caution when eating or drinking outside, such as cooking or picnicking.

Immunotherapy in Insect Allergies

Anyone who has had a significant response to a stinging insect should be evaluated by an allergist for possible venom immunotherapy (allergy vaccines that develop immunity to insect allergy). Patients with pronounced sensitivity to insect venom and specific symptoms may receive allergy injection therapy for insect sting allergy. Allergic immunotherapy against stinging insects is almost 100% effective in these patients.

This type of treatment usually involves a gradually increasing dose of venom over 10-20 weeks. A maintenance dose is then given every four to eight weeks. Approximately three to five years later, the termination of the venom vaccine is considered. Three to five years of therapy provides long-term protection for most people. The risk of severe adverse reactions from this poison treatment is the least (less than 0.2%) and no deaths have been reported to date.