Newswise — Although allergies to stinging insects are more common, allergic reactions have been reported following many different types of arthropod bites, primarily "kissing bugs" (Triatoma), flies, or mosquitoes.
"Allergic reactions to insect bites require immediate medical attention," said Richard D. deShazo, M.D., chair of the ACAAI Insect Hypersensitivity Committee and an allergist at University of Mississippi Medical Center, Jackson, Miss. "Most people are not allergic to insect bites but need to be able to recognize the difference between an allergic reaction and a normal or large local reaction.
"People who know they are allergic should never be without an emergency kit containing epinephrine (adrenaline). If you experience any symptoms of an allergic reaction for the first time from an insect sting or bite, get to an emergency room right away," Dr. deShazo said.
These symptoms include hives, itchiness, swelling in areas other than the insect bite site, difficulty breathing, dizziness, hoarse voice and swelling of the tongue. In severe allergic reactions, called anaphylaxis, the person can lose consciousness and can have cardiac arrest.
"In the western and southwestern United States, Triatoma bites appear to be an important cause of anaphylaxis," said John E. Moffitt, M.D., also an allergist at University of Mississippi Medical Center, Jackson, Miss. "Since their bite is usually painless and inflicted during sleep, the victim may not be aware of the bite, and resulting allergic reactions may not be diagnosed or mistakenly attributed to other causes. The lack of commercial antigen limits diagnostic and treatment capabilities."
"Personal protection measures from kissing bugs involve avoidance where possible and use of pesticides approved for indoor use. Prevention of bug entry into homes may involve outdoor light management and sealing entry points around the home," he said.
"Blankets and sheets should be examined for Triatoma. Removal of piles of paper, clothing and other clutter from the bedroom may reduce hiding places. Since the bugs rarely bite covered skin, wearing of pajamas with long legs and sleeves is recommended. Some also recommend the use of insect repellants on exposed skin before sleep," Dr. Moffitt said.
Most people who get mosquito bites develop small, itchy skin reactions that last for a few hours or a few days. These reactions are caused by the saliva the mosquito injects into the skin at the time of the bite, according to F. Estelle R. Simons, M.D., an allergist at the University of Manitoba, Winnipeg, Canada.
"Increased IgE antibody to mosquito saliva develops in people with mosquito allergy, causing more severe reactions at the sites of the mosquito bites," said Dr. Simons. "These allergic reactions, such as a large red swelling, a skin blister, bruise, or hives, may last for a week or more. Rarely, severe acute allergic reactions involving many body systems may occur."
Steps to prevent mosquito allergy include avoiding mosquito-infested areas, wearing protective clothing, eliminating standing water on surrounding property, keeping window and door screens in good condition, avoiding scented products and using mosquito repellants. Although repellents containing DEET continue to be highly effective, the Centers for Disease Control and Prevention (CDC) updated guidance to include the addition of two active ingredients " picaridin and oil of lemon eucalyptus, which have been shown to offer long-lasting protection against mosquito bites.
Patient information on insect venom allergy, anaphylaxis and allergy shots is available by calling the ACAAI toll free number at (800) 842-7777 or visiting its Web site at http://www.acaai.org.
The ACAAI is a professional medical organization comprising nearly 5,000 qualified allergists-immunologists and related health care professionals. The College is dedicated to the clinical practice of allergy, asthma and immunology through education and research to promote the highest quality of patient care.
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