From Israel, Sting Operation: Puttin’ the Hurt on Hospitals


Only a fraction of children who are stung by insects and exhibit moderate to severe symptoms of an allergic reaction receive treatment at a hospital, according to a new study headed up by an Israeli physician.

The study, titled "Allergic Reactions to Insect Stings: Results From a National Survey of 10,000 Junior High School Children in Israel," also highlights the great difference between Jewish and Arab children in allergic reactions.

The results can be found in the current issue of the Journal of Allergy and Clinical Immunology, the peer-reviewed journal of the American Academy of Allergy, Asthma & Immunology.

Insect stings are some of the most common causes of anaphylaxis (a severe and potentially fatal allergic reaction) worldwide, and are frequently unrecognized by patients and their physicians.

Yael Graif, M.D., of the Rabin Medical Center in Petach Tikvah, Israel, and colleagues analyzed the results of a questionnaire completed by more than 10,000 Israeli children ages 13 and 14 to see how often they had been stung by insects, how severe a reaction they had to the sting, and if they were treated at a hospital.

Honey-bee and yellow-jacket stings were the most common; more than half (56.3 percent) of the children had been stung at least once. Of the children stung, 11.5 percent had a large, local reaction that lasted several days, while 6.5 percent had a mild systemic reaction with hives or angioedema (swelling), and 2.5 percent reported a moderate-to-severe systemic reaction with difficulty breathing, asthma attack, abdominal pain or loss of consciousness. Arab children also had significantly more allergic reactions of all three types than Jewish children.

The emergency department was visited by 5.8 percent of all children who were ever stung. The rate varied by the type of reaction – 10.4 percent with a local reaction, 7.5 percent with a mild systemic reaction.

According to Graif, researchers recommend that all patients with a severe reaction to an insect sting should be hospitalized for observation for at least 24 hours.

Graif and colleagues concluded that as in other countries, and despite good access to care, Israeli children with moderate-to-severe allergic sting reactions do not seek the medical attention that they should. They also noted standardized international studies might be useful in setting guidelines for prevention of the stings, education and care.

The AAAAI is the largest professional medical-specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease.

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