Few kids with serious insect stings get needed care

Most children who suffer a serious allergic reaction to an insect sting are not taken to a hospital as they should be, a large study conducted in Israel suggests.

Researchers found that only 6 percent of children who’d ever been stung by a bee, wasp or hornet were taken to the emergency room. More importantly, just 14 percent of those who’d had a moderate to severe allergic reaction - including breathing problems, abdominal pain and loss of consciousness - went to the hospital.

That was little more than the 10 percent of children with localized skin reactions who were treated in the emergency room, according to findings published in the Journal of Allergy and Clinical Immunology.

Paradoxically, parents may find isolated skin reactions more distressing than the more serious, systemic allergic responses to insect stings, Dr. Yael Graif, the study’s lead author, told Reuters Health.

This is likely because the skin reaction can involve remarkable swelling and redness that persist for several days, according to Graif, of the Rabin Medical Center in Petah Tiqva.

But it’s the systemic allergic reactions that arise within an hour of the sting that can be severe or even life threatening. These signs and symptoms - caused by the immune system’s overreaction to the insect venom - can range from a relatively mild case of hives to serious problems, such as breathing difficulty, abdominal pain, a drop in blood pressure or loss of consciousness.

If a child has any of these more severe symptoms within an hour of the sting, Graif said, he or she should be taken to the nearest hospital immediately. Once the emergency has passed, the child should see an allergist for follow-up, the researcher added.

The study included more than 10,000 13- and 14-year-old schoolchildren in Israel who completed questionnaires on their history of insect stings, allergic reactions and hospital visits for treatment.

Overall, 56 percent said they’d been stung by a bee, wasp or hornet at least once and 4 percent of these subjects said they’d had moderate or severe systemic reactions. Twelve percent reported milder systemic symptoms, such as hives, while roughly 20 percent had large localized skin reactions.

A recent U.S. study found that most children (58 percent) with localized reactions received treatment at a hospital, Graif’s team notes. While only 31 percent who had a serious allergic response received hospital care.

Together, the researchers conclude, the studies highlight the low percentage of children with serious sting reactions who get the recommended care, and the relatively high number of mildly affected children who unnecessarily turn up at the emergency room.

SOURCE: Journal of Allergy and Clinical Immunology, June 2006.

Provided by ArmMed Media
Revision date: July 6, 2011
Last revised: by Janet A. Staessen, MD, PhD