Kids with Sting Reaction Don't Always Go to Hospital

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.

The study, entitled "Allergic reactions to insect stings: Results from a national survey of 10,000 junior high school children in Israel" can be found in the May 2006 issue of the Journal of Allergy and Clinical Immunology (JACI), the peer-reviewed journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Insect sting is one of the most common causes of anaphylaxis (a severe and potentially fatal allergic reaction) worldwide and is frequently unrecognized by patients and their physicians. Yael Graif, MD, Rabin Medical Center, Petah Tiqva, Israel, and colleagues analyzed the results of a questionnaires 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%) of the children had been stung at least once. Of the children stung, 11.5% had a large, local reaction that lasted several days, while 6.5% had a mild systemic reaction with hives or angioedema (swelling), and 2.5% 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% of all children who were ever stung. The rate varied by the type of reaction - 10.4% with a local reaction, 7.5% with a mild systemic reaction, and 14.5% with a moderate-to-severe 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.

American Academy of Allergy, Asthma & Immunology (AAAAI)