Everything you want
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Advice and recommendations
for patients from EAACI experts

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Insect venom


The following recommendations may help you prevent an insect sting:

  • At outdoor work, it is recommended to wear a brogue and tight fitting clothes with long sleeves and trouser legs.
  • The colour of textile materials should be light and their surface smooth.
  • At picking fruits or flowers, leather gloves should be worn.
  • No sweet food (e.g., fruits, sweeties, sugary drinks) should be consumed during outdoor activity.

Sting risk is increased within a distance of less than 10 m to the insects nest. To reduce that risk, a variety of measures are helpful:

  • Wearing of protective clothing with nets and gloves;
  • Nests should not be jarred.
  • Hectic movements should be avoided.

In case of a sting, the following measures are recommended:

  • Immediate removal of the stinger, if it is still in place;
  • The site of the sting should be covered, e.g. by hand, to prevent evaporation of alarm pheromones, which could attract other insects and stimulate them to sting.

The decision to start SIT for bee or wasp venom allergy is based on a history of a systemic sting reaction and on findings demonstrating a sensitization to the venom of the culprit insect. Specific immunotherapy is mandatory for patients who have experienced sting reactions with respiratory or cardiovascular symptoms. SIT is also urgently recommended for patients who only present with mild systemic sting reactions limited to the skin, but who simultaneously show specific, individual risk factors. Moreover, if quality of life is reduced, SIT can be performed in all patients with systemic immediate type sting reactions independently from the severity grade of the sting reaction. Only for children with mild reactions confined to the skin SIT is not mandatory.

In most patients, SIT can be stopped after three to five years, if SIT and a re-sting were tolerated without systemic reactions. If there is no tolerance or if a patient presents with individual risks, a decision has to be made as to whether SIT should be continued or not. Life-long SIT is indicated for some patients, e.g. for those with mastocytosis or in case of a prior sting reaction requiring cardiopulmonary resuscitation.