What are Insect Allergies?

Insect allergies are not uncommon.  In general, an insect can either bite or sting their prey.  The insect sting is usually more serious than the bite of an insect with regards to allergic reactions.  There are usually two types of untoward effects caused by insect bites and stings.

1. Local reactions:  Redness, swelling, itching, and/or pain at the site of the insect bite or sting are very common.  Mosquitoes, gnats, fleas, ticks, and spiders are the most common insects that cause local reactions in the Washington, DC, Northern Virginia, and Maryland metropolitan area.  These reactions are likely to result from an irritant response from the biological substances of the insect or venom on the skin and underlying tissues.  The symptoms usually begin within a few hours after the bite or sting and can last for several days.  Though the most bothersome effects resolve spontaneously, application of ice and mild topical corticosteroid agents like 1% hydrocortisone cream can control the inflammatory process.  Antihistamines may be helpful in the relief of itching.
2. Systemic reactions:  Stings from certain insects belonging to Hymenoptera order (e.g., honey bees, yellow jackets, white-faced hornets, yellow-faced hornets, and wasps can cause life- threatening immediate type hypersensitivity reactions (i.e., anaphylaxis) in susceptible individuals.  Venom from these insects contains protein antigens which interact with specific antibodies resulting in the release of a large number of chemical mediators into the blood stream.  These mediators adversely affect many organ systems in the individual causing serious and dangerous reactions.  The signs and symptoms usually begin within a few minutes after the sting and may rapidly progress unless promptly treated.

A skin testing procedure is available to identify the patients who are at risk for generalized systemic reactions.  For those who are susceptible to serious reactions, a treatment regimen to reduce their risk of life-threatening events after insect stings is available.  This desensitization protocol, also referred to as venom allergy shots or venom immunotherapy, is highly effective in minimizing the chances of future serious reactions to insect stings.  These patients are also prescribed an epinephrine self-injectable device (e.g., EpiPen, Auvi-Q, Adrenaclick) to carry for use in case of a systemic reaction following insect stings.  They are told to go to the closest emergency room, if they ever use their epinephrine self-injectable device.

One important note to add regarding insect bites is that they may transmit various infectious diseases to the intended target.  The following diseases have been associated with mosquito bites:  yellow fever, malaria, Zika virus, chikungunya, dengue fever, filariasis (elephantiasis), Western equine encephalitis, Eastern equine encephalitis, Japanese equine encephalitis, St. Louis encephalitis, Venezuelan encephalitis, La Crosse encephalitis, West Nile virus, Rift Valley fever, and Ross River fever.  Tick bites are associated with Lyme disease, mammalian meat allergy, Rocky Mountain spotted fever, Rickettsia helvetica spotted fever, tularemia, typhus, relapsing fever, babesiosis, tick paralysis, cytauxzoonosis, Crimean-Congo hemorrhagic fever, Colorado tick fever, Powassan virus, tick-borne meningoencephalitis, and ehrlichiosis anaplasmosis.

The board certified allergists at Black & Kletz Allergy are extremely knowledgeable in the diagnosis and treatment of insect bites and stings.  If you suspect a reaction from an insect, whether allergic or not, please do not hesitate to call us to schedule an appointment.