Allergic disease, Allergy Testing, Stinging Insect Allergy, Latex and
If you have been diagnosed with asthma or allergies, your physician will likely refer you to an allergist/immunologist for care. You may wonder: What is allergic disease? How can an allergist/immunologist help? This page is intended to provide information on allergic disease and on the role that an allergist/immunologist plays in the appropriate management and treatment of these diseases.
Approximately 50 million Americans suffer from some form of allergic disease. Allergic disease can develop at any age, and heredity plays a key role in who will develop it. If one parent has allergic disease, the estimated risk of the child to develop allergies is 48%, and the child's risk grows to 70% if both parents have allergies.
Symptoms of allergic disease are the result of events occurring in your immune system - the body's defense mechanism against harmful substances. The body of an individual with allergic disease identifies some substances, called allergens, as harmful. These substances, which are harmless to most people, trigger allergic reactions within that person's immune system.
When someone predisposed to allergic disease encounters an allergen to which they are sensitive, a chain of events occurs. The primary culprit instigating these events in people with allergies is an antibody called Immunoglobulin E, or IgE. IgE "defends" the body by seeking to remove the offending allergen(s) from the body's tissues and bloodstream. The first time an allergen enters an allergic person's body, IgE antibodies are produced in response. These antibodies then travel to cells called mast cells, attach themselves to these cells, and wait for the next time the allergen(s) enters the system.
When they do, the IgE antibodies "capture" the allergens, essentially removing them from circulation. The mast cells then assist further by releasing special chemicals called mediators. These mediators produce the classic symptoms of allergic reactions - swelling of body tissues, sneezing, wheezing, coughing and other symptoms. Due to the complexity of allergic disease, it is not yet fully understood why some substances trigger allergies and others do not, nor why every person does not develop an allergic reaction after exposure to allergens.
* Allergic rhinitis, or "hay fever." In the United States, approximately 35 million people suffer from this disease, which is characterized by sneezing, congestion, itching and dripping of the nose, and itchy, watery eyes.
* Asthma, a chronic lung disease characterized by coughing, chest tightness, shortness of breath and wheezing. Asthma affects more than 17 million Americans, and asthma cases appear to be increasing annually. Asthma symptoms may be triggered by allergens or other, non-allergic stimuli, such as respiratory tract infections, cold air or tobacco smoke.
* Sinusitis and otitis media, common allergic diseases often triggered by allergic rhinitis. Sinusitis is an inflammation of the nasal sinuses, which are hollow cavities within the cheek bones found around the eyes and behind the nose. This condition affects over 15% of the U.S. population. Otitis media - or common ear infections - is the most common childhood disease requiring physician care.
* Atopic dermatitis, also called eczema. Symptoms of this allergic skin condition include itching, reddening, and flaking or peeling of the skin. This rash is usually seen in young infants, but can occur later in individuals with personal or family histories of atopy, meaning asthma or allergic rhinitis.
* Urticaria, also known as hives, and angioedema. Hives are itchy, red bumps that appear on the surface of the skin. They can occur in clumps and range in size, and can be either chronic - appearing and disappearing for no reason - or acute. Triggers of acute hives include infection or ingestion of some foods or medications. Often appearing with hives, angioedema is a non-itchy swelling in the deeper layers of the skin.
* Anaphylaxis, a severe, systemic allergic reaction generally caused by substances that are injected or ingested (eaten), including some foods and medications, insect stings and latex. Symptoms can include a feeling of warmth, flushing, tingling in the mouth, a red, itchy rash, feelings of light-headedness, shortness of breath, severe sneezing, anxiety, stomach or uterine cramps, and/or vomiting and diarrhea. In severe cases, a drop in blood pressure results in a loss of consciousness and shock. Without immediate treatment - an injection of epinephrine (adrenalin) and expert care - anaphylaxis can be fatal.
An allergist/immunologist is a physician specially trained to manage and treat allergies and asthma. Becoming an allergist/immunologist requires completion of at least nine years of training. After completing medical school and graduating with a medical degree, a physician will then undergo three years of training in internal medicine (to become an internist) or pediatrics (to become a pediatrician). Once physicians have finished training in one of these specialties, they must pass the exam of either the American Board of Pediatrics (ABP) or the American Board of Internal Medicine (ABIM). Internists or pediatricians who wish to focus on the subspecialty of allergy/immunology then complete at least an additional two years of study, called a fellowship, in an allergy/immunology training program. Allergist/immunologists who are listed as ABAI-certified have successfully passed the certifying examination of the American Board of Allergy and Immunology (ABAI), following their fellowship.
As a result of this extensive study and training, an allergist/immunologist is the best-qualified medical professional to effectively manage the comprehensive needs of patients with allergic disease. Allergist/immunologists are trained in the prevention, diagnosis, and treatment of immune system problems such as allergies, asthma, inherited immunodeficiency diseases, autoimmune diseases and even AIDS. Unlike a cold, allergic disease is not a condition that someone can just "get over." The help of a trained allergist/immunologist can reduce how often patients need to stay home from work or school due to symptoms. Studies show that those under the care of an allergist/immunologist also make fewer visits to emergency rooms, and are better able to daily manage their allergies and asthma.
If you are enrolled in a managed care organization, your insurer will have a specific set of guidelines that help your primary care physician decide when to refer you to an allergist/immunologist. Once you are referred, the allergist/immunologist will work to accurately diagnose your condition by taking a thorough patient history, including information about your symptoms, family history, and home and work environments. Your allergist/immunologist will also conduct allergy skin testing and any other needed tests. Combining specific information from your history and tests, the allergist/immunologist will be able to make an accurate diagnosis. To help prevent symptoms, he or she will work with you to develop an appropriate management plan and will prescribe the most cost-effective treatment, including recommendations for particular medications and/or devices, and any needed environmental control measures. Your allergist/immunologist and allied health staff will not only prescribe medications and devices, but will also show you how and when to use them.
To ensure optimal care, patients with allergies and asthma must take an active role in their treatment by asking questions, learning about triggers of their condition, and understanding reasons for various methods of treatment. Open communication is a necessary, successful part of allergic disease management. As a patient, you may want to ask these questions:
* Is the physician who is treating me or my family specifically trained to make an appropriate diagnosis and provide effective management and treatment of allergic disease?
* Has my physician completed a fellowship in allergy and immunology?
* Does my physician regularly attend continuing medical education programs in allergy and immunology?
* What does the diagnosis and treatment of my allergies and/or asthma entail? What are my options? Do my symptoms meet insurance guidelines for allergy referral?
* Has the diagnosis and treatment plan my physician prescribed been proven effective by virtue of accepted standards for scientific evaluation?
You and your allergist/immunologist can work together so that you can make appropriate changes in your environment and take medications as prescribed. With appropriate diagnosis and effective management of your allergic disease, you should be able to experience the optimal quality of life that you deserve.
Your allergist/immunologist can provide you with more information on the management and treatment of allergic disease.
The content of this brochure is for informational purposes only. It is not intended to replace evaluation by a physician. If you have questions or medical concerns, please contact your allergist/immunologist.
American Academy of Allergy,
Asthma and Immunology
555 East Wells Street, Suite 1100
Milwaukee, WI 53202
AAAAI Web site www.aaaai.org
When your body comes in contact with a virus or bacteria the immune system protects your body by producing antibodies and other substances to fight off these invaders. An allergy or an allergic reaction is when the immune system recognizes a harmless substance as an invader and tries to protect the body from it. The antibody in this case that is produced is called immunoglobulin E, or IgE.
When IgE is produced it is specific to the allergen. What that means is if you are exposed to cat and your body mistakes it as something harmful to you your immune system produces anti-cat IgE antibody. If you are also allergic to dust your produce an IgE antibody to dust. Each time IgE is produced, the IgE molecules attach themselves to mast cells that are found in large numbers in the eyes, nose, lungs, intestines, and immediately beneath the skin. These mast cells contain many chemicals, including a substance called histamine which, when released into the body, can cause runny nose, sneezing, watery eyes, itching, hives, and wheezing. These are the symptoms that people who suffer from allergies live with.
In some cases, reactions can occur in several places throughout the body. Welts or hives may appear, spasm in the lungs may cause coughing or wheezing, the throat and tongue may swell; if anaphylaxis (severe allergic reaction) occurs, it may be fatal.
Avoidance is the best defense against allergies. At your first appointment we will be discussing methods you can use into your home to lessen the allergen in your environment. If you are unable to avoid the allergen, medications may be taken to relieve symptoms. Medications may help relieve symptoms, but they do not alter the allergy immune response. If symptoms cannot be controlled, allergy shots may be prescribed. Often people take allergy shots because they don't want to take medications every day. Allergy shots can put your allergies into remission. Read more about allergy shots on our website.
Tips to Remember are created by the Immunotherapy Committee of the American Academy of Allergy, Asthma and Immunology.
Seasonal allergic rhinitis, often referred to as "hay fever," affects more than 35 million people in the United States. These seasonal allergies are caused by substances called allergens. Airborne pollens and mold spores are outdoor allergens that commonly trigger symptoms during the spring and fall. During these times, seasonal allergic rhinitis sufferers experience increased symptoms-sneezing, congestion, a runny nose, and itchiness in the nose, roof of the mouth, throat, eyes and ears-depending on where they live in the country and the exact allergen to which they are allergic.
Pollens are the tiny, egg-shaped male cells of flowering plants. These microscopic, powdery granules are necessary for plant fertilization. The average pollen particle is less than the width of an average human hair.
Pollens from plants with bright flowers, such as roses, usually do not trigger allergies. These large, waxy pollens are carried from plant to plant by bees and other insects. On the other hand, many trees, grasses and low-growing weeds have small, light, dry pollens that are well-suited for dissemination by wind currents. These are the pollens that trigger allergy symptoms.
Seasonal allergic rhinitis in the early spring is often triggered by the pollens of such trees as oak, western red cedar, elm, birch, ash, hickory, poplar, sycamore, maple, cypress and walnut. In the late spring and early summer, pollinating grasses-including timothy, bermuda, orchard, sweet vernal, red top and some blue grasses-often trigger symptoms.
In addition to ragweed-the pollen most responsible for late summer and fall hay fever in much of North America-other weeds can trigger allergic rhinitis symptoms. These weeds include sagebrush, pigweed, tumbleweed, Russian thistle and cockleweed.
Each plant has a period of pollination that does not vary greatly from year to year. However, weather conditions can affect the amount of pollen in the air at any given time. The pollinating season starts later in the spring the further north one goes. Depending on where you live in the United States, the pollen season can begin as early as January (in the southern states). Generally, the pollen season lasts from February or March through October. Trees pollinate earliest, from late February through May, although this may fluctuate in different locations-starting in April in the northern United States to as early as January in the south. Grasses follow next in the cycle, beginning pollination in May and continuing until mid-July. Weeds usually pollinate in late summer and early fall.
Molds are microscopic fungi-related to mushrooms-but without stems, roots or leaves. Their spores float in the air like pollen, and are present throughout the year in many states. Unlike pollens, molds do not have a specific season, but are affected by weather conditions such as wind, rain or temperature. Outdoor mold spores begin to appear after a spring thaw and reach their peak in July in warmer states and October in the colder states. Molds can be found all year long outdoors in the South and on the West coast.
Common airborne molds include alternaria, cladosporium and aspergillus. Molds are present in almost every possible habitat. Outdoors, they can be found in soil, vegetation and rotting wood. Molds can also be found indoors in attics, basements, bathrooms, refrigerators and other food storage areas, garbage containers, carpets and upholstery.
Pollen and mold counts measure the amount of airborne allergens present in the air. Counts are compiled by a variety of methods. Pollen and mold spore counts can be determined daily, and are reported as grains per cubic meter of air. Certified aeroallergen counters at many universities, medical centers and clinics provide these counts on a volunteer basis.
The National Allergy BureauT (NABT) is the nation's only pollen and mold counting network certified by the AAAAI. As a free service to the public, the NAB compiles pollen and mold counts from certified stations across the nation and reports them to the media three times each week. These counts are also available on the NAB page of the AAAAI's Web site, www.aaaai.org.
Interpretation of pollen and mold counts and their relationship to symptoms is complex. Sampling techniques such as the type of device used and its location within the community can affect counts. While many patients develop symptoms when pollen counts are 20-100 grains per cubic meter, one's symptoms may also be affected by recent exposure to other allergens, the intensity of pollen exposure, and individual sensitivity. Pollen counts reported to the public are generally taken the preceding one to three days, and may vary widely from day to day during a season. Overall, the use of pollen counts in predicting symptom severity in a given individual is somewhat limited.
Weather can influence hay fever symptoms. Allergy symptoms are often minimal on days that are rainy, cloudy or windless, because pollen does not move about during these conditions. Hot, dry and windy weather signals greater pollen and mold distribution and thus, increased allergy symptoms.
If you are allergic to plants in your area, you may believe that moving to another area of the country with different plants will help to lessen your symptoms. However, many pollens (especially grasses) and molds are common to most plant zones in the United States. Additionally, other related plants can also trigger the same symptoms. Many who move to a new region to escape their allergies find that they acquire allergies to new airborne allergens prevalent in their area within one to two years. Therefore, moving to another part of the country to escape allergies is often ultimately disappointing, and not recommended.
Appropriate treatment-not escape-is the best method for coping with your allergies. If your seasonal allergy symptoms are making you miserable, see your allergist/immunologist, who will take a thorough history and conduct tests, if needed, to determine exactly which pollens or molds are triggering your symptoms. He or she will help you determine when these airborne allergens are most prevalent in your area. To lessen your symptoms, your allergist/immunologist may also prescribe an allergy nose spray, non-sedating antihistamine, decongestant or other medications.
If your symptoms continue or if you have them for many months of the year, your allergist may also recommend immunotherapy treatment, also called allergy vaccinations or shots. This treatment involves receiving injections periodically-as determined by your allergist/immunologist-over a period of three to five years. This treatment helps your immune system to become more and more resistant to the specific allergen, and lessens your symptoms as well as the need for future medications.
Following are some Dos and Don'ts that you may want to follow during the pollen and mold seasons to lessen your exposure to the pollens or molds that trigger your allergy symptoms.
keep windows closed at night to prevent pollens or molds from drifting into your home. Instead, if needed, use air conditioning, which cleans, cools, and dries the air.
minimize early morning activity when pollen is usually emitted-between 5-10 a.m.
keep your car windows closed when traveling.
try to stay indoors when the pollen count or humidity is reported to be high, and on windy days when dust and pollen are blown about.
take a vacation during the height of the pollen season to a more pollen-free area, such as the beach or sea.
take medications prescribed by your allergist/immunologist regularly, in the recommended dosage.
take more medication than recommended in an attempt to lessen your symptoms.
mow lawns or be around freshly cut grass; mowing stirs up pollens and molds.
rake leaves, as this also stirs up molds.
hang sheets or clothing out to dry. Pollens and molds may collect in them.
grow too many, or overwater, indoor plants if you are allergic to mold. Wet soil encourages mold growth.
Tips to Remember are created by the Public Education Committee of the American Academy of Allergy, Asthma and Immunology.
Cold and allergy symptoms are usually very similar, but the main difference is the length of time that symptoms last. A cold normally disappears after a week. Allergies, on the other hand, can last for weeks or even longer. The following chart provides a few guidelines to help you differentiate between a common cold and allergies.
Many people may not realize they have allergies, often attributing their congestion and runny nose to a cold. Left untreated, allergies can cause more serious conditions like sinusitis or ear infections. It is important to decipher between allergies and colds.
|Symptoms||Runny or stuffy nose, sneezing, wheezing, watery and itchy eyes.||Can include fever and aches and pains along with allergy symptoms.|
|Warning Time||Symptoms begin almost immediately after exposure to allergen(s).||Usually takes a few days to hit full force.|
|Duration||Symptoms last as long as you are exposed to the allergen and beyond, until the reaction triggered by the allergen ends. If the allergen is present year-round, symptoms may be chronic.||Symptoms should clear up within several days to a week.|
Symptoms last as long as you are exposed to an allergen and beyond. If the allergen is present year-round, symptoms may be chronic.
Symptoms should clear up within several days to a week.
A cold is caused by a virus. Antibiotics have no effect on viruses, so most people must simply wait for the common cold to run its course. Common symptoms include a sore and scratchy throat, sneezing and a runny nose. Other symptoms may include a high temperature, headache, watery eyes, cough and an achy feeling throughout the entire body. A cold can last anywhere from a week to ten days. During that time, a sick person can easily infect others. For this reason, be sure to frequently wash your hands, use a disinfectant on any contaminated surfaces and be careful when sneezing and coughing around others. Spreading germs is the most common way to catch a cold Allergies often cause sneezing, itching, watery nasal drip, stuffy nose, and watery, red, itchy eyes. These same symptoms can occur at the beginning of a cold. Allergy symptoms generally respond quickly to antihistamines and decongestant medications and can be prevented by prescription nasal sprays. Colds are caused by infection with viruses. There are more than 300 viruses known to cause colds. Most children get between 4 and 12 colds per year and adults between 2 and 6. Cold symptoms can be nearly identical to allergy symptoms but systemic symptoms often accompany the nasal and eye symptoms. Fever is associated with about 20% of colds. Body aches, feeling tired all over or just feeling lousy is common with a cold. Sore throat, swollen glands, hoarseness and cough may also occur. Colds may begin abruptly and often spread among family members or coworkers.
Millions of Americans think they’re suffering from a cold, when they’re actually experiencing sinusitis. Sinusitis is an inflammation of one ore more of the nasal sinuses, the hollow cavities within the cheek bones, found around the eyes and behind the nose.
* Nasal congestion
* Green or gray nasal discharge
* Post Nasal Drip
* Pressure in the face
* Chronic cough
Colds are the most common cause of acute sinusitis, but people with allergies are far more likely to develop sinusitis than those who do not have allergies. Left untreated, allergies can lead to sinusitis. Approximately 31 million Americans develop sinusitis each year, resulting in more than 18 million physician visits and more than $5.8 billion in overall health expenditures.
Allergies can trigger inflammation of the sinuses and nasal mucous linings. This inflammation prevents the sinus cavities from clearing out bacteria, and increases your chances of developing secondary bacterial sinusitis. If you test positive for allergies, your allergist/immunologist can prescribe appropriate medications to control your symptoms, thereby reducing the risk of developing an infection. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase symptoms.
If sinusitis is caused by a bacterial infection, treatment begins with an antibiotic. Medications such as decongestants, mucus-thinning medicine or cortisone nasal sprays are prescribed to reduce blockage and control allergies, which should help prevent sinusitis from developing. Antihistamines, cromolyn and topical steroid nasal sprays also help control allergic inflammation and keep the sinus passages open.
If you are allergic, you are reacting to a particular substance. Any substance that can trigger an allergic reaction is called an allergen. To determine which specific substances are triggering your allergies, your allergist/immunologist will safely and effectively test your skin, or sometimes your blood, using tiny amounts of commonly troublesome allergens.
Allergy tests are designed to gather the most specific information possible so your doctor can determine what you are allergic to and provide the best treatment.
Adults and children of any age who have symptoms that suggest they have an allergic disease. Allergy symptoms can include:
* Respiratory symptoms: itchy eyes, nose, or throat; nasal congestion, runny nose, watery eyes, chest congestion or wheezing.
* Skin symptoms: hives, generalized itchiness or atopic dermatitis
* Other symptoms: anaphylaxis (severe life-threatening allergic reactions), abdominal symptoms (cramping, diarrhea) consistently following particular foods, stinging insect reactions other than large local swelling at the sting site.
Generally, inhaled allergens such as dust mites, tree, grass or weed pollens will produce respiratory symptoms and ingested (food) allergies will produce skin and/or gastrointestinal symptoms or anaphylaxis but both types of allergens (ingested and inhaled) can produce the spectrum of allergy symptoms.
To help you manage your allergy symptoms most effectively, your allergist/immunologist must first determine what is causing your allergy. For instance, you don't have to get rid of your cat if you are allergic to dust mites but not cats.
Allergy tests provide concrete specific information about what you are and are not allergic to. Once you have identified the specific allergen(s) causing your symptoms, you and your physician can develop a treatment plan aimed at controlling or eliminating your allergy symptoms. With your allergy symptoms under control you should see a considerable improvement in the quality of your life. Improved sleep quality because of less congestion, days without constant sneezing and blowing your nose, improved ability to exercise, and better control of your atopic dermatitis (eczema) are some of improvements you may gain from your allergy treatment plans.
Because your physician has made a diagnosis of allergies, you know that one or more allergens is causing your allergic reaction—itching, swelling, sneezing, wheezing, and other symptoms. Your symptoms are probably caused by one of these common allergens:
* products from dust mites (tiny bugs you can't see) that live in your home;
* proteins from furry pets, which are found in their skin secretions (dander), saliva and urine (it's actually not their hair);
* molds in your home or in the air outside;
* tree, grass and weed pollen; and/or
* cockroach droppings.
More serious allergic reactions can be caused by:
* venoms from the stings of bees, wasps, yellow jackets, fire ants and other stinging insects;
* natural rubber latex, such as gloves or balloons; or
* drugs, such as penicillin.
All of these allergens are typically made up of proteins. Allergy tests find which of these proteins you may be reacting to.
The allergen extracts or vaccines used in allergy tests are made commercially and are standardized according to U.S. Food and Drug Administration (FDA) requirements. Your allergist/immunologist is able to safely test you for allergies to substances listed above using these allergen extracts.
Prick Technique: The prick technique involves introducing a small amount of allergen into the skin by making a small puncture through a drop of the allergen extract. If you have an allergy, the specific allergens that you are allergic to will cause a chain reaction to begin in your body.
People with allergies have an allergic antibody called IgE (immunoglobulin E) in their body. This chemical, which is only found in people with allergies, activates special cells called mast cells. These mast cells release chemicals called mediators, such as histamine, the chemical that causes redness and swelling. With testing, this swelling occurs only in the spots where the tiny amount of allergen to which you are allergic has been introduced. So, if you are allergic to ragweed pollen but not to cats, the spot where the ragweed allergen touched your skin will swell and itch a bit, forming a small dime-sized hive. The spot where the cat allergen scratched your skin will remain normal. This reaction happens quickly within your body.
Test results are available within 15 minutes of testing, so you don't have to wait long to find out what is triggering your allergies. And you won't have any other symptoms besides the slightly swollen, small hives where the test was done; this goes away within 30 minutes.
Intradermal: involves injecting a small amount of allergen under the skin with a syringe. This form of testing is more sensitive than the prick skin test method. This form of allergy testing may be used if the prick skin tests are negative.
Scratch tests: The term scratch test refers to a technique not commonly used at the present, which involves abrading the skin and then dropping the allergen on the abraded site.
Challenge testing: Involves introducing small amounts of the suspected allergen by oral, inhaled or other routes. With the exception of food and medication, challenges are rarely performed. When they are performed, the must be closely supervised by an allergist/immunologist.
Blood (RAST) test: Sometimes your allergist/immunologist will do a blood test, called a RAST (radioallergosorbent) test. Since this test involves drawing blood, it costs more, and the results are not available as rapidly as skin tests. RAST tests are generally used only in cases in which skin tests can not be performed, such as on patients taking certain medications, or those with skin conditions that may interfere with skin testing.
Other types of allergy testing methods the American Academy of Allergy, Asthma and Immunology considers to be unacceptable are: applied kinesiology (allergy testing through muscle relaxation), cytotoxicity testing, urine autoinjection, skin titration (Rinkel method), provocative and neutralization (subcutaneous) testing or sublingual provocation. If your physician plans to conduct any of these tests on you, please see an AAAAI member allergist/immunologist for appropriate allergy testing.
Adults and children of any age can be tested for allergies. Because different allergens bother different people, your allergist will take your medical history to determine which test is the best for you. Some medications can interfere with skin testing. Antihistamines, in particular, can inhibit some of the skin test reactions. Use of antihistamines should be stopped one to several days prior to skin testing.
* Some people are allergic to insect stings. This means that their immune systems overreact to the venom injected by a stinging insect.
* Insects to which people can have allergic reactions include members of the Hymenoptera class
o Honey Bee
o Yellow Jacket
o Yellow Hornet
o White-faced Hornet
o Fire Ants
* Symptoms may include only redness, swelling and itching at the site of the sting. Some people have large local reactions (large amount of swelling contiguous to the site of the sting). Unfortunately, more serious and potentially life threatening reactions called anaphylaxis can occur. Symptoms can include hives, swelling, trouble breathing, loss of consciousness and sometimes death.
* To avoid stinging insects, it is important to learn what they look like and where they live. If you live in the south, the Yellow Jacket or the fire ant are the most likely insects to sting you. Honey Bees are the culprits in California and fire ants are present in the South west. Children and adults are approached differently depending on their reactions. If you are a child and have just skin reactions such as hives or swelling, research has shown that you are at little risk for more life threatening reactions and you will not benefit from allergy shots for insects. Conversely, adults with more than a local reaction should be evaluated for insect allergy and consider venom immunotherapy if they are allergic.
* Contrary to popular belief, an individual's pattern of reactivity to a sting usually repeats itself. If you develop hives only after being stung, the same will happen if stung again in the majority of patients. There is generally not a progressive worsening of symptoms with future stings. All adults with anaphylactic reactions and children who have more than skin reactions should be evaluated by a board certified allergist.
Knowing how to avoid stings from fire ants, bees, wasps, hornets and yellow jackets leads to a more enjoyable summer for everyone. Stinging insects are most active during the summer and early fall, when nest populations can exceed 60,000 insects. Insect repellents do not work against stinging insects.
Yellow jackets will nest in the ground and in walls. Hornets and wasps will nest in bushes, trees and on buildings. Use extreme caution when working or playing in these areas. Avoid open garbage cans and exposed food at picnics. Also, try to reduce the amount of exposed skin when outdoors.
Effective methods for insecticide treatment of fire ant mounds use attractant baits consisting of soybean oil, corn grits or chemical agents. The bait is picked up by the worker ants and taken deeper into the mound to the queen. It can take weeks for these insecticides to work.
Allergists-immunologists recommend the following additional precautions to avoid insect stings:
* Avoid wearing sandals or walking barefoot in the grass. Honeybees and bumblebees forage on white clover, a weed that grows in lawns throughout the country.
* Never swat at a flying insect. If need be, gently brush it aside or patiently wait for it to leave.
* Do not drink from open beverage cans. Stinging insects will crawl inside a can attracted by the sweet beverage.
* When eating outdoors, try to keep food covered at all times.
* Garbage cans stored outside should be covered with tight-fitting lids.
* Avoid sweet-smelling perfumes, hair sprays, colognes and deodorants.
* Avoid wearing bright-colored clothing.
* Yard work and gardening should be done with caution.
* Keep window and door screens in good repair. Drive with car windows closed.
* Keep prescribed medications handy at all times and follow the attached instructions if you are stung. These medications are for immediate emergency use while en route to a hospital emergency room for observation and further treatment.
* If you have had an allergic reaction to an insect sting, it's important that you see an allergist-immunologist.
© Copyright 2000 American College of Allergy, Asthma and Immunology
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