Clinical and immunologic survey in beekeepers in relation to their sensitization.

Beekeepers often present allergic symptoms and represent a natural and experimental model of anaphylaxis and specific immunotherapy. Two hundred BKs were investigated. Both allergic and nonallergic subjects were selected very carefully in terms of immunologic status and exposure to bee stings. They were surveyed by a questionnaire, the titration of total serum IgE, and bee venom-specific IgE and IgG. Skin tests to HBV were performed in 176 subjects. Skin test sensitivity to HBV and allergic symptoms were significantly (p less than 0.0001) related to the estimated number of annual stings. BKs did not have allergy for more than 200 bee stings received in a year, and skin tests were negative in all cases. Many subjects who received between 50 and 200 annual stings had positive skin tests, and 9% of them had a systemic allergic history. Systemic anaphylaxis was present in 20% of BKs who received between 25 to 50 annual stings, and in 45% of BKs who are stung less than 25 times a year. Specific IgE was present in 42% of BKs whatever the number of stings received, but the titer was lower when the number of stings increased. The presence of specific IgE in subjects who are stung numerous times and who do not present allergic symptoms at the time of the stings suggests that outbreaks of anaphylaxis may be possible in nonallergic BKs. Specific IgG titrated by the Pharmacia IgG-RAST was less than 150 U/ml in most allergic subjects and over this level in most nonallergic BKs.(ABSTRACT TRUNCATED AT 250 WORDS)