An epidemiologic study of insect allergy in children. I. Characteristics of the disease.

Of 235 children with a history of allergic reactions to insect stings studied, 59 had severe life-threatening systemic reactions, 123 had mild, non-life-threatening systemic reactions, and 53 had large local reactions. The overall male-female ratio was 2:1. Venom skin tests were positive in approximately 89% of each group. Prior whole body extract therapy increased the likelihood of venom skin test reactivity to multiple insect venoms from 51 to 78%. Venom skin test results did not correlate with the severity of previous allergic reactions. One hundred and nine children with NLTR and positive venom skin tests were entered into one of two groups--venom immunotherapy or observation only. During the first six months the treatment group had the expected fourfold rise in venom-specific IgE antibody titers, whereas the observation group had a decline of the mean IgE titer. Patients in the observation group who were accidentally stung had a transient rise in IgE antibody titers. The small number of accidental stings which occurred in both groups resulted in reactions milder than the original reactions. Although based on preliminary data, venom immunotherapy may not be necessary for some children with previously mild systemic symptoms.