At a glance: Wasp venom allergy

Oedema, erythema and pain at the site of the sting develops over hours and settles within a few days
Oedema, erythema and pain at the site of the sting develops over hours and settles within a few days

Epidemiology  

Sensitisation to wasp venom can occur after a single sting.  

Most common in the late summer and early autumn.  

Clinical features  

Oedema, erythema and pain at the site of the sting which is a non-allergic reaction to the venom. This usually develops over hours and settles within a few days.  

May cause blistering and secondary infection.  

Mild reactions result in urticaria, pruritis and/or angio-oedema.  

More severe reactions may cause anaphylaxis and can develop within 10 minutes.  

Investigations  

Wasp specific IgE (RAST) or skin-prick testing.  

Management 

Oral antihistamines for local reactions, with steroids reserved for more severe localised reactions  

Adrenaline IM if any life-threatening features and systemic steroids.  

Advice on avoidance.  

Immunotherapy is effective and should be considered in patients with a history of severe generalised reactions.  

Advice on avoiding wasp stings includes avoiding walking barefooted on grass, avoiding orchards, and not drinking directly from a can.  

Contributed by Dr Sangeeta Dhami, GP Locum, Edinburgh, and Professor Aziz Sheikh, division of community health sciences, University of Edinburgh  

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