ants and Insect-Bites-and-Stings

Traveling to different regions, one might encounter a species to which they have a known allergy, or other related and unrelated species. A first-time systemic reaction can occur while on vacation, even in those with previous asymptomatic stings. Three main groups of Hymenoptera are responsible for most sting reactions. Honey bee species are virtually identical around the world. Among social wasps (family Vespidae), the yellowjacket (genus Vespula and Dolichovespula) and hornet (genus Vespa) venoms have almost complete cross-reactivity, whereas paper wasp (genus Polistes) venoms show only partial cross-reactivity with other vespid venoms. Venom immunotherapy (VIT) confers 80% to 95% protection against related insects, though isolated species of paper wasps and yellowjackets exist in every country that may be distinct from the ones at home. Those allergic to imported fire ants (genus Solenopsis) in the United States should not react to other ant species around the world. Stinging ants belong to several unrelated subfamilies in different geographic regions, which do not have cross-reactive venom. The chances of encountering specific species of Hymenoptera at a traveler's destination vary by location, planned activities, and season. In this article, we discuss special considerations for traveling, including distribution of stinging insects around the world, risk factors for more severe reactions, ways to prepare for a trip, and when allergist examination or treatment may be helpful before travel.

Topics: Animals; Ants; Arthropod Venoms; Bee Venoms; Bees; Hymenoptera; Hypersensitivity; Insect Bites and Stings; Wasp Venoms; Wasps

Hymenoptera venom allergy is characterised by systemic anaphylactic reactions that occur in response to stings from members of the Hymenoptera order. Stinging by social Hymenoptera such as ants, honeybees, and vespids is one of the 3 major causes of anaphylaxis; along with food and drug exposure, it accounts for up to 43% of anaphylaxis cases and 20% of anaphylaxis-related fatalities. Despite their recognition as being of considerable public health significance, stinging ant venoms are relatively unexplored in comparison to other animal venoms and may be overlooked as a cause of venom allergy. Indeed, the venoms of stinging ants may be the most common cause of anaphylaxis in ant endemic areas. A better understanding of the natural history of venom allergy caused by stinging ants, their venom components, and the management of ant venom allergy is therefore required. This article provides a global view on allergic reactions to the venoms of stinging ants and the contemporary approach to diagnose and manage ant venom allergy.

Topics: Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Arthropod Venoms; Humans; Hymenoptera; Insect Bites and Stings

Hymenoptera species include stinging insects such as wasps, hornets, bees, and fire ants. Allergic reaction to the venom of these insects is a common presenting complaint for patients in primary care and emergency medicine during warmer months. Patients' clinical presentations may vary, and clinicians must identify the type of reaction to determine treatment and follow-up plans. Treatment of patients allergic to Hymenoptera venom should be individualized based on risk factors, reaction type, and associated comorbidities. This article reviews common features of clinical presentation, diagnosis, and the current mainstays in management of Hymenoptera venom allergy.

Topics: Animals; Ants; Arthropod Venoms; Bees; Humans; Hypersensitivity; Insect Bites and Stings; Risk Factors

The main insects causing allergy reactions to stinging insect in humans are Apidae (bees), Vespidae (wasps, yellow jackets and hornets) and Formicidae (ants). Their venom stings are composed of various biologically active peptides and protein components, some of which can cause toxicity or anaphylaxis in humans. The protein venom demonstrate some common allergenic activity such as for fire ants and vespids, which have two common allergens that are phospholipase A1 (enzymatic activity) and antigen 5 with unknown biological activity. The common allergens seem to share some degree of immunological cross-reactivity, particularly when the sequence homology is above 70%. Therefore immunotherapeutic approaches targeting more than one specific species are of interest. Recent widespread increases of various ant species in many countries have resulted in higher number of reported about serious allergic reactions to stings. Most insect-allergy related cases have been reported for species from Solenopsis, Myrmecia and Pachycondyla genera, and their stings can often result in human fatalities. In addition, stinging ants can have serious health effects on livestock, agricultural damage adversely affecting the biodiversity of the region. This review discusses the impact of important ant species on human health in the Asia-Pacific region along with the molecular immunological aspects of the identified venoms and current status of diagnostics and therapeutics.

Topics: Animals; Ant Venoms; Ants; Asia; Desensitization, Immunologic; Humans; Hypersensitivity; Insect Bites and Stings; Insect Proteins

Hypersensitivity reactions caused by ant stings are increasingly recognized as an important cause of death by anaphylaxis. Only some species of ants ( e.g. Solenopsis spp., Myrmecia spp., and Pachycondyla spp.) cause allergic reactions. Ant species are identified by evaluating the morphologic structures of worker ants or by molecular techniques. Ant venom contains substances, including acids and alkaloids, that cause toxic reactions, and those from Solenopsis invicta or the imported fire ant have been widely studied. Piperidine alkaloids and low protein contents can cause local reactions (sterile pustules) and systemic reactions (anaphylaxis). Imported fire ant venoms are cross-reactive; for example, the Sol i 1 allergen from S. invicta has cross-reactivity with yellow jacket phospholipase. The Sol i 3 allergen is a member of the antigen 5 family that has amino acid sequence identity with vespid antigen 5. The clinical presentations of ant hypersensitivity are categorized into immediate and delayed reactions: immediate reactions, such as small local reactions, large local reactions, and systemic reactions, occur within 1-4 hours after the ant stings, whereas delayed reactions, such as serum sickness and vasculitis, usually occur more than 4 hours after the stings. Tools for the diagnosis of ant hypersensitivity are skin testing, serum specific IgE, and sting challenge tests. Management of ant hypersensitivity can be divided into immediate (epinephrine, corticosteroids), symptomatic (antihistamines, bronchodilators), supportive (fluid resuscitation, oxygen therapy), and preventive (re-sting avoidance and immunotherapy) treatments.

Topics: Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Cross Reactions; Hypersensitivity; Insect Bites and Stings

Allergic reactions to insect bites and stings are common, and the severity of reactions range from local reaction to anaphylaxis. In children, large local reaction to bites and stings is the most common presentation. Stings from insects of the order Hymenoptera (bees, wasps and ants) are the most common cause of insect anaphylaxis; however, the proportion of insect allergic children who develop anaphylaxis to an insect sting is lower than that of insect allergic adults. History is most important in diagnosing anaphylaxis, as laboratory tests can be unreliable. Venom immunotherapy is effective, where suitable allergen extract is available, but is only warranted in children with systemic reactions to insect venom. Large local reactions are at low risk of progression to anaphylaxis on subsequent stings, and hence, venom immunotherapy is not necessary.

Topics: Anaphylaxis; Animals; Ants; Australia; Bees; Child; Desensitization, Immunologic; Humans; Hymenoptera; Hypersensitivity, Immediate; Insect Bites and Stings; Wasps

To describe the current efforts to use biological control agents to reduce fire ant population levels, thus ultimately reducing the number of human sting and allergic reaction incidents.. Climate change and worldwide fire ant expansion will increase the frequency of human encounters and allergenic events, putting additional pressure on the public health sector. Six species of fire ant decapitating flies are now established in the United States. The microsporidium Kneallhazia solenopsae is well established and new fire ant hosts have been identified. The fire ant virus Solenopsis invicta virus 3 shows good potential for use as an environmentally friendly biopesticide because of its virulence and host specificity.. During separate founding events in the United States, Australia, mainland China, and Taiwan, fire ants native to South America escaped their native pathogens and parasites. Consequently, fire ant populations in these introduced regions pose a serious public health threat to the human populations by envenomation and subsequent allergic reactions. Specific, self-sustaining biological control agents have been discovered, studied, and released into fire ant populations in the United States in an effort to re-establish an ecological/competitive balance, resulting in reduced fire ant densities and human exposure.

Topics: Animals; Ant Venoms; Ants; Humans; Hypersensitivity; Insect Bites and Stings; Microsporidia; Pest Control, Biological; Viruses

The impact of the imported fire ant (IFA) is complex, in large part, because several very different species of "Fire Ants" have invaded and one of these has two forms, all of which are hard to separate by the public, as well as, some investigators not focused on the ant. Each of these different "IFA" species and forms differ in their impact. Further, these ants impact a number of "things" ranging from the environment and wildlife (plants and animals) as well as people, their environment and infrastructure. In addition, they can not only lead to death of living things (including people), but they can destroy many aspects of our environment and infrastructure at the cost of millions of dollars. But there are some beneficial aspects and some people can make many thousands of dollars due to their presence. This is an attempt to look at these issues.

Topics: Animals; Ants; Bees; Humans; Insect Bites and Stings; Introduced Species; Plant Diseases

Venom immunotherapy (VIT) is commonly used for preventing further allergic reactions to insect stings in people who have had a sting reaction. The efficacy and safety of this treatment has not previously been assessed by a high-quality systematic review.. To assess the effects of immunotherapy using extracted insect venom for preventing further allergic reactions to insect stings in people who have had an allergic reaction to a sting.. We searched the following databases up to February 2012: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE (from 1946), EMBASE (from 1974), PsycINFO (from 1806), AMED (from 1985), LILACS (from 1982), the Armed Forces Pest Management Board Literature Retrieval System, and OpenGrey. There were no language or publication status restrictions to our searches. We searched trials databases, abstracts from recent European and North American allergy meetings, and the references of identified review articles in order to identify further relevant trials.. Randomised controlled trials of venom immunotherapy using standardised venom extract in insect sting allergy.. Two authors independently undertook study selection, data extraction, and assessment of risk of bias. We identified adverse events from included controlled trials and from a separate analysis of observational studies identified as part of a National Institute for Health and Clinical Excellence Health Technology Assessment.. We identified 6 randomised controlled trials and 1 quasi-randomised controlled trial for inclusion in the review; the total number of participants was 392. The trials had some risk of bias because five of the trials did not blind outcome assessors to treatment allocation. The interventions included ant, bee, and wasp immunotherapy in children or adults with previous systemic or large local reactions to a sting, using sublingual (one trial) or subcutaneous (six trials) VIT. We found that VIT is effective for preventing systemic allergic reaction to an insect sting, which was our primary outcome measure. This applies whether the sting occurs accidentally or is given intentionally as part of a trial procedure.In the trials, 3/113 (2.7%) participants treated with VIT had a subsequent systemic allergic reaction to a sting, compared with 37/93 (39.8%) untreated participants (risk ratio [RR] 0.10, 95% confidence interval [CI] 0.03 to 0.28). The efficacy of VIT was similar across studies; we were unable to identify a patient group or mode of treatment with different efficacy, although these analyses were limited by small numbers. We were unable to confirm whether VIT prevents fatal reactions to insect stings, because of the rarity of this outcome.Venom immunotherapy was also effective for preventing large local reactions to a sting (5 studies; 112 follow-up stings; RR 0.41, 95% CI 0.24 to 0.69) and for improving quality of life (mean difference [MD] in favour of VIT 1.21 points on a 7-point scale, 95% CI 0.75 to 1.67).We found a significant risk of systemic adverse reaction to VIT treatment: 6 trials reported this outcome, in which 14 of 150 (9.3%) participants treated with VIT and 1 of 135 (0.7%) participants treated with placebo or no treatment suffered a systemic reaction to treatment (RR 8.16, 95% CI 1.53 to 43.46; 2 studies contributed to the effect estimate). Our analysis of 11 observational studies found systemic adverse reactions occurred in 131/921 (14.2%) participants treated with bee venom VIT and 8/289 (2.8%) treated with wasp venom VIT.. We found venom immunotherapy using extracted insect venom to be an effective therapy for preventing further allergic reactions to insect stings, which can improve quality of life. The treatment carries a small but significant risk of systemic adverse reaction.

Topics: Adult; Allergens; Animals; Ants; Bee Venoms; Child; Desensitization, Immunologic; Humans; Insect Bites and Stings; Randomized Controlled Trials as Topic; Wasp Venoms

The review summarizes knowledge about ants that are known to sting humans and their venoms.. Fire ants and Chinese needle ants are showing additional spread of range. Fire ants are now important in much of Asia. Venom allergens have been characterized and studied for fire ants and jack jumper ants. The first studies of Pachycondyla venoms have been reported, and a major allergen is Pac c 3, related to Sol i 3 from fire ants. There are very limited data available for other ant groups.. Ants share some common proteins in venoms, but each group appears to have a number of possibly unique components. Further proteomic studies should expand and clarify our knowledge of these fascinating animals.

Topics: Allergens; Animals; Ant Venoms; Ants; Asia; Humans; Hypersensitivity; Insect Bites and Stings; Insect Proteins; North America

Ants belong to the family Formicidae of the order Hymenoptera and they are one of the world's dominant insect groups. Ants can be present at all stages of carrion decomposition as they are typically observed shortly after death or during the early postmortem period, but even later once the fly maggots had left the body. Their role in the faunal succession varies from predator on the eggs and larvae of other insects (mainly Diptera), thus reducing significantly the rate of decomposition, to scavenger on the flesh or exudates from the corpse itself. As they can deeply affect the occurrence of cadaver entomofauna, the presence or absence of ants should be taken into account in every case involving postmortem interval estimates based on entomological evidence. In fact, the effects of ants on carrion reduction seem to be mainly dependent on species, on their amount or abundance, and on geographic area. The feeding action of ants can cause many irregular, serpiginous, scalloped areas of superficial skin loss, and small punctate and scratch-type lesions may be often observed on the body, which are the result of postmortem ant bites. Usually ant injuries are orange-pink to yellow in color and diffusely scattered over the skin surface. These injuries consist of small and rather shallow gnawed holes that can be easily misinterpreted as antemortem abrasions or resulting from strong acids. No bleeding is associated with such skin lesions but sometimes considerable hemorrhage can take place, especially where removal of superficial layers of skin occurs in congested parts of the body. As ants attack the uncovered areas of the body, ant bites can frequently give rise to suspicion especially if located on the neck mimicking antemortem injuries. They are also occasionally misinterpreted as patterned abrasion due to the imprinted effect of a blunt or offending object. On closer inspection, artifacts made by ants can be immediately apparent especially when the ants are identified upon the body, but final diagnosis can be only confirmed at the autopsy by gross and microscopic analysis. The features of such lesions will be illustrated in detail by reviewing some interesting forensic cases.

Topics: Animals; Ants; Feeding Behavior; Forensic Pathology; Humans; Insect Bites and Stings; Postmortem Changes; Skin

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Endemic Diseases; Greenhouse Effect; Homing Behavior; Humans; Incidence; Insect Bites and Stings; United States

Imported fire ants pose a real and present danger to allergic individuals living in endemic areas. This overview examines the impact of their presence, specifics of their venom and approach to the treatment of the hypersensitive individuals.. Imported fire ant sting attack rates are high in endemic areas with sensitization occurring early in life among those dwelling in these locations. Once considered an outdoor pest, sting attacks are now known to occur indoors with the very young and the very old being especially susceptible due to the decreased mobility of these age extremes. Immunotherapy with whole body extract appears efficacious with both traditional and rush schedules finding utility among allergists. Both the mobility of the populace and the portability of imported fire ants have broadened the presence of both allergic patients and the ant itself among allergists previously unfamiliar with hypersensitive patients or the imported fire ant.. Recent work has focused on achieving more rapid protection in hypersensitive patients given the high sting attack rates in endemic area with sensitization occurring early in life among those exposed to the imported fire ant.

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Clinical Protocols; Contraindications; Desensitization, Immunologic; Endemic Diseases; Humans; Insect Bites and Stings; Molecular Mimicry; Patient Education as Topic; United States

The medically important groups of Hymenoptera are the Apoidea (bees), Vespoidea (wasps, hornets, and yellow jackets), and Formicidae (ants). These insects deliver their venom by stinging their victims. Bees lose their barbed stinger after stinging and die. Wasps, hornets, and yellow jackets can sting multiple times. Most deaths related to Hymenoptera stings are the result of immediate hypersensitivity reactions, causing anaphylaxis. Massive envenomations can cause death in nonallergic individuals. The estimated lethal dose is approximately 20 stings/kg in most mammals. Anaphylactic reactions to Hymenoptera stings are not dose dependent or related to the number of stings. Bee and wasp venoms are made up primarily of protein. Conversely, fire ant venoms are 95% alkaloids. Four possible reactions are seen after insect stings: local reactions, regional reactions, systemic anaphylactic responses, and less commonly, delayed-type hypersensitivity. Clinical signs of bee and wasp stings include erythema, edema, and pain at the sting site. Occasionally, animals develop regional reactions. Onset of life-threatening, anaphylactic signs typically occur within 10 minutes of the sting. Diagnosis of bee and wasp stings stem from a history of potential contact matched with onset of appropriate clinical signs. Treatment of uncomplicated envenomations (stings) consists of conservative therapy (antihistamines, ice or cool compresses, topical lidocaine, or corticosteroid lotions). Prompt recognition and initiation of treatment is critical in successful management of anaphylactic reactions to hymenopteran stings. Imported fire ants both bite and sting, and envenomation only occurs through the sting. Anaphylaxis after imported fire ant stings is treated similarly to anaphylactic reactions after honeybee and vespid stings. The majority of Hymenopteran stings are self-limiting events, which resolve in a few hours without treatment. Because life-threatening anaphylactic reactions can progress rapidly, all animals stung should be closely monitored and observed. In the following review article, we will examine the sources and incidence, toxicokinetics, pathological lesions, clinical signs, diagnosis, treatment, and prognosis for dogs and cats suffering Hymenoptera stings.

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Arthropod Venoms; Bee Venoms; Bees; Cat Diseases; Cats; Diagnosis, Differential; Dog Diseases; Dogs; Histamine H1 Antagonists; Hymenoptera; Insect Bites and Stings; Lethal Dose 50; Prognosis; Wasp Venoms; Wasps

Topics: Animals; Ant Venoms; Ants; Endemic Diseases; Humans; Incidence; Insect Bites and Stings; Risk Assessment; Severity of Illness Index; Skin Diseases, Vesiculobullous; United States

To identify ants other than Solenopsis invicta and Solenopsis richteri reported to cause adverse reactions in humans.. We conducted a literature review to identify reports of medical reactions to ants other than S. invicta and S. richteri. Our review of medical and entomological literature on stinging ants was generated from MEDLINE and FORMIS, respectively, using the key words stinging ants and ant stings. The search was limited to articles in English published from 1966 to 2004 on MEDLINE and all years on FORMIS. We also present 3 new case reports of severe reactions to stings by 2 different species of ants, Pseudomyrmex ejectus and Hypoponera punctatissima.. Articles that concerned anaphylactic (IgE-mediated) or anaphylactic-like (resembling anaphylaxis but mechanism unknown) immediate reactions to ant stings or bites were included in this review.. Taken together, our data demonstrate that S. invicta and S. richteri are not alone in their capability to cause serious allergic or adverse reactions. A diverse array of ant species belonging to 6 different subfamilies (Formicinae, Myrmeciinae, Ponerinae, Ectatomminae, Myrmicinae, and Pseudomyrmecinae) and 10 genera (Solenopsis, Formica, Myrmecia, Tetramorium, Pogonomyrmex, Pachycondyla, Odontomachus, Rhytidoponera, Pseudomyrmex, and Hypoponera) have now been shown to have this capability.. Awareness that species other than imported fire ants may cause severe reactions should lead to more rapid evaluation and treatment and further investigation of the medical entomology of these ants.

Topics: Adolescent; Adult; Animals; Ant Venoms; Ants; Child; Female; Humans; Hypersensitivity; Infant; Insect Bites and Stings; Male; Middle Aged

Arthropods are important in medicine for a multitude of reasons. Their bites and stings may induce allergic reactions, ranging from annoying to life-threatening. Many arthropod products are also capable of inciting allergic responses in sensitized persons. In recent years, bites and stings have gained greater attention owing to increased concern about disease transmission. A common hypersensitivity response to arthropod bites, stings, and products is papular urticaria. This eruption occurs primarily in children, who eventually "outgrow" this disease, probably through desensitization after multiple arthropod exposures. Papular urticaria is most often caused by fleas or bedbugs, but virtually any arthropod is capable of inducing such a reaction. Two arthropod classes of medical importance are the Arachnida (spiders, scorpions, ticks, and mites) and the Insecta (lice, fleas, bedbugs, flies, bees, and ants). Animals in these two classes are probably responsible for more morbidity and mortality worldwide than are any other group of venomous creatures. In general, the diagnosis of arthropod bites and stings is dependent on maintenance of a high index of suspicion and familiarity with the arthropod fauna not only in one's region of practice, but also in the travel regions of one's patients. Learning objective At the completion of this learning activity, participants should be familiar with the clinical manifestations caused by a variety of arthropods as well as the treatment and possible sequelae of arthropod attacks.

Topics: Animals; Ants; Arthropods; Bedbugs; Bees; Bites and Stings; Culicidae; Diptera; Humans; Insect Bites and Stings; Lice Infestations; Mites; Scorpion Stings; Scorpions; Siphonaptera; Spider Bites; Ticks; Urticaria; Wasps

We review the medical reports of fire ant attacks on residents of nursing homes in the context of the medical entomology of these insects, and present recommendations to prevent and manage future attacks. Two reports were recent cases, while a computer-assisted search yielded four other similar cases of attacks by foraging fire ants in the last 10 years. One patient experienced an anaphylactic reaction and 4 patients died within 1 week of the attack. Ants were usually noted in health care facilities days before the attacks. The presence of fire ants around immobile, often cognitively impaired, patients seems to be the primary risk factor for massive fire ant attacks. Health care providers and administrators in fire ant endemic areas must be aware that the presence of fire ants in hospitals and nursing homes represents a hazard. Fire ant infestation can lead to sting attacks on patients, causing respiratory tract obstruction, worsening of pre-existing medical conditions, or frank anaphylaxis. All the attacks reported here have resulted in legal action involving physicians and health care facilities.

Topics: Animals; Ants; Humans; Insect Bites and Stings; Nursing Homes

Topics: Animals; Ants; Bees; Diagnosis, Differential; Humans; Insect Bites and Stings; Nurse Practitioners; Nursing Assessment; Primary Health Care; Scorpions; Skin Care; Spiders; Ticks; Wasps

Insect stings are an important cause of anaphylaxis. Anaphylaxis can also occur from insect bites but is less common. Insect venoms contain several well-characterized allergens that can trigger anaphylactic reactions. Effective methods to diagnose insect sting allergy and assess risk of future sting reactions have been developed. Management strategies using insect avoidance measures, self-injectable epinephrine, and allergen immunotherapy are very effective in reducing insect-allergic patients' risk of reaction from future stings. Diagnostic and management strategies for patients allergic to insect bites are less developed.

Topics: Anaphylaxis; Animals; Ants; Desensitization, Immunologic; Humans; Insect Bites and Stings; Wasps

Topics: Animals; Ants; Bees; Diagnosis, Differential; Female; Humans; Insect Bites and Stings; Male; Spider Bites; Wasps

Contact with insects may induce cutaneous or systemic reactions, ranging from little more than annoying to life threatening. The diagnosis depends on maintaining a high index of suspicion and being familiar with the insect fauna of the patient's environment and area of travel.

Topics: Animals; Ants; Bees; Culicidae; Humans; Insect Bites and Stings; Insect Repellents; Phthiraptera; Siphonaptera; Skin Diseases; Wasps

Ants belong to the order Hymenoptera, along with bees, wasps, yellow jackets, etc., they are the most successful animal genera in this world. It is their selfless social structure which accounts for their huge impact. Their effect on man ranges from the parasol ant, which makes plant cultivation untenable in certain parts of South America, to Solenopsis Invicta in the southeastern United States of America, which kill ground dwelling birds and small animals, harass livestock, and renders farmland unusable. With the exception of the Bulldog Ant of Australia (which is the size of a medium cockroach) direct toxic effects are not a lethal threat to man. Human fatalities and morbidity are related to secondary infections of excoriated stings or allergic anaphylaxis. This article reviews history and recent developments regarding stinging ants around the world.

Topics: Adult; Allergens; Animals; Ants; Female; Humans; Hypersensitivity; Immunotherapy; Insect Bites and Stings; Male; Tissue Extracts

Residents in the southeastern United States would hardly describe life with the aggressive imported fire ant as peaceful coexistence. The continued spread of these insects has produced agricultural problems, changes in the ecosystem, and increasing numbers of subjects with sting sequelae, including hypersensitivity reactions, secondary infections, and rare neurologic sequelae. Evolutionary changes have facilitated their expansion northward into Virginia and westward into California, and increasing urbanization will likely permit further expansion. Recent reports of building invasion with sting attacks inside occupied dwellings, including health care facilities, heighten public health concerns. This article reviews the medically important entomology, clinical aspects of stings, and the current approaches to chemical control of fire ants. We also propose directions for future research and treatment.

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Humans; Immunotherapy; Insect Bites and Stings; Population Surveillance; United States

Imported fire ant sting reactions are becoming an increasing problem in the United States. It is important for clinicians to be familiar with their possible cutaneous and noncutaneous presentations. We present 3 cases with multiple fire ant stings, followed by a review of the literature.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Ants; Female; Humans; Insect Bites and Stings; Male; Venoms

Imported fire ants now infest more than 310 million acres in the United States and Puerto Rico. Colonies have been found in Arizona, California, New Mexico, and Virginia. Available reports suggest that each year, fire ants sting more than 50% of persons in endemic areas, resulting in a variety of medical consequences.. To describe fire ant attacks among patients in health care facilities.. Case series and literature review.. Two nursing homes in Mississippi.. Two nursing home residents.. Clinical records to describe clinical sequelae of multiple stings.. With the 2 incidents reported here, the total number of reported indoor fire ant attacks on humans since 1989 is 10. Six of the persons attacked, including the 2 nursing home residents described here (who died after the stings), had preexisting neurologic impairment. Eight of the 10 attacks have been reported in the past 4 years.. The presence of fire ants in occupied dwellings indicates the presence of active fire ant colonies in the immediate proximity. Efforts to eradicate these insects should be undertaken immediately, especially if immobile persons are present. These persons should be considered at risk for fire ant attacks as long as the ants are present.

Topics: Aged; Animals; Ant Venoms; Ants; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Insecticides; Middle Aged; Nursing Homes

Reading this article will reinforce the reader's knowledge of the taxonomy, origin, and distribution of fire ants and will increase his ability to diagnose and manage reactions caused by the two imported species, Solenopsis invicta and richteri. This review will also enhance the reader's knowledge of the available diagnostic methods and therapeutic measures, including the role of fire ant venom versus whole body extract in the management of fire ant allergy.. Information for this review was obtained primarily from abstracts and articles written by investigators recognized for their expertise in fire ant venom research.. References were selected based on their clinical applicability and relevance to the epidemiology and pathophysiology of imported fire ant hypersensitivity.. The imported fire ant represents a significant health hazard for persons living in fire ant endemic areas in the southern United States. Sting reactions range from local pustules and large, late-phase responses to life-threatening anaphylaxis. Fire ant allergen-specific immunotherapy can reduce the risk of subsequent systemic reactions. Four important Sol i venom allergens have been isolated and characterized. Clinical studies have been designed to compare the safety and efficacy of fire ant venom with whole body extract for diagnosis and treatment of fire ant allergy.

Topics: Animals; Ant Venoms; Ants; Electrophoresis, Polyacrylamide Gel; Humans; Hypersensitivity; Immunotherapy; Insect Bites and Stings; Insect Control; Skin Tests

Topics: Animals; Ants; Bees; Child; Desensitization, Immunologic; Diagnosis, Differential; Humans; Insect Bites and Stings; Wasps

Stings by the imported fire ant almost always lead to dermal wheal and flare reactions followed by sterile pustules at sting sites. Less commonly, large local dermal reactions, pyoderma, anaphylaxis, or neuropathy may occur. Such reactions have previously been associated with contact with the insects out of doors. We present two previously unreported cases of indoor attacks on individuals by imported fire ants. One patient experienced a cerebrovascular accident in association with the attack, whereas the second patient had no obvious sequelae. With those two reports, a total of four such indoor massive sting episodes have appeared in the recent medical literature. Physicians and other individuals living in areas indigenous to the fire ant should be aware that infestation of buildings with fire ants may be associated with attacks on human beings indoors. Individuals with cognitive dysfunction seem to be especially at risk for attacks by fire ants.

Topics: Aged; Animals; Ants; Cerebrovascular Disorders; Emergencies; Fatal Outcome; Female; Humans; Insect Bites and Stings; Male; Recurrence; Time Factors

Stings from imported fire ants constitute a problem encountered more and more frequently in practice settings across the Southern United States. Envenomation (impregnation of venom) in children is especially common. Current medical regimens for the treatment of other stinging insects are of little value in preventing local cutaneous reactions to fire-ant stings. The pathogenesis of reactions from imported-fire-ant stings is discussed, and suggestions for prevention, treatment and patient education are provided.

Topics: Aged; Animals; Ants; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Male; Patient Education as Topic; Primary Health Care

Insect sting anaphylaxis is a relatively common problem estimated to affect at least 0.4% of the population and is responsible for at least 40 deaths per year in the United States. The allergic reactions are mediated by IgE antibodies directed at constituents in honeybee, yellow jacket, hornet, and wasp venoms. In addition, increasing numbers of reactions occur from fire ant stings, non-winged Hymenoptera present in the Southeastern United States. The anaphylactic symptoms are typical of those occurring from any cause. Most reactions in children are mild, frequently involving dermal manifestations (hives, edema) only. The more severe reactions, such as shock and loss of consciousness, can occur at any age but are relatively more common in adults. Following sting anaphylaxis, approximately 50% of unselected patients will continue to have allergic reactions to subsequent stings. The natural history of the disease process is influenced by the severity of the anaphylactic symptoms. Children with dermal reactions only have a benign course and are unlikely to have recurrent reactions. Patients with more severe reactions are at risk for repeat anaphylaxis. Patients with a history of insect sting anaphylaxis and positive venom skin tests should have epinephrine available and are candidates for subsequent venom immunotherapy, which provides almost 100% protection against subsequent re-sting reactions. Recommendations for the duration of immunotherapy are evolving. Venom therapy can be stopped if skin test reactions become negative. For most patients, 3 years of therapy appears adequate, despite persistence of positive venom skin tests.

Topics: Animals; Ants; Bees; Clinical Protocols; Epinephrine; Histamine Antagonists; Humans; Hypersensitivity, Immediate; Immunotherapy; Insect Bites and Stings; Medical History Taking; Radioallergosorbent Test; Skin Tests; Wasps

Topics: Agriculture; Animals; Ant Venoms; Ants; Humans; Hypersensitivity; Insect Bites and Stings; Insecticides; North Carolina

The imported fire ant is a major insect cause of generalized hypersensitivity in the southern United States. The alkaloids in the ant's unique venom also produce substantial morbidity due to local reactions, both toxin- and IgE-mediated. Immunotherapy--with whole body extracts as well as with venom--is given only to patients with systemic reactions.

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Arthropod Venoms; Central Nervous System Diseases; Cross Reactions; Humans; Hypersensitivity; Immunotherapy; Insect Bites and Stings; Skin

A 3-year-old child experienced edema of the face and extremities approximately 2 weeks after being stung on the legs, scrotum, and penis by "fire ants" (Solenopsis invicta). After diagnosis of idiopathic minimal-change nephrotic syndrome and treatment with steroids, the edema rapidly disappeared. Follow-up 3 years after his hospitalization showed no recurrence of nephrotic syndrome. We have correlated this case with previously published reports of the causal relationship of allergy to nephrotic syndrome, but we are unaware of any previously published correlation between ant bite and nephrotic syndrome.

Topics: Animals; Ant Venoms; Ants; Child, Preschool; Humans; Insect Bites and Stings; Male; Nephrotic Syndrome

Stinging insect envenomation and allergy remain important clinical and research problems. Approximately 40 deaths occur annually as a result of these stings. The dermatologist can help to avoid this outcome by appropriate recognition of the offending insect and by instituting or arranging the appropriate therapy and avoidance. Bee-sting kits should be encouraged for sensitive individuals. Dermatologists should be alert to the increasing imported fire ant problem, be able to make the diagnosis, and help the patient recognize and avoid these pesky arthropods.

Topics: Adult; Anaphylaxis; Animals; Ants; Bees; Humans; Hymenoptera; Insect Bites and Stings; Male; Wasps

Topics: Anaphylaxis; Animals; Ants; Humans; Insect Bites and Stings

This is the first case report of imported fire ants invading a building and aggressively attacking a human being, resulting in multiple stings. This case illustrates that, although the venom has a high LD50 in mice, it does not induce toxic systemic effects in humans when the venom is introduced intradermally.

Topics: Aged; Animals; Ant Venoms; Anti-Bacterial Agents; Ants; Female; Fluid Therapy; Histamine H1 Antagonists; Humans; Insect Bites and Stings

Topics: Africa; Animals; Ants; Asia; Australia; Ecology; Humans; Insect Bites and Stings; Plants; South America; Tropical Climate

One to two million Americans have a history of systemic allergic reactions to stinging insects and must live with the knowledge that future stings could be catastrophic. Recent advances have been made in diagnosis and treatment of this problem. Pure venoms have been recognized to be superior to the whole body extract as diagnostic and treatment antigens. Use of pure venoms for immunotherapy gives far better protection than whole body extract for the allergic patient and represents a major advance in the field of allergy. The imported fire ant is very different from the other common stinging insects in its venom components, the type of local reactions caused by its sting, and the fact that whole body extract from this insect seems to be as good an antigen for diagnosis and treatment as pure venom. Although important discoveries about insect allergy have been made recently, some very important questions are yet to be answered. Among these are: (1) Can suppliers of venom provide us with enough venom to treat all patients with insect allergy? (2) How long should immunotherapy be continued? and (3) Would treatment with specific antigens from venom be superior to using whole venom? We all await the answer to these and other questions with hopeful anticipation.

Topics: Anaphylaxis; Animals; Ants; Bee Venoms; Humans; Hymenoptera; Hypersensitivity; Immunotherapy; Insect Bites and Stings

Topics: Animals; Ants; Bees; Humans; Hymenoptera; Insect Bites and Stings; Rats; Venoms; Wasps

Topics: Animals; Ants; Bedbugs; Culicidae; Diptera; Disease Vectors; Hemiptera; Hexachlorocyclohexane; Humans; Hymenoptera; Insect Bites and Stings; Lice Infestations; Myiasis; Phthiraptera; Siphonaptera

Topics: Adolescent; Adult; Age Factors; Animals; Antigens; Ants; Bees; Child; Child, Preschool; False Negative Reactions; False Positive Reactions; Female; Guinea Pigs; Humans; Hypersensitivity; Hypersensitivity, Delayed; Immune Sera; Injections, Subcutaneous; Insect Bites and Stings; Insecta; Male; Middle Aged; Pheromones; Precipitins; Rabbits; Sex Factors; Skin Tests; Tissue Extracts; Venoms

Venom immunotherapy can be initiated by different schedules, but randomized comparisons have not been performed.. We aimed to compare the safety of 2 initiation schedules.. Patients of any age with prior immediate generalized reactions to jack jumper ant (Myrmecia pilosula) stings were randomized to venom immunotherapy initiation by a semirush schedule over 10 visits (9 weeks) or an ultrarush schedule over 3 visits (2 weeks). In a concurrent treatment efficacy study, the target maintenance dose was randomized to either 50 μg or 100 μg. The primary outcome was the occurrence of 1 or more objective systemic reactions during venom immunotherapy initiation. Analyses were by intention to treat. We also assessed outcomes in patients who declined randomization.. Of 213 eligible patients, 93 were randomized to semirush (44 patients) or ultrarush (49 patients) initiation. Objective systemic reactions were more likely during ultrarush initiation (65% vs 29%; P < .001), as were severe reactions (12% vs 0%; P= .029). Times to maximal increases in venom-specific IgG(4) were no different between treatments, whereas the maximal increase in venom-specific IgE occurred earlier with ultrarush treatment. Similar differences between methods were observed in patients who declined randomization. One hundred seventy-eight patients were randomized to maintenance doses of either 50 μg (90 patients) or 100 μg (88 patients). The target maintenance dose had no effect on the primary outcome, but multiple-failure-per-subject analysis found that the 50 μg dose reduced the likelihood of reactions.. Ultrarush initiation increases the risk of systemic reactions. A lower maintenance dose reduces the risk of repeated reactions, but the effect on treatment efficacy is unknown.

Topics: Adult; Animals; Ants; Arthropod Venoms; Desensitization, Immunologic; Drug Administration Schedule; Female; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Male; Middle Aged; Treatment Outcome

Thirty-three adult patients who had had systemic allergic reactions to fire ant stings and 33 insect-nonallergic control subjects were skin tested with single lots of Solenopsis invicta (Sol i) fire ant venom (IFAV) and two commercially available imported fire ant whole body extracts (IFA WBEs). All three extracts were analyzed for protein concentration. Sol i II and Sol i III concentrations were each assayed by means of two ELISAs with complementary monoclonal antibodies, one species specific and one cross-reactive. Radioallergosorbent test (RAST) to IFAV and both IFA WBEs was performed on sera from all study subjects. Both IFA WBEs contained high concentrations of fire ant body proteins. Sol i II and III concentrations each varied twofold between the two IFA WBE preparations. Patients were generally more reactive to IFAV than IFA WBE by skin testing and RAST. IFAV RAST appeared to be a more sensitive assay than IFA WBE RAST. No adverse reactions occurred to skin testing with IFAV, but intradermal testing with higher concentrations of IFA WBE caused delayed large local reactions in 16 of 30 (53%) control subjects. These reactions were attributed to the large amounts of extraneous body proteins in IFA WBE. These results (1) demonstrate that skin testing with IFAV is safe, (2) indicate that IFAV is more potent than IFA WBE, and (3) suggest that IFAV may be the superior reagent for diagnosis of fire ant allergy.

Topics: Adult; Animals; Ant Venoms; Ants; Drugs, Investigational; Female; Humans; Hypersensitivity; Insect Bites and Stings; Male; Middle Aged; Radioallergosorbent Test; Skin Tests; Tissue Extracts

Meat tenderizer containing the proteolytic enzyme papain was tested for therapeutic efficacy in the sting of the imported fire ant. The parameters of pain and itching were used to evaluate qualitatively the sting response in 22 healthy medical students, and the laser Doppler velocimeter was used to assess quantitatively the change in cutaneous blood flow. The results indicated that, during the acute-phase reaction, no clinically or statistically significant difference was found between stings treated with meat tenderizer and stings treated without tenderizer. Therefore we conclude that meat tenderizer is of no therapeutic value in the acute treatment of the imported fire ant sting.

Topics: Animals; Ants; Drug Combinations; Humans; Insect Bites and Stings; Papain; Regional Blood Flow; Skin; Sodium Chloride; Sodium, Dietary

Topics: Adult; Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Female; Humans; Insect Bites and Stings; Male

Imported fire ant (IFA) whole-body extract subcutaneous immunotherapy (IT) is a safe and effective treatment for IFA hypersensitivity, with a recommended length of treatment of 3 to 5 years.. To evaluate long-term IFA IT adherence in patients with IFA allergy living in an endemic area.. During 2007 to 2014, patients with IFA-sting systemic reactions and a recommendation to start IFA IT were prospectively enrolled in this study. Subjects were contacted annually for interval IT adherence. Institutional review board approval was obtained.. A total of 87 subjects, ages 2 to 64 years, with a recommendation to initiate IFA IT, were enrolled. Subjects were predominantly adult (76%) and female (55%), and 30% had asthma. Of these patients, 77 (89%) initiated treatment within 1 year of recommendation; 18 (23%) adhered to a 3-year course; and 10 (13%) adhered to a 5-year course. At 3 years, there were no significant differences in adherence between male and female subjects (28% vs 19%, P = .33), children and adults (25% vs 22%, P = .79), or those with or without asthma (30% vs 20%, P = .31). Adherence in subjects with mild initial reactions was lower than in subjects with moderate-to-severe reactions (0% vs 25%, P = .05) at 3 years only. Conventional buildup and concurrent flying Hymenoptera venom immunotherapy were predictive of adherence. Reasons for discontinuation were relocation to a nonendemic area (29%) and inconvenience (27%).. This study showed poor long-term adherence to IFA IT at 3 and 5 years. Initial sting severity, buildup protocol, and concurrent flying Hymenoptera venom immunotherapy were predictors for long-term IT adherence.

Topics: Adolescent; Adult; Animals; Ant Venoms; Ants; Asthma; Child; Child, Preschool; Desensitization, Immunologic; Female; Humans; Hypersensitivity; Immunotherapy; Insect Bites and Stings; Male; Middle Aged; Young Adult

Venomous invasive ants are rapidly dispersing throughout oceanic islands. Medics unfamiliar with envenomation or venom-induced anaphylaxis may be unprepared for the range of possible reactions and corresponding treatments. We detail the suboptimal treatment of a patient suffering anaphylaxis from an ant sting on a remote island and describe what treatment should have been provided.. The patient experienced stings on his feet from an ant later identified as tropical fire ant, Solenopsis geminata. Clinical examination revealed throat swelling without obstruction of the airway or pharynx.. The patient was provided the following suboptimal treatment: intravenously-administered antihistamine and saline perfusion. Injected epinephrine should be the standard first line of treatment for anaphylaxis, even when not all symptoms are present.. A rise in invasive hymenopteran stings on oceanic islands is inevitable, and proactively improving public awareness and medical training could save lives.

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Humans; Insect Bites and Stings; Islands

Topics: Angioedema; Animals; Ants; Humans; Insect Bites and Stings

Imported fire ants aggressively sting humans, leading to a variety of local and systemic effects. Fire ants display a behavioral adaptation to survive flooding, called "rafting," bringing humans into even more contact with fire ants.. To assess frequency of encounters with fire ant rafts, duck hunters on the website "Duck Hunter's Forum" were asked about their experiences with the ants while wading or boating in flooded areas. All members of the group received a brief explanation and asked to respond directly if they had had such an encounter. They were then asked to fill out a short 6-question survey.. There were 2021 views of the thread about fire ant raft encounters, with 35 (1.7%) responses. Twenty-four (68.6%) said they had experienced encounters with fire ant rafts. Six responders described purposely or inadvertently physically touching the rafts with their body parts, boat, or a paddle, causing the ants to enter their boat or to climb directly onto the hunter(s). Five respondents were stung (number of stings from "a few" to 50), describing reactions to stings as "small pustules," "whelps," and "pimple-like, puss-filled whelps.". These results confirm that fire ant rafts formed during flooding present a potential hazard to persons walking, wading, or boating in those areas. We suggest that these rafts are an under-appreciated health hazard. It is reasonable to assume that people in flooded areas occasionally contact these floating rafts and are stung multiple times. We provide preliminary prevention/protection recommendations for health professionals, to be shared with their patients and the general public.

Topics: Animals; Ant Venoms; Ants; Exanthema; Floods; Humans; Insect Bites and Stings; Ships

There are no studies describing 12-week extended maintenance interval (EMI) immunotherapy (IT) efficacy in preventing anaphylaxis to imported fire ant (IFA) stings.. The purpose of this study was to determine the safety and efficacy of 12-week maintenance intervals in patients treated with IFA IT.. After a minimum of 3 months of conventional maintenance interval IT and verification of baseline efficacy, adults with IFA hypersensitivity were prospectively enrolled and extended their maintenance doses to 6-, 8-, and 12-week intervals. Efficacy was confirmed by means of an annual IFA sting challenge.. A total of 25 patients initiated EMI. The severity of their initial systemic reactions was mild in 8 patients (32%), moderate in 10 patients (40%), and severe in 7 patients (28%). Maintenance IT duration at trial entry was less than 3 years in 18 patients (mean 11 months; range 3-28 months), 3 to 5 years in 4 patients (mean 46 months; range 36-57 months), and greater than 5 years in 5 patients (mean 111 months; range 67-197 months). The treatment cohort did not experience systemic reactions to extended interval injections, cluster refill injections, field stings, or sting challenges.. This prospective longitudinal cohort study revealed that in adults 18 years old or older who have received at least 3 months of maintenance dose IFA-whole body extract IT with proven efficacy, extension to a 12-week EMI is a safe effective treatment option. The benefits of EMI include a reduced number of injections, clinic visits, and lapses in maintenance IT.

Topics: Adolescent; Adult; Anaphylaxis; Animals; Ant Venoms; Ants; Humans; Immunotherapy; Insect Bites and Stings; Longitudinal Studies; Prospective Studies

Venoms are excellent model systems for studying evolutionary processes associated with predator-prey interactions. Here, we present the discovery of a peptide toxin, MIITX

Topics: Amino Acid Sequence; Animals; Ant Venoms; Ants; Drug Hypersensitivity; Epidermal Growth Factor; Insect Bites and Stings; Mice; Molecular Mimicry; Toxins, Biological

Artefacts are postmortem findings that often complicate an investigation into death. The police and relatives may be bewildered by them, and forensic pathologists need to be well versed with the intricacies that they can pose. We studied postmortem records over a year and report three cases of ant bite artefacts which led the relatives and the police to suspect the manner of death. A thorough postmortem examination endorsed the findings as ant bite artefacts and so correctly advised the police investigation.

Topics: Animals; Ants; Artifacts; Humans; Insect Bites and Stings; Police

The first large-scale evaluation of prescribing patterns for imported fire ant (IFA) in a large US health care system was published by Haymore et al in 2009. In this first evaluation of prescriptions from 1990 to 2007, the most often prescribed maintenance IFA prescription was 0.5 mL of 1:200 wt/vol.. To provide an updated description of IFA prescribing patterns over the ensuing 11 years from same large health care system.. We reviewed 1349 new IFA prescriptions written from 2007 to 2018, from a large nationwide health care system, with primary end points being maintenance prescription strength and prescribing patterns.. In comparison to the data published by Haymore et al in 2009, which reported that 17% of the prescriptions were written for 0.5 mL of 1:100 wt/vol maintenance, we found that 69% (95% CI: 66.4%-71.4%) of IFA prescriptions written in the past 11 years were for the maintenance concentration of 0.5 mL of 1:100 wt/vol. We further studied the linear trend over time of percentage of prescriptions written for individual concentrations and observed that the percentage of 1:100 wt/vol prescriptions increased 3.5% yearly (R. Our study shows significant improvement in the accuracy and precision of IFA immunotherapy dosing for patients with IFA hypersensitivity, with ascendancy of 0.5 mL 1:100 wt/vol as the predominant treatment dose. A total of 87% of patients within our study were treated within the parameter recommendations, a stark improvement from findings in the 2009 Haymore study.

Topics: Animals; Ant Venoms; Ants; Complex Mixtures; Delivery of Health Care; Desensitization, Immunologic; Drug Prescriptions; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Military Health; Time Factors; United States

Hymenopteran stings are the most common animal insult injury encountered in the emergency department. With increasing global spread of imported fire ants in recent decades, the rate of Formicidae assault has become a serious problem in many countries. Formicidae-associated injuries gradually increased in Taiwan in recent decades and became the second most common arthropod assault injury in our ED. The present study aimed at comparing the clinical characteristics of Formicidae sting patients with those of the most serious and common group, Vespidae sting patients, in an emergency department (ED) in Taiwan.. This retrospective study included patients who were admitted between 2015 to 2018 to the ED in a local teaching hospital in Taiwan after a Vespidae or Formicidae sting. Cases with anaphylactic reaction were further compared.. We reviewed the records of 881 subjects (503 males, 378 females; mean age, 49.09 ± 17.62 years) who visited our emergency department due to Vespidae or Formicidae stings. A total of 538 (61.1%) were categorized into the Vespidae group, and 343 (38.9%) were sorted into the Formicidae group. The Formicidae group had a longer ED length of stay (79.15 ± 92.30 vs. 108.00 ± 96.50 min,. Formicidae sting patients presented to the ED with higher rate allergic reactions and spent more time in the ED than Vespidae sting patients. However, Vespidae sting patients had more complications and higher rates of admission, especially with anaphylactic reaction. Laboratory data, especially creatine kinase data, were more valuable to check in Vespidae sting patients with an anaphylactic reaction in the ED. Both groups exhibited positive correlations with temperature and a higher rate on weekend days.

Topics: Adult; Aged; Anaphylaxis; Animals; Ant Venoms; Ants; Emergency Service, Hospital; Female; Histamine Antagonists; Humans; Insect Bites and Stings; Length of Stay; Male; Middle Aged; Retrospective Studies; Taiwan; Treatment Outcome; Wasp Venoms; Wasps

Anaphylaxis is rarely associated with the vasospastic acute coronary syndrome with or without the presence of underlying coronary artery disease. We report here a case of Kounis syndrome in a man with no known cardiovascular risk developed acute ST-elevation myocardial infarction complicated with complete heart block following Solenopsis (fire ant) bite.

Topics: Animals; Ants; Humans; Insect Bites and Stings; Kounis Syndrome; Male; Middle Aged; ST Elevation Myocardial Infarction

To describe the ocular findings and the long-term outcomes of patients diagnosed with corneal injury due to little fire ants (LFAs).. This is a retrospective case series of patients evaluated with corneal injury due to LFAs from October 2015 to January 2018 at the Cornea Clinic in Meir Medical Center. Patients underwent anterior segment optical coherence tomography (AS-OCT) imaging during the follow-up.. Four patients reported ocular contact with LFAs and presented to our department with unilateral, scattered, small, dense, round, bright white opacities in the anterior corneal stroma, which remained unchanged in appearance over time, despite topical antibiotic and steroid treatment. No inflammatory signs were noted in the anterior chamber. Follow-up was performed clinically using AS-OCT for periods of 9 to 26 months after the incidents. AS-OCT findings demonstrated small, subepithelial, hyperreflective foci at the level of the anterior stroma to a depth of 145 to 250 μm, with posterior shadowing that remained unchanged over time. These findings were well-correlated with biomicroscopy findings.. LFA bites can cause long-lasting corneal injury in humans with characteristic clinical biomicroscopic findings. The corneal lesions do not respond to conventional topical treatment. AS-OCT imaging can be a useful modality for diagnosis and follow-up. Awareness by both patients and ophthalmologists of this clinical entity may be helpful in diagnosis and management.

Topics: Aged; Animals; Anti-Bacterial Agents; Ants; Corneal Injuries; Drug Combinations; Female; Glucocorticoids; Humans; Insect Bites and Stings; Intraocular Pressure; Male; Middle Aged; Ophthalmoscopy; Retrospective Studies; Slit Lamp Microscopy; Tomography, Optical Coherence

For many decades, the sting of Samsun ant (Pachycondyla sennaarensis) has been a serious clinical challenge for the people living in some of the major Middle East and Asian countries. In the present study, the therapeutic potential of Nigella sativa derived plant extract component, thymoquinone (TQ) has been tested against the Samsun ant venom (SAV) at the toxic dose in the rats.. The adult male rats were divided into four groups (n = 10): control, SAV treated, SAV + TQ treated and TQ alone treated. It was found that the sub-lethal dose of SAV alters not only many of the kidney and liver function markers but also induces oxidative stress in the animals. Moreover, the SAV also disturbs various immunological parameters including expression of PMNs, CD-80, CD-86, interleukins and other cytokines compromising the affected organism towards mild to severe allergic reactions including life-risking anaphylaxis.. The plant extract, TQ, effectively restores many of the biochemical and oxidative stress parameters comparable to the normal concomitant with improving the immunological aspects that might attributive in relieving from SAV-induced toxicity and allergic reactions in the affected organism to a greater extent.. Hence, TQ has an excellent antidote property against SAV-induced toxicities in vivo. Although the study is a vivid indication of the potential therapeutic potential of TQ against the SAV induced in vivo toxicity, yet the actual mechanism of interaction translating the toxicity amelioration warrants further investigations.

Topics: Acute Disease; Animals; Ant Venoms; Anti-Inflammatory Agents; Ants; B7-1 Antigen; B7-2 Antigen; Benzoquinones; Biomarkers; Disease Models, Animal; Immunity, Innate; Insect Bites and Stings; Kidney Function Tests; Liver Function Tests; Male; Nigella sativa; Plant Extracts; Rats; Rats, Wistar

Treatment of imported fire ant (IFA) hypersensitivity includes avoidance and venom immunotherapy (VIT) that reduces the risk of reactions to less than 5%. Previous studies have shown that rush immunotherapy (RIT) is safe and efficacious. It is unknown if multiple RIT procedures on individuals with breaks in VIT are safe and effective. This is a retrospective chart review of three patients who have undergone six IFA VIT rush protocols at our institution. Patients were all female with a median age of 27 years. All are active duty service members without medical problems who reside in an IFA endemic area. Reviewed protocols consisted of 10 injections of IFA whole body extract given in 1 day. Local reactions were the only side effect noted. All patients completed the protocols without further incident. Following each protocol, median VIT adherence was 9 months (range 2-72 months). Reasons for stopping VIT were deployment and pregnancy. Non-adherence is common and leads to breaks in VIT. The risk of VIT resumption in patients with previous RIT or VIT is unknown. This case series illustrates the safety and efficacy of repeated IFA VIT rush procedures in patients who for personal and service related reasons had breaks in VIT.

Topics: Adult; Animals; Ant Venoms; Ants; Female; Humans; Hypersensitivity; Immunotherapy, Active; Insect Bites and Stings; Retrospective Studies

Topics: Adult; Anaphylaxis; Animals; Ant Venoms; Ants; Desensitization, Immunologic; Humans; Insect Bites and Stings; Male; Mastocytosis; Middle Aged; Treatment Outcome

A variety of insect-related ocular injuries have been reported in the literature. However, no reports have been published documenting injuries resulting from exposure of the ocular surface to ants. This is surprising, given the relatively ubiquitous presence of ants. This is the first known case report to describe various techniques utilized in the removal of ants from the ocular surface.. This case report details the presentation of a distressed 24-year-old woman who presented to the Emergency Department with an ocular foreign body associated with pain and increased lacrimation. She was identified to have an ant adherent to her conjunctiva. Various techniques of removal were performed, with the ant finally removed without any trauma to underlying tissues.. This is the first case report to detail various techniques utilized in the removal of ants from the ocular surface, and discusses salient features that treating physicians should be aware of in managing patients presenting with ant bites.

Topics: Anesthetics, Local; Animals; Ant Venoms; Ants; Conjunctiva; Emergency Service, Hospital; Eye Foreign Bodies; Female; Humans; Insect Bites and Stings; Tetracaine; Young Adult

Topics: Aged; Animals; Ant Venoms; Ants; Humans; Immunoglobulin E; Immunotherapy; Insect Bites and Stings; Male

Pain is a natural bioassay for detecting and quantifying biological activities of venoms. The painfulness of stings delivered by ants, wasps, and bees can be easily measured in the field or lab using the stinging insect pain scale that rates the pain intensity from 1 to 4, with 1 being minor pain, and 4 being extreme, debilitating, excruciating pain. The painfulness of stings of 96 species of stinging insects and the lethalities of the venoms of 90 species was determined and utilized for pinpointing future directions for investigating venoms having pharmaceutically active principles that could benefit humanity. The findings suggest several under- or unexplored insect venoms worthy of future investigations, including: those that have exceedingly painful venoms, yet with extremely low lethality-tarantula hawk wasps (

Topics: Animals; Ants; Arthropod Venoms; Bees; Female; Humans; Insect Bites and Stings; Lethal Dose 50; Male; Mice, Inbred ICR; Pain; Social Behavior; Wasps

Specific IgE against Solenopsis invicta (imported fire ant) remains the current diagnostic tool for allergy to ants worldwide. However, S. invicta may not be the only cause of ant anaphylaxis in Thai patients.. To characterize ant species causing anaphylaxis in Thai patients and to test allergenic reactivity to whole body extracts (WBE) of S. geminata (tropical fire ants) in patients with evidence of IgE-mediated ant anaphylaxis.. Thirty-two patients with ant anaphylaxis were identified. The causative ants collected by the patients were subjected to species identification. Twelve patients with ant anaphylaxis and showed positive skin test or serum specific IgE to S. invicta and 14 control subjects were recruited. Whole body extraction from S. geminata was performed for protein characterization using SDS-PAGE and protein staining. IgE-immunoblotting and ELISA-specific IgE binding assays were performed on patients' sera and compared with controls.. Of 32 patients with ant anaphylaxis, the most common causative ant identified was S. geminata (37.5%). Western blot analysis of crude S. geminata revealed 13 refined protein components that bound to patients' serum IgE. Three major allergens with molecular masses of 26, 55 and 75 kDa were identified. All 12 patients gave positive results for specific IgE to S. geminata with statistically significant higher absorbance units of 0.390 ± 0.044, compared to healthy control group (0.121 ± 0.010), P < 0.01.. S. geminata is identified as the most common causative ant anaphylaxis in Thai patients. Its WBE comprises of 13 IgE-binding components and 3 major allergens (26, 55 and 75 kDa), which supported possible IgE-mediated mechanism.

Topics: Allergens; Anaphylaxis; Animals; Ants; Humans; Immunoglobulin E; Insect Bites and Stings; Insect Proteins; Thailand

Topics: Animals; Anti-Bacterial Agents; Anticoagulants; Ants; Bartonella Infections; Brain Diseases; Diagnosis, Differential; Doxycycline; Heart Arrest; Humans; Insect Bites and Stings; Male; Middle Aged; Pulmonary Embolism; Tomography, X-Ray Computed; Vancomycin; Warfarin

Topics: Animals; Anti-Bacterial Agents; Ants; Exanthema; Female; Humans; Infant; Insect Bites and Stings; Rural Population; Skin; Sri Lanka; Treatment Outcome

Fire ants are widely studied, invasive and venomous arthropod pests. There is significant biomedical interest in immunotherapy against fire ant stings. However, mainly due to practical reasons, the physiological effects of envenomation has remained poorly characterized. The present study takes advantage of a recently-described venom protein extract to delineate the immunological pathways underlying the allergic reaction to fire ant venom toxins. Mice were injected with controlled doses of venom protein extract. Following sensitization and a second exposure, a marked footpad swelling was observed. Based on eosinophil recruitment and production of Th2 cytokines, we hereby establish that fire ant proteins per se can lead to an allergic response, which casts a new light into the mechanism of action of these toxins.

Topics: Animals; Ant Venoms; Ants; Cytokines; Dendritic Cells; Eosinophils; Hypersensitivity; Insect Bites and Stings; Insect Proteins; Lymph Nodes; Male; Mice, Inbred BALB C

The Rush Immunotherapy (RIT) protocol is a valid alternative in order to reach the maintenance phase early. However, there are scarce studies in the literature that have evaluated the safety and the efficacy of an ant RIT process in children.. To evaluate the safety and the efficacy of an ant RIT protocol and to identify the risk factors for systemic reactions (SRs) during an RIT procedure in children.. A retrospective review was conducted for those children who were receiving an ant RIT procedure. The 3-day RIT protocol consisted of hourly subcutaneous injections in order to achieve a 0.5 ml maintenance dose of a 1:100 weight/ volume (wt/vol) of the Solenopsis invicta whole body extract. The safety for an RIT procedure was monitored by using the World Allergy Organization Subcutaneous Immunology Systemic Reaction Grading System. The efficacy was assessed by the reactions after a field ant re-sting.. A total of 20 children who were receiving an ant RIT therapy were reviewed. The mean age was 9.5±3.07 years. There were 6 systemic reactions (SRs) from 324 injections during the RIT procedure (1.85%). All of the systemic reactions were Grade 1-2. There were no associations of SRs regarding age, gender, an atopic history, or the levels of immunoglobulin E (IgE) sensitization to the ants. Among the 14 patients who experienced a field ant re-sting, 4 (28.5%) patients developed Grade 3 SRs. These Grade 3 reactions were resolved after an increase of the maintenance dose to 0.5 ml of a 1:50 wt/vol. There was a significant difference in the mean age of those children who had ant re-sting systemic reactions and those who had no reactions (6.75±0.95 year vs. 10.8±3.29, p=0.036).. Rush immunotherapy with ant in children is safe and it has a low occurrence of severe systemic reactions. It is an alternative treatment for those patients requiring a rapid protection.

Topics: Adolescent; Allergens; Animals; Ants; Biomarkers; Child; Desensitization, Immunologic; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Male; Skin Tests

Stings from the Asian needle ant are an important cause of anaphylaxis in East Asia. A 23-kDa protein homologous to antigen 5 is the major allergen produced by these ants. In this study, we aimed to produce a recombinant antigen 5 allergen, Pac c 3.. Recombinant Pac c 3 allergen from the Asian needle ant was expressed in Pichia pastoris and purified by ammonium sulfate precipitation and Ni affinity chromatography. IgE reactivity was demonstrated by ELISA and immunoblotting.. The recombinant protein was recognized in 5 of 6 (83.3%) serum samples from patients with demonstrated anaphylaxis to ants. IgE reactivity to an antigen 5 allergen from Asian needle ant venom sac extract was specifically inhibited by the recombinant protein. It was also able to inhibit IgE binding to the vespid allergen Ves v 5 by ImmunoCAP analysis, indicating the presence of cross-reactivity.. A recombinant Pac c 3, cross-reactive with Ves v 5, from the Asian needle ant was successfully produced in the methylotrophic yeast P. pastoris. This protein could be useful for the development of component-resolved diagnostics.

Topics: Adult; Allergens; Amino Acid Sequence; Anaphylaxis; Animals; Ants; Case-Control Studies; Cross Reactions; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Insect Proteins; Male; Middle Aged; Molecular Sequence Data; Recombinant Proteins; Sequence Alignment; Young Adult

Topics: Animals; Ant Venoms; Ants; Ceremonial Behavior; Humans; Indians, South American; Insect Bites and Stings; Male

Ants are among the insects that colonize exposed human and animal corpses during the early stage of decomposition. In Calabria, Italy (as well as in other countries), Formicidae have been observed preying on immature stages of Diptera and other insects, as well as causing irregular scalloped areas of superficial skin loss on human corpses and animal carcasses. We present a case of injuries on a human corpse caused by ant feeding. The macroscopic appearance is described and the results of a histochemical investigation of the skin lesions caused by worker ants are reported for the first time. The investigation was carried out on the fresh corpse of a 53-year-old man discovered in a rural area of Cosenza province (Calabria, southern Italy). Numerous irregular areas of superficial skin loss caused by the ant Tapinoma nigerrimum (Nylander 1856) (Hymenoptera, Formicidae) were observed on the body surface, inflicted very early in the post-mortem period. Because the classification of lesions is of crucial importance for forensic investigations, the macroscopic appearance and distribution pattern of the lesions on the corpse are illustrated. The histochemical investigation of the damaged skin explains, for the first time, the mechanism of production of the lesions.

Topics: Animals; Ants; Environment; Forensic Pathology; Humans; Insect Bites and Stings; Italy; Male; Middle Aged; Skin

Haemolytic-uremic syndrome (HUS) is a severe, life-threatening disease with symptoms such as haemolytic anaemia, renal failure, and a low platelet count. Possible aetiology includes bacterial infections, medication, post-hematopoietic cell transplantation, pregnancy, autoimmune disease, and acquired immunodeficiency syndrome.. We report the case of a 21-year-old healthy man who developed acute renal failure caused by HUS. Typical symptoms of HUS combined with severe uraemia developed following a large local reaction after suspected Solenopsis invicta (fire ant) bites. He was successfully treated with plasma exchange and achieved complete recovery of renal function.. This is the first case illustrating a serious systemic reaction of HUS to fire ant bites, and highlights this severe complication in patients who sustain fire ant bites.

Topics: Animals; Ants; Hemolytic-Uremic Syndrome; Humans; Insect Bites and Stings; Male; Plasma Exchange; Treatment Outcome

Topics: Allergens; Animals; Ant Venoms; Ants; Humans; Hypersensitivity; Insect Bites and Stings

Topics: Adult; Anaphylaxis; Animals; Ants; Glucocorticoids; Glycyrrhizic Acid; Histamine Antagonists; Humans; Insect Bites and Stings; Isotonic Solutions; Male; Middle Aged; Treatment Outcome

Topics: Acute Kidney Injury; Anaphylaxis; Animals; Ant Venoms; Ants; Child, Preschool; Humans; Insect Bites and Stings; Male; Rhabdomyolysis; Syndrome

Topics: Animals; Ant Venoms; Ants; Humans; Insect Bites and Stings; Male; Toothache; Vision, Ocular

Ant allergy is a rare problem and most published reports are from outside India. We report a toddler who suffered from severe anaphylaxis reaction due to bite of Red fire ant (Solenopsis geminata).

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Humans; India; Infant; Insect Bites and Stings; Male

Topics: Adult; Anaphylaxis; Animals; Anti-Allergic Agents; Ants; Drug Administration Routes; Female; Humans; Insect Bites and Stings; Respiration, Artificial; Treatment Outcome

To determine the Australian native ant species associated with ant sting anaphylaxis, geographical distribution of allergic reactions, and feasibility of diagnostic venom-specific IgE (sIgE) testing.. Descriptive clinical, entomological and immunological study of Australians with a history of ant sting anaphylaxis, recruited in 2006-2007 through media exposure and referrals from allergy practices and emergency physicians nationwide. We interviewed participants, collected entomological specimens, prepared reference venom extracts, and conducted serum sIgE testing against ant venom panels relevant to the species found in each geographical region.. Reaction causation attributed using a combination of ant identification and sIgE testing.. 376 participants reported 735 systemic reactions. Of 299 participants for whom a cause was determined, 265 (89%; 95% CI, 84%-92%) had reacted clinically to Myrmecia species and 34 (11%; 95% CI, 8%-16%) to green-head ant (Rhytidoponera metallica). Of those with reactions to Myrmecia species, 176 reacted to jack jumper ant (Myrmecia pilosula species complex), 18 to other jumper ants (15 to Myrmecia nigrocincta, three to Myrmecia ludlowi) and 56 to a variety of bulldog ants, with some participants reacting to more than one type of bulldog ant. Variable serological cross-reactivity between bulldog ant species was observed, and sera from patients with bulldog ant allergy were all positive to one or more venoms extracted from Myrmecia forficata, Myrmecia pyriformis and Myrmecia nigriceps.. Four main groups of Australian ants cause anaphylaxis. Serum sIgE testing enhances the accuracy of diagnosis and is a prerequisite for administering species-specific venom immunotherapy.

Topics: Adult; Anaphylaxis; Animals; Ant Venoms; Antivenins; Ants; Australia; Female; Humans; Insect Bites and Stings; Male; Middle Aged

Topics: Anaphylaxis; Animals; Ants; Child, Preschool; Humans; Immunoglobulin E; Insect Bites and Stings; Italy; Male

Invasive species can impose novel selection pressures on natives, such as toxins to which native taxa are not adapted. Native species may survive such invasions by evolving mechanisms to avoid toxin exposure or increase toxin tolerance. Red imported fire ants (Solenopsis invicta) employ an alkaloid-based venom to defend their colonies and capture prey. In this study we aim to characterize the sublethal effects of invasive fire ant venom on a native vertebrate, the eastern fence lizard (Sceloporus undulatus), and to determine whether lizard populations that have been exposed to these fire ants for approximately 35 generations have increased physiological resistance to the venom. We documented the sublethal impact of fire ant venom on fence lizard performance by naturally exposing lizards to fire ant stings and recording changes in three fitness-relevant measures: bite force, righting ability, and sprint speed. We also measured blood hemolysis induced by the venom. To test for the development of physiological resistance to fire ant venom we compared whole-body performance and hemolysis for two populations of lizards with different fire ant invasion histories. Fire ant venom showed no dosage-dependent sublethal effects on performance. In addition, there is no evidence that lizards have evolved increased physiological resistance: the impact of fire ant venom on whole-body performance and hemolysis did not differ between the naïve and experienced populations. Lizards may instead rely on adaptive shifts in escape behavior and morphology following invasion to survive fire ant attack.

Topics: Alabama; Animals; Ant Venoms; Ants; Arkansas; Bite Force; Dose-Response Relationship, Drug; Ecosystem; Female; Hemolysis; Insect Bites and Stings; Lizards; Locomotion; Male

Topics: Adult; Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Australia; Humans; Immunotherapy; Insect Bites and Stings; Male; Tasmania

Imported fire ants (IFAs) are endemic in the southeastern United States, including Texas; can sting multiple times; and are a well-known cause of anaphylaxis. There are few data available on how many stings typically lead to systemic reactions (SRs). Likewise, there are no reports currently in the literature that characterize the safety of IFA subcutaneous immunotherapy (SCIT).. We sought to analyze a case-cohort sample of patients for IFA SCIT risk factors and to characterize the index field reactions of these patients.. A case-cohort study based on a 3-year retrospective chart review (2005-2008) at a single institution was performed for patients receiving IFA SCIT. Field reactions leading to initiation of IFA SCIT were also reviewed.. Seventy-seven patients (40 female patients; mean age, 34 years) received 1,887 injections, and 7 patients experienced 8 SRs, for a rate of 0.4% per injection and 9.1% per patient. SRs were mild. Having an SR to skin testing was associated with increased odds of having an SR to IFA SCIT (odds ratio, 4.75; 95% CI, 1.13-20.0), as were large local reactions (odds ratio, 34.5; 95% CI, 6.52-182). No other risk factors were identified. Of the index field reactions leading to IFA SCIT, 59% were the result of 1 sting, and 87% of subjects experienced only 1 SR before initiation of IFA SCIT. Two of 4 patients who experienced loss of consciousness during the index field reaction required an increased maintenance dose for optimal response.. IFA SCIT is safe; however, having an SR to skin testing or the presence of large local reactions increases the odds of having an SR to IFA SCIT. The majority of SRs to IFA field stings resulted from 1 sting.

Topics: Administration, Sublingual; Adult; Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Case-Control Studies; Desensitization, Immunologic; Feasibility Studies; Female; Humans; Insect Bites and Stings; Male; Retrospective Studies; Skin Tests; Unconsciousness

We report a 40-year old man in Uganda with ulcerated skins lesions, hypotension, and anaphylaxis caused by bites of safari ants. Treatment was successful. Physicians should be aware of anaphylaxis caused by ant bites.

Topics: Adult; Allergens; Anaphylaxis; Animals; Ants; Drug Hypersensitivity; Humans; Immunoglobulin E; Insect Bites and Stings; Insect Repellents; Skin Diseases; Uganda; Wasp Venoms

The ant species Pachycondyla chinensis, which has spread from Far Eastern Asia to New Zealand and North America, induces anaphylactic reactions in human with its sting. However, the major allergens of P. chinensis have not yet been characterized.. We selected seven patients with histories of anaphylaxis induced by P. chinensis. Two-dimensional electrophoresis (2-DE) was used to identify the major allergens. We subsequently performed Western blots for P. chinensis-specific IgEs, N-terminal amino acid sequencing, ESI-MS/MS, and RT-PCR using primers based on the N-terminal sequence.. Six of the anaphylactic subjects had an IgE specific to a 23 kDa allergen of P. chinensis. Two candidates for major allergens, 23 kDa (pI 8.7) and 25 kDa (pI 6.2), were revealed by 2-DE using P. chinensis-specific IgE immunoblotting. In N-terminal sequencing and ESI-MS/MS analysis, 23 kDa (pI 8.7) and 25 kDa (pI 6.2) allergens, belonging to the protein families of antigen 5, were identified and share marked amino acid sequence similarity. The 23 kDa allergen is 206 amino acids in length and homology searches showed 54.0% and 50.0% homology with Sol i 3 and Ves v 5, respectively.. The major allergens of P. chinensis are 23 kDa (pI 8.7) and 25 kDa (pI 6.2) proteins that belong to the antigen 5 family of proteins.

Topics: Adult; Allergens; Amino Acid Sequence; Anaphylaxis; Animals; Ants; Cloning, Molecular; Electrophoresis, Gel, Two-Dimensional; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Male; Middle Aged; Molecular Sequence Data; Sequence Homology, Amino Acid; Spectrometry, Mass, Electrospray Ionization

Topics: Adult; Anaphylaxis; Animals; Ants; Humans; Insect Bites and Stings; Male

Imported fire ant (IFA) stings are an important cause of stinging insect hypersensitivity in endemic areas. IFA stings are difficult to avoid, and many studies have shown high field sting rates. No studies report the natural IFA sting rate that patients experience while receiving IFA immunotherapy.. To determine the frequency of IFA stings in patients receiving IFA immunotherapy compared with an aeroallergen immunotherapy control group.. Patients were surveyed by telephone to characterize the frequency of stings, reactions, and attitudes toward IFA avoidance.. A total of 23 of 28 patients reported IFA stings during their IFA immunotherapy compared with 16 of 28 patients during their aeroallergen immunotherapy. More of the IFA immunotherapy-treated patients were stung than the aeroallergen immunotherapy patients, which is inconsistent with our hypothesis (chi2 = 4.139, P < .042). The annualized sting rates between the IFA immunotherapy and aeroallergen immunotherapy groups were similar (1.82 vs 1.72 stings per year, P < .55). The IFA immunotherapy patients were more likely to report any kind of reaction (chi2 = 9.124, P < .003) compared with the control group. Most patients reported feeling careful to avoid stings.. Patients with IFA hypersensitivity treated with IFA immunotherapy do not experience a decreased frequency of stings resulting from attention to sting avoidance. IFA stings are frequent and difficult to avoid. Rush IFA immunotherapy is a good option for many patients to achieve protection quickly.

Topics: Adolescent; Adult; Aged; Allergens; Animals; Ants; Child; Female; Humans; Hypersensitivity; Immunotherapy, Active; Insect Bites and Stings; Male; Middle Aged; Sentinel Surveillance; Surveys and Questionnaires; Telephone; Texas; Young Adult

No large evaluation has been performed of the maintenance vial concentration commonly used by physicians when prescribing imported fire ant (IFA) immunotherapy since the publication of the first Stinging Insect Hypersensitivity Practice Parameter 10 years ago.. To describe the prescribing patterns for IFA immunotherapy among practicing allergists in a large health care setting and the impact of published Practice Parameter recommendations.. Data from the US Army Centralized Allergen Extract Laboratory were analyzed to determine IFA immunotherapy prescribing patterns from 1990 to May 2007. This extract laboratory provides prescriptions for more than 320 US Department of Defense, US Department of Veterans Affairs, and US Public Health Service clinics.. A total of 1,091 patients were given 1,437 new or revised prescriptions for IFA immunotherapy. Monotherapy for Solenopsis invicta and Solenopsis richteri was prescribed in 169 (11.8%) and 3 (0.1%) instances, respectively, with the remainder of patients given both IFA antigens. The most commonly prescribed maintenance vial dose was 0.5 mL of a 1:200 (wt/vol) dilution, accounting for 36.3% of prescriptions. A total of 17.3% of prescriptions had a maintenance vial dose of 0.5 mL of a 1:100 (wt/vol) dilution, 4.6% had a dilution of 1:10 (wt/vol), and 50.6% had a dilution between 1:10 and 1:100 (wt/vol). The mean starting dose was 4.4 10-fold dilutions below the maintenance dose (5.4 vials per treatment set).. The most commonly prescribed maintenance dose was 0.5 mL of a 1:200 (wt/vol) dilution, although most prescriptions used a maintenance dose consistent with recommended dosing in the Stinging Insect Practice Parameters. Both IFA antigens were used by most physicians. Further study evaluating the effective dose range for IFA immunotherapy is needed.

Topics: Animals; Ant Venoms; Ants; Complex Mixtures; Delivery of Health Care; Desensitization, Immunologic; Drug Prescriptions; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Time Factors

In this paper, I review the strange, unplanned and unexpected journey I have had with Solenopsis invicta, the imported fire ant. Through serendipity, good fortune and repeated invenomation, I have come to count as collaborators a number of entomologists, toxicologists, allergists and immunologists who have guided me on this journey to the ants. We now understand the mechanisms for the cutaneous reactions experienced by 50% of the exposed population stung per year, as well as the immunologic and toxicologic properties of the ants unique venom. Allergen immunotherapy to fire ant extracts has been demonstrated to protect patients from repeat anaphylaxis. Methods have been developed to prevent and treat massive sting attacks on frail elders, including those in residential and medical facilities. The potential beneficial effects of venom components are under investigation. And yes, the journey and the stings continue.

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; History, 20th Century; History, 21st Century; Humans; Insect Bites and Stings; Southeastern United States

The red (Solenopsis invicta) and black (Solenopsis richteri) imported fire ants (IFA) are a common cause of venom allergy in the southeastern United States. Hypersensitivity to stings of native fire ants is less common, although anaphylaxis has been reported to various native Solenopsis species. There have been numerous reports of indoor stings caused by IFA, including in nursing homes and private residences. The following is a report of fatal anaphylaxis to a native fire ant sting in an infant that occurred indoors at a daycare facility. A 3-month-old female was left unattended on a bed. The caregiver had heard the child crying, but attributed this to colic. A short time later, the caregiver found the child apneic and covered with ants. Emergency medical services were summoned, and resuscitation attempts were unsuccessful. Postmortem examination revealed approximately 40 erythematous lesions without pustules. Examination of the respiratory system was notable for congested parenchyma and mild laryngeal edema. Laboratory studies revealed an elevated tryptase of 23.9 ng/mL and radioallergosorbent test (RAST) of 1.4% specific IgE antibody binding to Solenopsis richteri venom. RAST for specific IgE antibody binding to Solenopsis invicta venom was negative. Ants recovered from the scene were identified by an entomologist as Solenopsis xyloni, a native fire ant endemic to the southwestern United States. Native fire ants have features that distinguish them from IFA. Some native species do not build mounds, and stings may not result in pustules characteristic of IFA. There is significant cross-reactivity among the venoms of Solenopsis species, although some species' specificity exists for the Sol 2 allergen. Testing and treatment with IFA whole-body extract is likely to be to be effective for native fire ant allergy. A mixture of S. invicta and S. richteri extracts should be considered when native fire ant species are presumed to cause the primary sensitization to reduce the chance that species-specific reactivity is missed.

Topics: Anaphylaxis; Animals; Ant Venoms; Antibodies; Ants; Child Day Care Centers; Edema; Erythema; Fatal Outcome; Female; Forensic Pathology; Humans; Immunoglobulin E; Infant; Insect Bites and Stings; Larynx; Tryptases

A 27-year-old woman suffered from anaphylaxis after being stung by Solenopsis invicta ants while she was handling wood from South America. The patient reported no previous adverse reactions to stings by other hymenopteran species. Intradermal skin tests with hymenoptera venom (Vespula vulgaris, Polistes species, Apis melifera) were negative. Serum specific immunoglobulin (Ig) E yielded positive results for S invicta (5.28 kU/L) and negative results for A melifera, Ves v 5 and Pol a 5. Immunodetection assays showed the presence of serum IgE against the Sol i 2 allergen. The patient had probably been stung previously although inadvertently by red fire ants while she handled infested wood from South America, and precautionary measures are thus advisable when this material is to be handled. To our knowledge this is the first case of anaphylaxis from red fire ant stings reported in Europe.

Topics: Adult; Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Insect Proteins; South America; Spain; Wood

We describe a 59-year-old patient who developed acute renal failure because of rhabdomyolysis after extensive red fire ant bites. This case illustrates a serious systemic reaction that may occur from fire ant bites. Consistent with the clinical presentation in rhabdomyolysis associated with non-traumatic causes, hyperkalemia, hypophosphatemia, hypocalcemia, and high anion gap acidosis were not observed in this patient. While local allergic reactions to fire ant bites are described in the literature, serious systemic complications with rhabdomyolysis and renal failure have not been previously reported. It is our effort to alert the medical community of the possibility of such a complication that can occur in the victims of fire ant bites.

Topics: Acute Kidney Injury; Anaphylaxis; Animals; Ants; Creatinine; Humans; Insect Bites and Stings; Male; Middle Aged; Renal Dialysis; Rhabdomyolysis

Fire ants and AHBs are aggressive social insects that readily attack when they perceive a threat. Rarely, each can cause fatal allergic reactions. However, AHBs can overwhelm and kill even healthy, nonallergic people. Such encounters are relatively rare, yet increasing in frequency. As a rule, fire ants can't overwhelm a healthy, mobile person, and even hundreds of stings are rarely fatal. AHBs, however, pose a greater threat to EMS and fire personnel when encountered. Every EMS agency in areas where AHBs are located (or predicted to migrate) should develop protocols for AHB attacks. Such a response should assure adequate personnel and, above all, rescuer safety. The protocol should be periodically practiced and reviewed.

Topics: Animals; Ants; Bees; Emergency Medical Services; Humans; Insect Bites and Stings; Occupational Health; United States

Severe cutaneous allergic vasculitis in a 60 year-old Caucasian male following the bite of the tropical fire ant, Solenopsis geminata (F.) is reported. Over the course of 8 weeks, the pathology progressed from an extensive red papular urticaria to vasculitis with peri-vascular inflammation and ulceration of the skin on the feet, ankles and lower limbs. Many of the affected areas of the skin eventually became covered with black eschar associated with further tissue breakdown and ulcer formation. After debridement, compression dressings, antimicrobial ointment and corticosteroids, complete healing eventually took place with only residual scarring. An awareness of the severe dermatologic reactions caused by a bite of S. geminata, albeit rare, is clinically important. Recognizing the characteristic skin lesions caused by the bite of S. geminata, treated with prompt administration of appropriate chemotherapy will speed recuperation of the patient and reduce possible secondary complications.

Topics: Animals; Ant Venoms; Ants; Humans; Indonesia; Insect Bites and Stings; Male; Middle Aged; Skin Diseases, Vascular; Urticaria; Vasculitis, Leukocytoclastic, Cutaneous

To determine the main causative species, reaction characteristics and geographical locations of ant sting anaphylaxis around Perth, Western Australia (WA).. Structured interviews were performed on a cohort of 10 patients referred to our Anaphylaxis Clinic who were allergic to ant venom, followed by field trips to collect ant specimens. A descriptive analysis of clinical data was performed.. Around Perth, Myrmecia gratiosa, a bull dog ant, was the only species of stinging ant found around the locations where reactions had occurred (eight patients). To the south-west of Perth, species implicated were another bull dog ant Myrmecia nigriscapa (one patient), and a jumper ant Myrmecia ludlowi (one patient). Twelve reactions were documented as mild (one), moderate (seven) and severe with hypotension (four). In three bull dog ant venom allergic patients, specific IgE was analysed, demonstrating substantial cross-reactivity with other bull dog ant species. Clinical patterns of reaction severity and response to repeated stings were consistent with known features of insect sting allergy.. A single species of bull dog ant, M. gratiosa, appears to be responsible for ant sting anaphylaxis around Perth. Further investigation is required for other regions of WA. The provision of effective immunotherapies for people allergic to native Australian ants might be simplified by the dominance of a limited number of ant species and IgE binding cross-reactivity between venoms, as was evident in this study.

Topics: Adult; Age Distribution; Anaphylaxis; Animals; Ant Venoms; Ants; Causality; Child; Child, Preschool; Cohort Studies; Comorbidity; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Male; Middle Aged; Recurrence; Western Australia

We have previously reported 10 indoor sting attacks by imported fire ants, most of which involved frail elderly people in the Southeastern United States. Since the range of these insects is expanding and attacks often attract media attention, we hypothesized that additional attacks of which we were unaware may have occurred and were reported in local newspapers.. We searched the archives from 1989 until 2004 of 182 US newspapers in fire ant endemic areas in 10 states.. Ten additional cases of indoor fire ant sting attacks were reported in local newspapers between 1991 and 2004. This brings the total to 16 attacks on adults and four on infants. Most adult attacks occurred in long-term care facilities, but three involved hospitalized patients. Morbidity ranged from nightmares to death in seven adults. One of the infants died and two suffered long-term morbidity. Six of the 20 sting victims died within 1 week of the attack. Seven of the 10 attacks reported in newspapers did not result in significant medical consequences, as compared with only two of the 10 attacks in previously published reports.. Increasing numbers of indoor fire ant sting attacks are occurring in the United States, and frail elderly people and infants are at risk. They should be removed from indoor areas where ants are present until the ants are eradicated.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Animals; Ant Venoms; Ants; Child, Preschool; Female; Frail Elderly; Housing; Humans; Infant; Infant, Newborn; Insect Bites and Stings; Male; Middle Aged; United States

Pachycondyla chinensis (Emery) (Formicidae: Ponerinae), a species introduced into North America > 70 yr ago, is found throughout Southeast Asia. Stinging of zookeepers by P. chinensis at the Greenville Zoo (Greenville, SC) initiated an investigation of this exotic species and a survey of sting victims. Eighty percent of sting victims experienced local reactions, including swelling < 5 cm in diameter around the sting site, recurring pain, skin redness, and mild-to-severe urticaria. These symptoms lasted 2 h to 5 d. Twelve percent of the sting victims reported minor reactions, including no swelling, localized redness, minor pain sensation at the time of sting, mild urticaria, and symptoms lasting < 1 h. Eight percent of the sting victims reported significant local reactions, including swelling > 5 cm in diameter around the sting site, recurring pain, skin redness, severe urticaria, and symptoms lasting 3-14 d. P. chinensis represents an emerging public health threat throughout its present range in the southeastern United States (i.e., Georgia, North Carolina, South Carolina, and Virginia). Because of reported adverse reactions to stings of P. chinensis, further studies on its ecology and medical and veterinary importance need to be undertaken.

Topics: Animals; Ants; Humans; Hypersensitivity; Insect Bites and Stings; Male; Public Health; Southeastern United States

Ant allergy is a rare clinical problem that ranges from local to systemic reaction and life-threatening anaphylaxis. Different types of ants including the imported fire ants, the black (samsum) ants, and others, are considered health hazard in many parts of the world. We report a 32-year-old Saudi female from Hafr-Al-Batin in the Northern region of Saudi Arabia, with history of recurrent anaphylaxis following black (samsum) ant stings and we review the related literature. This is the first report of black (samsum) ant allergy in Saudi Arabia.

Topics: Adrenergic Agonists; Adult; Anaphylaxis; Animals; Anti-Inflammatory Agents; Ants; Drug Therapy, Combination; Emergencies; Epinephrine; Female; Glucocorticoids; Humans; Injections, Subcutaneous; Insect Bites and Stings; Methylprednisolone; Saudi Arabia

The identity and origin of the West Indian plague ants of the early sixteenth and late eighteenth centuries have long been a mystery. By reviewing historic accounts with an analysis of the present-day Caribbean ant fauna, I have narrowed the list of suspects to two species and their insect symbionts.

Topics: Animals; Ant Venoms; Ants; Geography; History, 16th Century; History, 18th Century; Humans; Insect Bites and Stings; Symbiosis; West Indies

In contrast to aggressive mastocytosis, patients with indolent systemic mastocytosis (ISM) usually present with urticaria pigmentosa-like skin lesions. In those who lack skin lesions, mastocytosis is often overlooked or confused with endocrinologic, allergic, or other internal disorders.. We report on a 33-year-old male patient in whom severe hypotensive episodes occurred after contact with ants or yellow jackets. Since no specific IgE was detected, the serum tryptase concentration was measured and found to be clearly elevated (70 ng/ml). Consecutive staging and examination of the bone marrow revealed ISM. The patient was advised to circumvent insect contact, to take antihistamines on demand, and to carry an epinephrine self-injector for emergency events. In a retrospective analysis of 40 patients seen between 1988 and 2003, only 2 had a life-threatening mediator-related episode before ISM was diagnosed.. Our report confirms the diagnostic value of tryptase in patients with suspected mastocytosis. In addition, the report suggests that the lack of typical skin lesions does not exclude an indolent form of mastocytosis even if the serum tryptase is clearly elevated. Finally, our case further shows that mastocytosis can be an important differential diagnosis to be considered in patients with unexplained anaphylactoid or other mediator-related symptoms.

Topics: Adult; Anaphylaxis; Animals; Antigens; Ants; Austria; Bone Marrow; Cell Line; Cross-Sectional Studies; Female; Humans; Insect Bites and Stings; Male; Mast Cells; Mastocytosis, Systemic; Monocytes; Mutation; Proto-Oncogene Proteins c-kit; Recurrence; Serine Endopeptidases; Skin Diseases; Tryptases; Wasps

Many studies are available on systemic reactions to ant sting, but few have described the direct role of ants in respiratory allergy. The nonstinging house ant, Monomorium pharaonis (pharaoh ant), is a highly infesting species in indoor environments.. To determine whether the pharaoh ant is an indoor source of aeroallergens.. Two patients with asthma who lived in homes with ant infestation were enrolled. Pharaoh ants were collected at the patients' homes, and crude extracts were prepared. Skin prick tests with ant extracts were performed. Specific IgE to pharaoh ant was measured by enzyme-linked immunosorbent assay (ELISA), and the allergenic components were determined by using immunoblot analysis. Cross-reactivity among pharaoh ant, imported fire ant, Pachycondyla chinensis ant, and other indoor allergens was evaluated by ELISA inhibition tests. Specific bronchial challenge testing was performed using pharaoh ant extracts.. Both patients had positive skin test reactions to pharaoh ant extract and high levels of specific IgE antibodies to pharaoh ant. The ELISA inhibition test results demonstrated significant inhibition by pharaoh ant; however, P. chinensis, cockroach, and house dust mite showed no inhibition of the IgE binding to pharaoh ant. Two important IgE-binding components, 9.4 and 34 kDa, were identified by using immunoblot analysis. Pharaoh ant bronchial challenge test results showed typical early asthmatic reactions in 1 patient and dual asthmatic reactions in the other patient.. Ants can induce IgE-mediated bronchoconstriction regardless of sting in sensitized patients. Ants should be taken into consideration as a cause of respiratory allergy in patients living in homes with visual evidence of infestation.

Topics: Air Pollution, Indoor; Allergens; Animals; Ants; Bronchial Provocation Tests; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoblotting; Immunoglobulin E; Insect Bites and Stings; Middle Aged; Respiratory Hypersensitivity; Skin Tests

There are no published data on the natural history of large local and generalized cutaneous reactions to imported fire ant (IFA) stings in children.. To determine the natural history of large local and generalized cutaneous reactions to IFA stings in children not treated with immunotherapy by reviewing medical records from a venom clinic during the past 20 years.. Patients were selected for the study if they were 16 years or younger at the time of the reaction, had only cutaneous symptoms (generalized cutaneous or large local), and did not initiate immunotherapy. Each patient's parents were asked to recall whether the patient had experienced any further stings since the last evaluation at the venom clinic.. We contacted 31 of 57 patients evaluated between July 10, 1984, and February 5, 2004. Twenty patients (65%) reported that they had not developed more severe reactions with subsequent stings. Reactions remained cutaneous only. Eleven patients (35%) had not been stung again since the original evaluation. Five of these patients had moved out of the IFA-endemic region. None of the previously evaluated patients reported subsequent life-threatening anaphylaxis from IFA stings.. These limited data on IFA stings suggest a benign outcome in children 16 years and younger with large local or generalized cutaneous reactions. Larger and more extensive studies need to be conducted to further define the natural history of cutaneous reactions to IFA stings in children.

Topics: Adolescent; Animals; Ant Venoms; Ants; Child; Child, Preschool; Dermatitis; Disease Progression; Female; Humans; Immunotherapy; Infant; Insect Bites and Stings; Male; Recurrence; Retrospective Studies; Texas

Topics: Animals; Ant Venoms; Ants; Hong Kong; Humans; Insect Bites and Stings

Topics: Anaphylaxis; Animals; Ants; Humans; Insect Bites and Stings; Protective Clothing

Fire ant stings lead to significant morbidity and mortality each year. Virtually no information exists in the scientific literature about the effectiveness of personal protection measures against these ants.. To quantify the level of protection from ant stings by socks and cotton tights and to evaluate the efficacy of repellents and other chemicals in preventing stings.. Commercially obtained infant socks were fitted on a plastic doll's foot, which was touched to fire ant mounds in a series of controlled experiments. Socks and cotton tights were stretched over a human finger and placed in a fire ant mound to test the ability of ants to sting through fabric. Assays were developed to screen chemical substances for their ability to stop or prevent fire ant stings.. Socks of any type reduced the number of fire ants that reached the skin and delayed the time required for ants to reach the skin above the sock level. Fire ants were unable to sting through all socks tested. Ants successfully stung both paper towels and human skin, regardless of chemical substance or repellent applied to them.. Socks provide some degree of protection from fire ant stings; therefore, children living in fire ant-infested areas should wear them. Fire ants appear unable to sting through many commercially available socks. Cotton tights may be useful in protecting the lower extremities of children. Fire ants are not deterred from stinging by a wide variety of insect repellents and chemical substances.

Topics: Animals; Ants; DEET; Insect Bites and Stings; Insect Control; Insect Repellents; Protective Clothing; Sulfur

The case is reported of an elderly patient with known previous exposure to fire ant stings, and who presented with hand-foot syndrome (HFS) in the setting of multiple fire ant stings to the lower extremities. Both hands and both feet were red, swollen, and mildly tender. Treatment was with fluocinonide cream, and all symptoms resolved as the classic fire ant skin lesions regressed. HFS was initially reported in association with acute crisis in sickle cell anemia and thalassemia and more recently as a common toxicity of chemotherapy administration. This is the first report of its occurrence in the setting of fire ant envenomization. Although recent literature may indicate a potential therapeutic benefit from COX-2 antagonists, the process appears to be self-limited, and requires only conservative treatment.

Topics: Aged; Animals; Ants; Foot Dermatoses; Hand Dermatoses; Humans; Insect Bites and Stings; Male

Imported fire ants (IFA) represent a potential anaphylactic risk to IFA-sensitized individuals.. We examined the prevalence of allergic sensitization to IFA, yellow jacket venom (YJV), and peanut in an adult population from an IFA-infested region, Augusta, Georgia.. Specific IgE to IFA, YJV, and peanut were determined by using the Pharmacia UniCAP assay in 200 random blood donors from an Augusta blood bank. These results were compared with specific IgE to identical allergens in a random sample of blood donors from Oklahoma City, Oklahoma (OKC), a nonendemic region for IFA.. Prevalence of IFA-specific IgE (17%) in the Augusta population was significantly higher than to YJV (10%, P =.04) or peanut (7.5%, P =.004). The majority of individuals who had significant IgE to IFA (> or =0.35 kIU/L) did not have IgE to YJV (24/34 = 71%). YJV caused significantly more inhibition of IgE binding to a YJV solid phase than to an IFA solid phase when the 10 dual-positive sera were analyzed (58% vs 11%, P =.005). The prevalence of IFA-specific IgE in adults from Augusta was higher than in OKC (17% vs 2%, P =.0002). YJV-specific IgE was also more prevalent in Augusta compared with OKC (10% vs 6.0%, P =.04), whereas no difference was demonstrated for peanut-specific IgE (7.5% vs 6.5%, P =.6).. Allergic specific IgE to IFA is 1.7 times more common in adults living in an endemic area than specific IgE for other allergens associated with potentially fatal anaphylaxis. This suggests that IFA may pose the greatest risk of anaphylaxis for adults residing in IFA-endemic regions.

Topics: Adolescent; Adult; Aged; Allergens; Anaphylaxis; Animals; Ants; Arachis; Blood Donors; Endemic Diseases; Female; Georgia; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Insect Bites and Stings; Male; Middle Aged; Prevalence; Risk Factors; Single-Blind Method; Wasp Venoms

In the life of the fire ant, Solenopsis invicta, venom plays several important roles, including prey capture, defense, and anti-microbial action. Although this venom's chemistry, pharmacology, and effects on humans have been extensively studied, its patterns of synthesis and use have not. We determined the ability of different-aged workers to synthesize venom, and measured the amount of venom workers delivered per sting. Newly eclosed workers contained little or no venom in their reservoirs. The rate of synthesis was highest in workers aged 1 day after adult eclosion (1.17 microg venom/day for workers with headwidths of 1 mm), declined by 75% in workers aged 15 days (0.30 microg venom/day), and was negligible thereafter. Inducing ants to sting dummies as surrogates for humans, workers were found to deliver an average of 0.66 nl per sting, amounting to 3.1% of the average individual venom supply. Older workers (foragers) delivered less venom per sting than mid-age workers (reserves) and venom dose from nest-defenders was 55% higher in the spring than in the rest of the year. Thus, fire ant venom synthesis is limited to early life, and injected venom dose appears to be modulated. Economic explanations for the observed venom-use patterns are discussed.

Topics: Age Factors; Analysis of Variance; Animals; Ant Venoms; Ants; Behavior, Animal; Insect Bites and Stings; Seasons

Recently, immediate allergic reactions, including anaphylaxis, after Pachycondyla chinensis ant stings have been frequently reported in Korea. To estimate the prevalence of these reactions and the sensitization rate to P chinensis, we undertook a visit-questionnaire survey of the 327 adult residents living in a town in an ant-infested area in Korea. Skin prick tests with 6 common inhalant allergens, 3 bee venom allergens, and P chinensis whole body extract were performed on all ant-allergic subjects, on 86 asymptomatic residents, and on 37 controls outside the area. The serum-specific IgE to P chinensis extract was determined by ELISA. Seven subjects (2.1%) reported that they had experienced systemic allergic reactions to P chinensis stings; 4 of them had anaphylactic reactions. Large local reactions occurred in an additional 5 subjects (1.6%). All subjects with systemic allergic reactions had positive skin prick test results to P chinensis extract, whereas 23.3% of asymptomatic residents and 2.7% of the controls showed positive skin prick test results. The serum-specific IgE level was significantly higher in the subjects with systemic reactions than in the subjects with local reactions, the asymptomatic sensitizers, and the nonatopic controls. Sensitization to bee venom was found in 25% of the P chinensis -allergic subjects; this was significantly higher than the 3% rate seen in nonsensitized subjects. In conclusion, we report a 2.1% prevalence of systemic allergic reactions after P chinensis stings, based on self-reported symptoms, in an ant-infested area in Korea.

Topics: Adolescent; Adult; Aged; Allergens; Anaphylaxis; Animals; Ant Venoms; Ants; Female; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Insect Bites and Stings; Korea; Male; Middle Aged; Prevalence; Skin Tests; Surveys and Questionnaires

We investigated ant sting related fatalities in Australia over the period 1980-1999. Data was obtained from the Australian Bureau of Statistics and state coronial authorities. Six ant sting-related fatalities were identified, five in Tasmania and one in New South Wales. All were males aged between 40 and 80-years-of-age and most (5/6) had prior histories of jumper or bull ant (Myrmecia spp.) venom allergy. However, none of the deceased carried injectable adrenaline and most died within 20 min of a single sting. Significant cardiopulmonary co-morbidities were identified in all cases and, in addition, moderate-severe laryngeal oedema and coronary atherosclerosis was observed in most (4/6) cases at autopsy. Where ascertained, Myrmecia ant venom specific immunoglobulin E antibodies levels were always elevated and fell into two distinct patterns of immunoreactivity. Adult Tasmanian males with a prior history of ant venom allergy and cardiopulmonary co-morbidities are therefore at highest risk of a fatal outcome from ant stings. Deaths may be avoided by the early recognition of anaphylaxis and self-treatment with adrenaline as well as by the development of purified Myrmecia ant venom immunotherapy.

Topics: Adult; Aged; Animals; Ant Venoms; Ants; Australia; Humans; Hypersensitivity; Immunoglobulin E; Insect Bites and Stings; Male; Middle Aged; Serine Endopeptidases; Tryptases

Topics: Adult; Anaphylaxis; Animals; Ants; Follow-Up Studies; Humans; Insect Bites and Stings; Male; Risk Assessment; Urticaria

Cutaneous sporotrichosis is an uncommon infection, usually reported as sporadic cases resulting from inoculation with sharp environmental vegetative matter. We report such a case of multiple primary inoculations acquired from Solenopsis (fire ant) stings in a 54-year-old white man. The patient was treated effectively with itraconazole 200 mg twice a day for 4 months.

Topics: Animals; Ant Venoms; Antifungal Agents; Ants; Humans; Insect Bites and Stings; Itraconazole; Male; Middle Aged; Sporotrichosis

The range of imported fire ants now includes most of the southeastern United States, parts of the Southwest, portions of the East and West Coasts, and Puerto Rico. Increasingly, fire ant attacks on patients in health care facilities have been reported. In this paper, we provide recommendations for fire ant control in and around health care facilities that should help prevent building infestation and further attacks. In addition, we provide algorithms detailing fire ant prevention strategies (indoors and outdoors) and patient management after fire ant stings. Physicians in areas endemic for fire ants should be aware of the possibility that patients may be harmed by these insects, and also should be generally familiar with measures used to control fire ants.

Topics: Algorithms; Animals; Ants; Health Facilities; Humans; Insect Bites and Stings; Insect Control; Puerto Rico; Southeastern United States

There have been no reports dealing with the pathogenic mechanism and IgE-binding components in patients with anaphylaxis caused by a sting from Pachycondyla chinensis.. This study was conducted to observe the clinical features of patients with P chinensis -induced anaphylaxis. The roles of specific (s) IgE and sIgG4 antibodies were evaluated, and IgE-binding components were identified.. Seven patients with P chinensis -induced anaphylaxis and 15 unexposed control subjects were enrolled. P chinensis ants were collected at the patients' homes, and venom was prepared as P chinensis extract. Five patients complained of bee venom-induced anaphylaxis and had positive sIgE levels to yellow jacket venom, wasp venom, or both as well. Serum sIgE and sIgG4 were detected by means of ELISA. To identify IgE-binding components within P chinensis extracts, 12% SDS-PAGE with immunoblot analysis was applied.. All patients had positive skin prick test responses to P chinensis antigen and positive sIgE levels. Five (71%) patients had positive sIgG4 levels. Eight IgE-binding components (58, 46, 3l, 29, 27, 25, 22, and 12 kd) were noted, and the component at 12 kd was the most frequently found allergen (85%). IgE ELISA inhibition tests were performed on 2 groups of sera: one from patients with anaphylaxis induced by both P chinensis and bee venom (group A) and the other from patients with anaphylaxis induced by P chinensis venom alone without bee venom allergy (group B). ELISA inhibition tests with serum from group A showed significant inhibitions with addition of P chinensis extract, partial inhibitions with yellow jacket antigen, and minimal inhibitions with wasp or imported fire ant antigens. However, ELISA inhibition tests with serum from group B showed significant inhibitions with P chinensis antigen but no inhibition with wasp, yellow jacket, or imported fire ant antigens.. IgE-mediated reactions contributed to the development of P chinensis -induced anaphylaxis. Eight IgE-binding components and one major allergen (12 kd) were identified. Further studies will be needed to clarify the role of sIgG4 and to identify allergenic relationships with major bee and wasp allergens.

Topics: Adult; Aged; Allergens; Anaphylaxis; Animals; Ants; Electrophoresis, Polyacrylamide Gel; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoblotting; Immunoglobulin E; Immunoglobulin G; Insect Bites and Stings; Insect Proteins; Middle Aged; Skin Tests

This study provides the first baseline estimate of the impact of indoor IFA infestations in all 46 counties of our state. Clinicians need to be alert to the threat of unprovoked stings and possible anaphylaxis among disabled or confined patients in a variety of indoor settings.

Topics: Aged; Anaphylaxis; Animals; Ants; Female; Housing; Humans; Infant; Insect Bites and Stings; Insect Control; Male; South Carolina

Topics: Adolescent; Adult; Anaphylaxis; Animals; Ant Venoms; Ants; Data Collection; Humans; Insect Bites and Stings; Referral and Consultation; South Carolina

The biology, behaviour and venom of the ant Myrmecia nigrocincta are described. Symptoms of 15 cases of envenomation are described.

Topics: Adolescent; Adult; Animals; Ant Venoms; Ants; Australia; Child; Child, Preschool; Female; Humans; Insect Bites and Stings; Male; Middle Aged

Topics: Animals; Ants; Edema; Humans; Insect Bites and Stings; Necrosis; Skin; Skin Diseases; Ulcer

Imported fire ants are now firmly established in all 46 counties of South Carolina. In 1998 there were an estimated 660,000 cases in the state of which approximately 33,000 sought medical treatment at an estimated cost of 2.4 million dollars. Residents and visitors are at risk for IFA attacks that may occur indoors as well as outdoors. While IFA sting victims in endemic areas of the state may be less likely to seek medical treatment, patients in recently infested areas seem to be more likely to seek treatment since they are relatively unfamiliar with the multiple, painful IFA stings and pustules. Citizens need to control IFA infestations around and within their homes according to guidelines recommended by the Clemson University Cooperative Extension Service. Regional IFA control programs were discontinued in the past because of costs and environmental chemical concerns. Obviously, we need to support ongoing research aimed at developing improved and safe strategies for the local and regional control of IFA.

Topics: Animals; Ants; Humans; Insect Bites and Stings; South Carolina

Topics: Adolescent; Adult; Aged; Anaphylaxis; Animals; Ant Venoms; Ants; Female; Humans; Insect Bites and Stings; Male; Middle Aged; Surveys and Questionnaires; Victoria

Topics: Animals; Ants; Female; Humans; Insect Bites and Stings; Queensland

Topics: Adolescent; Allergens; Anaphylaxis; Animals; Ants; Bronchodilator Agents; Diphenhydramine; Epinephrine; Humans; Immunotherapy; Injections, Intravenous; Injections, Subcutaneous; Insect Bites and Stings; Male

Imported fire ants (Solenopsis invicta and Solenopsis richteri) are the source of a potentially lethal environmental hazard in the southeastern United States. Because of their resistance to natural and chemical control, fire ants can overwhelm their environment, causing destruction of land and animals. Fire ants can also cause a variety of health problems in humans, ranging from simple stings to anaphylaxis and death. We present a case of a 30-year-old woman who died of anaphylaxis following multiple fire ant stings. At autopsy, multiple skin lesions characteristic of those produced by fire ant stings were present on her arm. Postmortem blood samples were positive for imported fire ant venom-specific IgE antibodies (5654 ng/ml) and tryptase (12 ng/ml). Deaths caused by imported fire ant stings are rare but are likely to become more common as the fire ant population expands. In this report, we review deaths due to fire ant stings, discuss postmortem laboratory findings, and stress the importance of recognizing the characteristic skin lesions produced by fire ants.

Topics: Adult; Anaphylaxis; Animals; Ant Venoms; Ants; Cause of Death; Chymases; Fatal Outcome; Female; Humans; Immunoglobulin E; Insect Bites and Stings; Microscopy, Electron, Scanning; Serine Endopeptidases; Tryptases

Topics: Abruptio Placentae; Adult; Anaphylaxis; Animals; Ants; Female; Fetal Death; Gestational Age; Humans; Insect Bites and Stings; Pregnancy; Pregnancy Complications

Imported fire ants are a common cause of insect venom hypersensitivity in the Southeastern United States.. The purpose of this study was to determine the most frequent insect cause for evaluation in a Hymenoptera hypersensitivity clinic in an area endemic for the imported fire ants.. This was a retrospective study reviewing all patients seen in a venom clinic at a large teaching hospital.. Of the 703 patients evaluated, between 1985 and 1995, 515 (73%) had reactions consistent with systemic anaphylaxis for which a determination of specific IgE was appropriate. Of the 703 patients seen, 315 (45%) had a positive history and skin test positivity and were offered specific immunotherapy. This was 61% of those individuals skin tested. Of the total patients seen, imported fire ants were responsible for 42% of the visits to the clinic and accounted for 59% of the total immunotherapy that was begun in this endemic area.. In areas endemic for the imported fire ants, the most frequent cause of Hymenoptera hypersensitivity is the imported fire ant.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Ant Venoms; Ants; Child; Child, Preschool; Female; Humans; Hymenoptera; Hypersensitivity; Immunotherapy; Infant; Insect Bites and Stings; Male; Middle Aged; Retrospective Studies; Skin Tests; Texas

Topics: Aged; Animals; Ants; Carcinoma, Squamous Cell; Clitoris; Female; Humans; Insect Bites and Stings; Vulvar Neoplasms

There are four species of fire ants found in the United States in addition to the most common, Solenopsis invicta. Reactions have been reported from stings of each of these species, but large numbers of insects and adequate amounts of venom for study are very difficult to obtain.. Venom was obtained, the purified allergens were isolated, and the complete amino acid sequences were determined for two of the three allergens from S. richteri. Skin testing and RAST studies were performed on patients with reactions to native fire ant stings and analyzed in comparison with clinical history.. The structures of S. richteri allergens have a high degree of similarity to S. invicta allergens. The Sol 2 allergens are less related to each other than either the Sol 1 (phospholipase AB) or Sol 3 (antigen 5) allergens. Patients sensitized to native species of fire ants react primarily to the Sol 1 and Sol 3 allergens, whereas those originally sensitized to S. invicta also react significantly to the Sol 2 and Sol 4 allergens. Some patients are initially sensitized to S. invicta and have life-threatening reactions to stings of native species. The tropical fire ant, S. geminata, has become a serious problem in some areas of the Pacific and South Asia, especially Okinawa and Guam.. The venoms from all of the species of fire ants examined appear to be highly cross-reactive. S. invicta imported fire ant venom extracts are probably sufficient for diagnosis and may warrant a clinical trial for immunotherapy of allergic reactions to venoms of any of the other four species.

Topics: Adult; Allergens; Amino Acid Sequence; Animals; Ant Venoms; Ants; California; Cross Reactions; Female; Florida; Humans; Insect Bites and Stings

Topics: Adult; Animals; Antivenins; Ants; Black Widow Spider; Diagnosis, Differential; Female; Humans; Insect Bites and Stings; Spider Bites; Spider Venoms; Victoria

Topics: Adaptation, Biological; Animals; Ant Venoms; Ants; Biological Evolution; Commerce; Humans; Hypersensitivity, Immediate; Immunotherapy; Insect Bites and Stings

Topics: Animals; Ant Venoms; Ants; Ecology; Health Facilities; Humans; Insect Bites and Stings; Insect Control

In the United Arab Emirates the sting of the Pachycondyla sennaarensis ant (PSA) causes allergic reactions in certain persons. It is a common problem and is becoming a public health hazard. Up to now the diagnosis has been based only on the history, because the mechanism of the reaction was not yet established.. The aim of our study was to prepare an allergenic extract that would be used for skin tests and to prepare a reagent for specific IgE titration. Results of both skin tests and specific IgE were to be compared with the clinical history.. We studied 31 patients with anaphylactic reactions and performed clinical examinations, skin tests, and specific IgE antibody titrations. A control group of 22 subjects were also studied.. In 30 of 31 patients (97%) findings of PSA skin tests and/or specific IgE were positive. In the control groups PSA skin test results were negative in 86% and negative for specific IgE in 68%.. The study shows that the mechanism of the reaction to the sting of the PSA is a type I IgE-mediated hypersensitivity and that the diagnosis can now be confirmed by skin tests and specific IgE determination.

Topics: Adolescent; Adult; Aged; Animals; Ants; Humans; Hypersensitivity; Immunoglobulin E; Insect Bites and Stings; Skin Tests

The progressive spread and increasing colony density of imported fire ants throughout the southeastern United States will result in increasing numbers of individuals with untoward reactions to the stings of these insects. In order to alert physicians that imported fire ant colonies may exist within homes and other inhabited dwellings and result in multiple stings to the occupants and to provide information about the management of this problem, we report two cases where individuals were stung indoors by imported fire ants. One of these cases involved the attack of a bed-bound patient by a colony of ants. The other report documents the establishment of an intact fire ant colony within an inhabited dwelling. Physicians should become familiar with the biology of these insects to assist patients in dealing with this problem.

Topics: Adult; Aged; Animals; Ants; Female; Housing; Humans; Insect Bites and Stings; Insect Control; Insecticides

Topics: Animals; Ants; Disease Reservoirs; Hospitals; Humans; Insect Bites and Stings; Insect Control

The case of cutaneous larva migrans presented here is typical for its mechanism and geographic location of infection, evolution of lesions, and prompt response to treatment. Except for pinworms, helminth infections are rarely thought of in emergency departments away from the areas where the parasites are especially prevalent. The several-day incubation period and modern-day ease of travel should place this illness on one's list of the differential diagnoses of pruritic lesions regardless of the location of practice. This case serves as a reminder that in a mobile society, diseases, as well as patients, can travel.

Topics: Adult; Animals; Ants; Diagnosis, Differential; Humans; Insect Bites and Stings; Larva Migrans; Male

While the cutaneous manifestations of the imported fire ant (IFA) sting are well known, neurologic sequelae are much more unusual. We report 2 cases of grand mal seizures associated with the sting of the IFA. The first patient suffered numerous stings without evidence of systemic reactions prior to the onset of the seizure. The second patient had manifestations of anaphylaxis prior to the occurrence of seizure. In both cases, the onset of seizures was delayed. As the geographic range of the IFA increases and more patients are stung, unusual reactions will be seen in greater frequency.

Topics: Adolescent; Adult; Anaphylaxis; Animals; Ants; Epilepsy, Tonic-Clonic; Female; Humans; Hypersensitivity, Delayed; Insect Bites and Stings; Male

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Humans; Immunotherapy; Insect Bites and Stings; Recurrence

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Humans; Immunotherapy; Insect Bites and Stings

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Humans; Immunotherapy; Insect Bites and Stings

Topics: Animals; Ants; Humans; Insect Bites and Stings; Skin; Urticaria

Topics: Adolescent; Adult; Anaphylaxis; Animals; Ants; Female; Humans; Insect Bites and Stings; Male; Middle Aged

Topics: Animals; Ants; Heart Arrest; Humans; Infant, Newborn; Insect Bites and Stings; Male; Shock

Stings by imported fire ants result in local reactions to the insect's venom; less frequently, they induce systemic allergic reactions. A 19-month-old child developed a characteristic localized cutaneous reaction at the sites of numerous stings after disturbing an ant mound. He experienced no secondary complications, and his pustular lesions resolved with conservative treatment.

Topics: Animals; Ants; Arm; Humans; Infant; Insect Bites and Stings; Male

Patients with allergic reactions to RIFA should be instructed in avoidance of RIFA and in the administration of epinephrine, given emergency identification information, and referred to an allergist for definitive diagnosis and for desensitization as indicated. RIFA are a growing menace in this country; as their habitat steadily extends north and west, no doubt a growing number of people will be affected by them. Their sting can be acutely life threatening and, as in this one case example, a severe reaction can profoundly affect the life of the victim.

Topics: Aftercare; Anaphylaxis; Animals; Ants; Education, Nursing, Continuing; Emergencies; Female; Humans; Insect Bites and Stings; Middle Aged; Patient Discharge

Topics: Animals; Ants; Humans; Insect Bites and Stings; Insect Control; North Carolina

Topics: Adult; Animals; Ants; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Male; Southeastern United States

A population of 2,366 primary care physicians in South Carolina was surveyed by mail to estimate the number of cases of insect morbidity treated in 1990. A response rate of 42.3 percent was obtained. Cases reported totaled 414 for Rocky Mountain spotted fever, 334 for Lyme disease, 143 black widow and 478 brown recluse spider bites and 4,975 fire ant stings. These are counts of cases from a mail survey, not from a research-based study. Five deaths were also reported; two for Rocky Mountain spotted fever, two due to black widow spider bites and one fire ant anaphylaxis.

Topics: Adolescent; Adult; Animals; Ants; Bites and Stings; Black Widow Spider; Child; Humans; Insect Bites and Stings; Lyme Disease; Prevalence; Rocky Mountain Spotted Fever; South Carolina; Spider Bites; Spiders; Ticks

Topics: Animals; Ant Venoms; Ants; Insect Bites and Stings

The specificities and sensitivities of skin test reactivity to imported fire ant (IFA) whole body extract (WBE) and IFA venom were compared with IFA WBE RAST and IFA venom RAST in the diagnosis of IFA allergy. Study groups consisted of 18 IFA allergic patients and 21 control subjects with no history of allergy to insect stings. All IFA allergic patients had positive skin tests to both IFA WBE and IFA venom. Six of 21 (29%) control subjects also had positive skin tests to both IFA WBE and IFA venom. A commercial IFA WBE RAST was positive in 10 of 18 (56%) IFA-allergic patients and 2 of 21 (10%) control subjects. Imported fire ant aqueous venom RAST was positive in 11 of 11 (100%) IFA-allergic patients and three of ten (30%) control subjects. Vespa IFA venom RAST was positive in 16 of 18 (89%) IFA-allergic patients and 5 of 21 (24%) controls. The sensitivities and specificities of IFA WBE skin testing, IFA venom skin testing, and IFA venom RAST did not differ significantly. Imported fire ant WBE RAST was less sensitive than the other diagnostic methods.

Topics: Adolescent; Adult; Animals; Ant Venoms; Ants; Child; Female; Humans; Hypersensitivity; Insect Bites and Stings; Male; Radioallergosorbent Test; Skin Tests

A survey of 5300 allergists was conducted to determine the number and geographic distribution of patients receiving immunotherapy for imported fire ant (IFA) allergy in the United States and Canada. Responses were received from 1293 physicians who reported a total of 2573 patients being treated in 28 states. Most patients were from the southeast, but some patients were reported to be receiving IFA immunotherapy in areas outside the boundaries of known IFA infestation. Although IFA is a widespread health hazard in the southeast, it appears to exert an uneven impact on allergy practice in this region. Of the 1293 physicians responding to the survey, 117 (9%) reported the use of whole body extract (WBE) in the treatment of 1746 patients with winged Hymenoptera-sting allergy. Continued use of WBE immunotherapy was reported by physicians from all regions of the United States and from Canada. The largest numbers of patients receiving winged WBE immunotherapy were reported from Texas (641), Pennsylvania (246), Florida (129), and Canada (127). The results of this survey suggest a need for continuing medical education regarding (1) the magnitude of the health hazard posed by the IFA and (2) the efficacy of venom versus WBE in the treatment of winged Hymenoptera-sting allergy.

Topics: Animals; Ants; Canada; Desensitization, Immunologic; Hymenoptera; Hypersensitivity; Insect Bites and Stings; Surveys and Questionnaires; United States

A physician questionnaire survey was conducted by the Fire Ant Subcommittee of the American Academy of Allergy and Immunology to document deaths caused by imported fire ant stings. From the 29,300 physicians surveyed, reports of 83 fatal and two near-fatal fire ant-sting reactions were received. Most anaphylactic deaths were reported from Florida (22) and Texas (19). After excluding duplicate reports, four confirmed deaths were documented in Alabama, 10 in Florida, two in Georgia, two in Louisiana, and 14 in Texas.

Topics: Adult; Age Factors; Anaphylaxis; Animals; Ants; Female; Humans; Infant; Insect Bites and Stings; Male; Middle Aged; Sex Factors; Surveys and Questionnaires; United States

RAST determinations using imported fire ant (IFA) whole-body extract (IFAWBE) and venom (IFAV) were performed with the sera of 29 sting-sensitive patients. Only 48% (14/29) of sera were positive (percent binding greater than or equal to 6%) in RAST to IFAWBE compared with 79% (23/29) positive to IFAV, and there was significantly greater binding to IFAV than to IFAWBE (p less than or equal to 0.0002). Thus, RAST with IFAV identified 31% more sting-sensitive individuals than RAST with IFAWBE, a finding similar to that noted in studies using IFAV and IFAWBE for skin testing. We conclude that IFAV is the more appropriate allergen for use in in vitro tests to detect IFA-specific IgE antibody in allergic patients.

Topics: Animals; Ant Venoms; Ants; Arthropod Venoms; Humans; Hypersensitivity; Insect Bites and Stings; Radioallergosorbent Test; Tissue Extracts

Topics: Ants; Cross-Sectional Studies; Humans; Insect Bites and Stings; South Carolina

Topics: Anaphylaxis; Animals; Ant Venoms; Ants; Arthropod Venoms; Cross Reactions; Desensitization, Immunologic; Humans; Hypersensitivity; Insect Bites and Stings

Fire ants (Solenopsis richteri and Solenopsis invicta) have received scant attention from individuals other than agriculturists, entomologists, and victims of the bite and sting. Since their original importation into Mobile, Alabama, these small, seemingly benign, creatures have slowly migrated throughout most of the southern United States. Not unexpectedly, physicians working in the southern portions of the United States have been confronted with increasingly large numbers of patients, particularly children, who have been bitten and envenomated by these insects. Information regarding the pathogenesis of fire ant bite reactions and an approach to treatment are provided.

Topics: Animals; Ant Venoms; Ants; Arthropod Venoms; Child; Dermatologic Agents; Humans; Hypersensitivity; Insect Bites and Stings; Palliative Care; United States

A survey of suburban residents of New Orleans, La., revealed that 58% of the individuals who responded had been stung by imported fire ants (IFA) within the previous year. More than half of the patients stung had dermal reactions that were distinct from the previously reported reactions to IFA in that immediate wheal-and-flare reactions evolved into pruritic, edematous lesions that persisted about the developing pustule for 24 hr or more. Twenty-one volunteers were stung with live IFA, and the course of the reactions was observed. Nine developed persistent reactions after stings. These reactions could be reproduced by the intradermal injection of IFA--whole body extract in only four of these nine subjects. Biopsy specimens of sting reactions at 6 hr demonstrated the reactions to be "late phase reactions" characterized by dense fibrin deposits like those previously noted in dermal reactions to ragweed and insulin. Eosinophils were present in the sting-associated pustules only in individuals who developed late-phase reactions. These data demonstrate that late-phase reactions occur commonly to IFA stings and that this form of insect hypersensitivity may not always be diagnosed by skin testing with whole body extract.

Topics: Ants; Biopsy; Dermatitis, Atopic; Humans; Hypersensitivity; Immunoglobulin E; Insect Bites and Stings; Skin; Skin Tests

Topics: Anaphylaxis; Ant Venoms; Ants; Arthropod Venoms; Female; Humans; Insect Bites and Stings; Middle Aged

Topical aluminum sulfate was not effective in relieving pain and stinging from the imported fire ant, contrary to a previous uncontrolled study.

Topics: Administration, Topical; Alum Compounds; Aluminum; Ants; Humans; Insect Bites and Stings; Pain; Sulfates

As the imported fire ant relentlessly expands its territory, more and more people are at risk of the insects' discomforting and sometimes dangerous stings. Thus, all primary care physicians in fire ant-infested areas should be familiar with diagnosis and treatment of fire ant stings and of allergic reactions to the stings. Fire ant venom is unique when compared with other Hymenoptera venoms, as it consists mainly of nonallergenic alkaloids that are of small molecular weight with only a small percentage of allergenic proteins. Fire ant wholebody extract, unlike other Hymenoptera wholebody extracts, retains its allergenic activity and is an adequate material for use in diagnostic testing and immunotherapy. Diagnosis of fire ant allergy can be readily made by the radioallergosorbent test (RAST) or by skin testing using fire ant wholebody extract. Immunotherapy with fire ant whole-body extract in allergic individuals can prevent serious recurrent systemic reactions.

Topics: Animals; Ants; Humans; Hypersensitivity; Immunotherapy; Insect Bites and Stings; Radioallergosorbent Test; Skin Tests; Venoms

Levels of IgE antibody to fire ant whole body extract (FA-WBE) and fire ant venom (FAV) were evaluated in 60 patients with clinical histories of fire ant sting hypersensitivity and 11 frequently stung individuals without significant clinical reactivity to fire ant. An overlap of levels of IgE antibody to FA-WBE and FAV was seen between groups of patients with increasingly severe clinical reactivity; however, the group mean IgE antibody level of patients without significant clinical reactivity differed markedly from the group means of patients with more severe clinical reactivity (p less than 0.001). In 31 patients a good correlation (r = 0.6935) was found comparing FA-WBE IgE antibody level with FA-WBE skin tests, and in 26 patients a good correlation (r = 0.8564) was obtained comparing FAV IgE antibody levels with FAV skin tests. An excellent Spearman rank correlation coefficient (r = 0.9197) was found on comparison of FAV and FA-WBE IgE antibody levels in 71 individuals. Cross-reactivity of FAV and FA-WBE was demonstrated by the ability of these reagents to competitively inhibit the binding of IgE antibody to solid-phase FA-WBE and FAV in the radioallergosorbent test (RAST). From these results we conclude that FAV and FA-WBE both contain relevant allergens important in fire ant-allergic individuals and that skin tests and RAST are both valid as diagnostic tests for fire ant allergy. Finally, there is a good correlation between RAST and skin tests using FA-WBE or FAV as test reagents, since these reagents are highly cross-reactive as demonstrated by their ability to inhibit each other in the RAST.

Topics: Adolescent; Adult; Aged; Ant Venoms; Antibodies, Anti-Idiotypic; Ants; Arthropod Venoms; Child; Child, Preschool; Cross Reactions; Humans; Hypersensitivity, Delayed; Immunoglobulin E; Infant; Insect Bites and Stings; Middle Aged; Radioallergosorbent Test; Skin Tests; Tissue Extracts

Four cases are described in which neurologic disturbances are the presenting symptoms after the imported fire ant (IFA) sting. The neurologic sequelae include focal motor and grand mal seizures and a mononeuropathy. The possible pathogenesis of these disorders is discussed.

Topics: Adult; Ants; Child, Preschool; Epilepsies, Partial; Epilepsy, Tonic-Clonic; Female; Humans; Insect Bites and Stings; Male; Nervous System Diseases

Topics: Adolescent; Adult; Animals; Ants; Bees; Child; Child, Preschool; Female; Georgia; Humans; Infant; Insect Bites and Stings; Male; Middle Aged; Spider Bites; Wasps

Arthropod bites and stings may cause intense pain, sometimes out of proportion to the size of the lesion. Severe reactions may arise from prior exposure and buildup of antibodies. Diagnosis often can be made from the clinical presentation if the physician is familiar with the effects of the uncommon bites and stings. Some uncommon bites, such as those of reduviids, can be treated symptomatically, but others, such as those of poisonous scorpions, call for antivenin therapy.

Topics: Ants; Calcium Gluconate; Desensitization, Immunologic; Histamine H1 Antagonists; Humans; Hypersensitivity; Insect Bites and Stings; Larva; Moths; Scorpion Stings; Scorpions; Triatominae

Topics: Administration, Topical; Ants; Drug Combinations; Fatty Alcohols; Humans; Insect Bites and Stings; Nitrofurazone

Topics: Adolescent; Adult; Aged; Animals; Ants; Child; Child, Preschool; Female; Georgia; Health Surveys; Humans; Infant; Infant, Newborn; Insect Bites and Stings; Male; Middle Aged

The sting of the imported fire ant (IFA), Solenopsis invicta Buren and Solenopsis richteri Forel, produces characteristic sterile pustules. Substantial morbidity and occasional mortality from secondary infection of the IFA pustule(s) or anaphylaxis in hypersensitive persons has occurred. IFAs are found in the southeastern and south central United States. The effects of various medical regimens currently used to treat IFA pustules were evaluated clinically and histologically in rabbits. Neither prophylaxis before the sting nor treatment after the sting altered the clinical or pathologic course of the IFA pustule in rabbit skin.

Topics: Abscess; Adult; Animals; Ants; Child; Female; Humans; Insect Bites and Stings; Male; Middle Aged; Rabbits; Skin Diseases; Skin Tests; United States

Topics: Ants; Dicrocoeliasis; Dicrocoelium; Humans; Insect Bites and Stings; Insect Vectors

Topics: Ants; Humans; Insect Bites and Stings; Insect Control; United States

Topics: Ants; Georgia; Humans; Insect Bites and Stings

Pharaoh's ants (Monomorium pharaonis) appeared in a children's hospital and wounded the skin of the pre-mature births. Possibilities for control are discussed.

Topics: Animals; Ants; Germany, East; Hospital Departments; Humans; Incubators, Infant; Infant, Newborn; Infant, Premature, Diseases; Insect Bites and Stings; Insect Control

Only the rare practicing physician does not see at least a few patients during the warm summer months who have come off second best in an encounter with a member of Hymenoptera or one or the other of the various species of the phylum Arthropoda. Next to children and certain occupational groups such as farmers, it is probable that the outdoor sports enthusiast is the most frequent victim of insect stings and bites. Often the victim is not sure just what attacked him, and the physician may have to make an educated guess based on the appearance and grouping of the wounds and on the nature of the patient's symptoms. Usually, secondary infection is the most frequent possibility after these attacks. However, the hypersensitive patient who suffers immediate or delayed allergic reaction poses the greater, if rarer problem.

Topics: Adult; Animals; Ants; Arachnida; Child; Culicidae; Diptera; Female; Histamine H1 Antagonists; Humans; Hymenoptera; Hypersensitivity; Insect Bites and Stings; Male; Sports; Ticks; Trombiculidae

Topics: Adolescent; Adult; Aged; Ants; Child; Child, Preschool; Female; Florida; Humans; Hypersensitivity; Infant; Insect Bites and Stings; Male; Middle Aged

Topics: Adult; Aged; Animals; Ants; Female; Florida; Homing Behavior; Humans; Hypersensitivity; Insect Bites and Stings; Male

Topics: Ants; Arthropods; Bees; Bites and Stings; Coleoptera; Humans; Insect Bites and Stings; Spider Bites; Tick Paralysis; Ticks; Wasps

Ants, bees, and other stinging hymenoptera can induce serious anaphylactic reactions in susceptible individuals. Certainly, hymenoptera venom contains potent antigens that have been useful in testing and treating hymenoptera-sensitive patients who fail to acquire protection from whole body extract therapy. However, before whole body extracts are forever abandoned, their antigen content and stability should be re-examined by means of modern immunologic methods.

Topics: Anaphylaxis; Ants; Bees; Desensitization, Immunologic; Humans; Hypersensitivity, Immediate; Immunotherapy; Insect Bites and Stings; Venoms

Topics: Animals; Ants; Australia; Bees; Bites and Stings; Child; Cnidaria; Fishes, Poisonous; Humans; Infant; Insect Bites and Stings; Mollusca; Octopodiformes; Platypus; Scorpion Stings; Scorpions; Snake Bites; Tick Toxicoses; Wasps

It is now apparent that venom and venom components of the Hymenoptera superfamilies of Apida (honeybee) and Vespida (wasps, yellow jackets, and hornets) are becoming increasingly important in the diagnosis and treatment of hypersensitivity reactions. Stings from fire ants (superfamily Formicidae, family Myrmicinae) have also been recognized as causes of systemic reactions in man. Fire ant venom is unique in its composition, consisting mainly of alkaloids in aqueous suspension with only trace amounts of protein. This study compares the skin reactivity of fire ant venom and synthesized alkaloid components with the whole body extract (WBE) of fire ants and other Hymenoptera. The venom as well as the WBE of fire ants was found useful for skin test diagnosis of sensitive individuals. There appear to be cross-reactive or shared antigens between fire ant venom, WBE, and WBE of other Hymenoptera. Successful passive transfer of skin reactivity to nonsensitive individuals was accomplished with sera from sensitive individuals. Loss of this passive transfer by heating sera at 56 degrees C for 4 hr is evidence in favor of IgE mediating the positive skin test to the venom.

Topics: Animals; Ants; Humans; Hypersensitivity; Immunization, Passive; Insect Bites and Stings; Piperidines; Skin Tests; Tissue Extracts; Venoms

Topics: Animals; Ants; Humans; Hypersensitivity; Insect Bites and Stings; Skin Tests; Tissue Extracts; Venoms

Allergy to insect stings may be quite serious, and occasionally lethal. Evaluation of these patients involves careful history taking. Skin testing for the stinging insects is helpful both for diagnosis and finding a beginning dose for hyposensitizing injections. According to many reports, these injections have been very effective in preventing subsequent severe reactions to insect stings. Prompt emergency treatment usually involves adrenalin injections. Insect avoidance procedures are effective.

Topics: Ants; Bees; Desensitization, Immunologic; First Aid; Humans; Hymenoptera; Hypersensitivity; Insect Bites and Stings; Medical History Taking; Skin Tests; Time Factors; Venoms; Wasps

Topics: Ants; Cross Reactions; Hypersensitivity; Insect Bites and Stings; Skin Tests; Species Specificity

Topics: Animals; Ants; Hypersensitivity; Insect Bites and Stings; United States

Two South American species of the fire ant group, Solenopsis richteri and Solenopsis invicta, now occupy more than 150 million acres in 13 southern states and cause systemic allergic reactions to their stings. We report 49 cases of such reactions with case reports and documentation. Specificity of the sting was documented by either typical pustule formation or positive skin tests. Of 37 patients treated with hyposensitizing injections, 10 have subsequently been restung. Only one suffered a systemic reaction. Problems of cross-reactivity with other insects are discussed and the literature is reviewed. Hypersensitivity to the imported fire ant continues to be a serious problem in the southern United States and appears to be amenable to properly instituted hyposensitization therapy.

Topics: Adolescent; Adult; Aged; Ants; Catecholamines; Child; Child, Preschool; Cross Reactions; Desensitization, Immunologic; Female; Glucocorticoids; Histamine H1 Antagonists; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Male; Middle Aged; Retrospective Studies; Skin Manifestations; Skin Tests; Species Specificity

Although the imported fire ant is a known rural problem, the problem it may pose to urban dwellers has not been documented. A telephone survey of 240 households selected by a probability sample of an upper middle class suburb of New Orleans was carried out to ascertain the experiences of residents with fire ants from June to August 1973. Overall, ant stings were reported for 29% of the study population, with sting rates of 55% among children under 10 years old. Among those stung, at least minimal allergic reactions were reported for 17%, and 4.4% required medical consultation. Of households with outdoor premises, 55% reported fire ant infestation, 86% of these used pesticides for fire ant control, and few felt that community assistance was needed for private property. Half of the respondents, however, favored a community control program for public grounds. These data may provide a basis for decision as to the need for community efforts in fire ant control.

Topics: Adolescent; Adult; Aged; Animals; Ants; Child; Child, Preschool; Community Health Services; Female; Housing; Humans; Infant; Infant, Newborn; Insect Bites and Stings; Insect Control; Louisiana; Male; Middle Aged; Pilot Projects; Urban Population

Topics: Adolescent; Adult; Aged; Ants; Child; Child, Preschool; Culicidae; Desensitization, Immunologic; Diptera; Female; Humans; Insect Bites and Stings; Male; Middle Aged; Norway; Psychodidae; Siphonaptera; South Africa; Tick Toxicoses; Triatominae; United Kingdom; United States

Topics: Acute Disease; Adrenal Cortex Hormones; Adult; Anaphylaxis; Ants; Desensitization, Immunologic; Epinephrine; Female; Humans; Insect Bites and Stings; Skin Tests

Topics: Age Factors; Ants; Desensitization, Immunologic; Humans; Hypersensitivity; Insect Bites and Stings; Seasons; Sex Factors; Skin Tests

Topics: Adolescent; Adult; Ants; Bees; Child; Child, Preschool; Desensitization, Immunologic; Diphenhydramine; Female; Humans; Hypersensitivity, Immediate; Infant; Insect Bites and Stings; Male; Middle Aged; Skin Tests

Topics: Ants; Hypersensitivity; Insect Bites and Stings; South Carolina; Surveys and Questionnaires

Topics: Adult; Ants; Child; Child, Preschool; Female; Humans; Hypersensitivity; Insect Bites and Stings; Male; Middle Aged; Physicians; Venoms

Topics: Adolescent; Adult; Ants; Child, Preschool; Desensitization, Immunologic; Female; Humans; Hypersensitivity, Immediate; Insect Bites and Stings; Male; Skin Tests; Time Factors

Topics: Anaphylaxis; Ants; Child; Emergency Medical Tags; Epinephrine; Female; Histamine H1 Antagonists; Humans; Insect Bites and Stings; Insect Control; Isoproterenol; Male; Middle Aged; Necrosis; Rural Health; United States; Venoms

Topics: Acetylcholine; Ants; Bees; Histamine; Histamine H1 Antagonists; Humans; Hyaluronoglucosaminidase; Insect Bites and Stings; Kinins; Phospholipases; Scorpion Stings; Scorpions; Serotonin; Shock; Venoms

Topics: Ants; Bites and Stings; Humans; Insect Bites and Stings; Mississippi; Snake Bites; Spider Bites; Spiders

Topics: Alcoholism; Ants; Ecology; Humans; Insect Bites and Stings; Male; Middle Aged; Skin; Species Specificity

Topics: Ants; Diagnosis, Differential; Granuloma; Humans; Hypersensitivity, Delayed; Insect Bites and Stings; Keratosis; Male; Middle Aged; Necrosis; Papilloma; Skin Diseases; Skin Diseases, Infectious; Skin Manifestations; Venoms

Topics: Adolescent; Ants; Coma; Humans; Insect Bites and Stings; Male; Skin Diseases

Topics: Adult; Animals; Ants; Anura; Bites and Stings; Buffaloes; Carnivora; Haplorhini; Humans; Insect Bites and Stings; Male; Middle Aged; Reptiles; Scorpions; Snake Bites; Wounds and Injuries

Topics: Animals; Ant Venoms; Ants; Insect Bites and Stings; Research; Toxicology; Venoms

Topics: Animals; Ants; Bees; Bites and Stings; Culicidae; Insect Bites and Stings; Wasps

Topics: Animals; Ants; Insect Bites and Stings; Insecta

Topics: Animals; Ants; Bites and Stings; Humans; Insect Bites and Stings