hChoices - Amazon Web Services
Transcript of hChoices - Amazon Web Services
Optimal wellness through technology, education and social engagement
hChoices.com
Stinging Insect Allergy
Presentation Overview
§ Epidemiology and Prevalence § Identifying and Characteristics of Insects § Reactions § Diagnosis § Treatment/Immunotherapy
Optimal wellness through technology, education and social engagement 2
Epidemiology
§ May develop at any age
§ Usually manifests after several uneventful stings
§ Males > females (? increased exposure)
§ Family history does not increase risk
Optimal wellness through technology, education and social engagement 3
The Stinging Insects
Identifying them and their characteristics
Optimal wellness through technology, education and social engagement 4
Hymenoptera
Honeybee Bumblebee Yellow jacket species Yellow hornet, white-faced hornet European, oriental hornets Paper wasp species Fire ants
Common Names Apis Bombus Vespula Dolichovespula Vespa Polistes Solenopsis
Bees Vespids Ants
Genus
Optimal wellness through technology, education and social engagement 5
Apidae Family
§ Wild: tree hollows, old logs
§ Domestic: commercial hives
Optimal wellness through technology, education and social engagement 6
www.scottcamazine.com/.../ 19StingingBee_jpg.htm
Apidae Family § Leave barbed stinger and
venom sac after sting, dies:
§ “Sting autonomy”
§ 50 µg venom per sting (up to 140 µg)
§ Venom sacs ~300 µg
Optimal wellness through technology, education and social engagement 7
Vespids § Yellow jackets, hornets, wasps § Feed on human foods (sweet) § Finer barbed stinger, can sting multiple times § Extensive venom cross-reactivity § Nests: layers of comb
Optimal wellness through technology, education and social engagement 10
http://entclub.org/members/agolden/gm-yellowjacket.jpg
Yellow Jackets § Ground dwellers
– Yard work, gardening, farming – Wall tunnels, crevices, hollow
logs § Very aggressive, sting with
minimal provocation (food) § Most common sting § 10-100 µg venom per sting § Late summer § Attracted to food
– Sting in mouth
Optimal wellness through technology, education and social engagement 11
Hornets § Related to yellow jackets § Genus: Dolichovespula § Extremely aggressive, especially
around nest. Chase! § Large nests in trees and shrubs § Sensitive to vibration § 2.4-5 µg venom per sting
Optimal wellness through technology, education and social engagement 13
home.cfl.rr.com/ billd2000/entomology.htm
Wasps
§ Genus: Polistes § Narrow waist § Honeycomb nests in shrubs,
under eaves of houses or barns, window sills, patio furniture, playgrounds, dryer vents
§ Scavengers: outdoor events, food and drink
§ 4.2-17 µg venom per sting
Optimal wellness through technology, education and social engagement 17
Formicidae Family
§ Sting multiple times in circular pattern by anchoring mandibles and pivoting
§ Sterile pseudopustule pathognomonic (24 hours); necrotic tissue. Should be left intact. Secondary infection most common complication
Optimal wellness through technology, education and social engagement 19
Management
§ Referral to an allergist § Avoidance § Emergency epinephrine: teach how to administer and under
what circumstances; repeat dosing § Venom immunotherapy § Consider medical alert bracelet or necklace
Optimal wellness through technology, education and social engagement 20
Avoidance Measures
§ Exterminate known or suspected nests; periodic surveillance § Avoid wearing brightly colored clothing or flowery prints § White and light colors are best § Avoid strongly scented material § Wear shoes outside
Optimal wellness through technology, education and social engagement 21
Avoidance Measures
§ Wear long pants, long-sleeved shirts, socks, head covering, work gloves, and hats
§ Caution around bushes, eaves, attics, garbage containers, picnic areas
§ Insecticides (not affected by insect repellants) § Caution when eating or drinking outdoors
Optimal wellness through technology, education and social engagement 22
What Bees See
Our eyes Bees eyes seeing ultraviolet
Bees see UV, blue and green
Optimal wellness through technology, education and social engagement 23
Diagnosis
§ History: identification, bring the insect to clinic – Activity, location, type of insect activity in the area, number of
stings, sting site, timing of symptoms, visual identification, emergency treatment, risk of repeated stings, reactions to subsequent stings
– Presence of a stinger?
§ Skin testing
Optimal wellness through technology, education and social engagement 24
Venom Immunotherapy (VIT)
§ Extremely effective in reducing risk of subsequent systemic reaction (95-97%)
§ Milder reactions
§ Duration of treatment – 3-5 years (4-5 years fire ant) – Indefinitely
• History or severe anaphylaxis with shock or loss of consciousness
Optimal wellness through technology, education and social engagement 25