BEE VENOM HYPERSENSITIVITY AND ITS MANAGEMENT - PATIENTS PERCEPTION OF VENOM DESENSITIZATION

The objectives of the study were to review bee venom immunotherapy fro m the patient's perspective: in particular its benefits and its proble ms, and to investigate any genetic tendency for bee venom hypersensiti vity. A self administered, 9 item questionnaire was sent to 219 patien ts who had undergone either inpatient or outpatient bee venom immunoth erapy at Flinders Medical Centre. The clinic records of these patients were also reviewed. The controls for the genetic study were sought fr om patients, staff and students at Flinders University and Flinders Me dical Centre. One hundred and forty-six questionnaires (some incomplet e and anonymous) were received. The female to male ratio was 1:2.5. Th e age at the time of the initial anaphylactic reaction to a bee sting ranged between 2 to 59 years, with 67% of patients being less than 20 years old. Forty percent of patients underwent venom immunotherapy for a period less than 2 years with only 11% maintaining therapy for the recommended period of 5 years or mom Thirty three percent of patients stopped their therapy on their own accord. see stings occurring during bee venom immunotherapy (n=56) were generally well tolerated except i n 8 subjects, 7 of whom had not reached the maintenance dose. The redu ction in systemic reactions to subsequent bee stings was significantly better in the study group receiving bee venom than in an historic con trol group treated with whole bee extract (p=0.03). Fear of bee stings and restricted life styles were improved during or after venom immuno therapy. The frequency of a positive family history of systemic reacti ons to bee stings in the patient cohort was 31%, whereas in controls i t was 15% (p=0.013). Bee venom immunotherapy has dual benefits patient s are protected from subsequent sting anaphylaxis and there is reduced psychological morbidity. However, to be effective, venom immunotherap y requires a prolonged period of carefully supervised treatment and ea ch venom injection can cause local and systemic side effects. Genetic factors appear to be present in those patients who develop immediate h ypersensitivity to bee stings.