Environment and allergic disease

Mites and cockroaches

Allergenic Insects in the Southwest  

• When insects sting, they inject venom that can cause allergic reactions in susceptible individuals.   The most common  reaction to a stinging insect is a diffuse swelling in the area of the sting.  These large local reactions may  be alarming but are almost always benign and subside spontaneously without specific treatment.  Reactions limited to swelling in the area of the sting do not pose a risk of dangerous reactions to subsequent stings.
• Uncommonly, severe systemic allergic reactions known as anaphylaxis can occur. 
• Honey bees, yellow jackets, paper wasps, harvester ants and native fire ants are the main cause of allergic sting reactions in the southwest. (Follow links for pictures).  They belong to the Hymenoptera order of insects.
• Honey bees leave a characteristic sting apparatus embedded in the skin after a sting, because of the barbed stylus in the sting. 
• Yellow jackets are found mainly at higher elevations, and are usually not a problem in metropolitan Tucson or Phoenix.  Hornets occur in the mountainous areas. 
• In the certain areas of the Sonoran desert, particularly  where people live close to prickly pear habitat, allergy to kissing bugs (cone-nose bugs, Triatoma) can develop.  These are blood sucking insects that typically cause painless bites and may cause allergic reactions while the victim is asleep.   Among the natural hosts of kissing bugs are pack rats that live in nests under prickly pear plants and like to establish nests in yard structures and out- buildings.  People severely allergic to kissing bugs should take all measures to keep the bugs out of the house, and have liquid antihistamine such as Benadryl and an epinephrine syringe available at the bedside. 
• Prevention of anaphylactic reactions:   For systemic reactions, sensitive individuals must carry and use an emergency epinephrine injection (EpiPen) and liquid diphenhydramine (Benadryl).  An allergist should then be consulted for skin testing and venom injection treatment.
  

Further Reading
Graft DF. Insect sting allergy. [Review] [108 refs] Medical Clinics of North America. 90(1):211-32, 2006 Jan.
Golden DB. Insect sting allergy and venom immunotherapy. [Review] [46 refs] Annals of Allergy, Asthma, & Immunology. 96(2 Suppl 1):S16-21, 2006 Feb.
Schumacher, M.J., Egen, N.B.: Significance of Africanized bees for public health: A review. Archives of Internal Medicine Vol 155: pp 2038-2043, 1995.
Levine MI, Lockey RF (eds) :  Monograph on Insect Allergy.   American Academy of Allergy and Immunology, Milwaukee WI, 3rd Edition, 1995.
AAAAI:   Stinging insects
AAAAI:   Anaphylaxis 

Disclaimer:   This site is for educational purposes only.  Any information that you have found in this web site is not intended to replace medical care or advice given to you by your own physicians. You should consider consulting your local medical library and other web sites for additional information. 

Comments and suggestions welcome!   Email: schumach@u.arizona.edu
Content Owner:  Michael J. Schumacher, MB, FRACP, The University of Arizona

Updated 8/2011