title: Bee and wasp venom allergy in Turkey.
abstract: BACKGROUND
  Beekeeping has progressed recently to where bee sting exposure is an important public health problem in Turkey.
  
  
  OBJECTIVE
  To investigate the status of bee and wasp sting allergy in a region of Turkey.
  
  
  METHODS
  We conducted a questionnaire-based study of 786 subjects (cellulose paper factory personnel and family members older than 16 years of age) in Cay town of Afyon. Skin prick test with common aeroallergens and measurements of total IgE and specific IgE for bee and wasp venom were performed in 212 randomly selected subjects.
  
  
  RESULTS
  Cumulative lifetime sting rate was 94.5% (geometric mean: 6.1 times), and last year bee sting rate was 20.4% (geometric mean: 1.6 times). Subjects who had beehives had higher risk of bee sting (P < .05) in the last year, whereas there was no significant difference among the groups for the cumulative lifetime sting exposure. Severe and mild systemic reactions were noted in 2.2% and 5.3%, respectively. Emergency room visits were reported in 9.3%, and familial Hymenoptera allergy in 10.2%. Fatal potential of bee sting was known by 81%. There was no mortality related with Hymenoptera allergy in records of the last 5 years. In 24 subjects with multiple sting exposures, allergic reactions changed severity in the latter exposures, which became less severe in five and more severe in 19 subjects. Atopy rate detected by prick testing was 20.3%. Specific IgE levels were class 1 in 22, class 2 in 11, and class 3 in 2 subjects for bee; and class 1 in 24 and class 2 in 2 subjects for wasp. Nobody had received immunotherapy for venom allergy. None of the factors including atopy, sex, occupation, smoking and family history of bee sting was significantly related with severity of the systemic reaction (P > .05).
  
  
  CONCLUSIONS
  Bee and wasp stings are prevalent in Turkey. Severe systemic reactions complicating the sting are frequent (2.2%). Public awareness of potential fatality and treatment of the allergic reaction is not adequate.
authors.affiliation: Hacettepe University Hospital, Department of Chest Diseases Adult Allergy Unit, Ankara, Turkey.
authors.forename: A F
authors.initials: AF
authors.lastname: Kalyoncu
authors.forename: A U
authors.initials: AU
authors.lastname: Demir
authors.forename: U
authors.initials: U
authors.lastname: Ozcan
authors.forename: C
authors.initials: C
authors.lastname: Ozkuyumcu
authors.forename: A A
authors.initials: AA
authors.lastname: Sahin
authors.forename: Y I
authors.initials: YI
authors.lastname: Bariş
mesh_terms: D000328:Adult; D000818:Animals; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D000918:Antibody Specificity; D001514:Bee Venoms / Q000009:adverse effects*; D001516:Bees; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000276:immunology*; D007073:Immunoglobulin E / Q000276:immunology; D007299:Insect Bites and Stings / Q000276:immunology*; D008297:Male; D014421:Turkey / Q000453:epidemiology; D014862:Wasp Venoms / Q000009:adverse effects*; D014863:Wasps
chemical_list: D000888:Antibodies, Anti-Idiotypic; D001514:Bee Venoms; D014862:Wasp Venoms; C026408:anti-IgE antibodies; D007073:Immunoglobulin E