title: European hornet (Vespa crabro) sting: a new risk factor for life-threatening reaction in hymenoptera allergic patients?
abstract: BACKGROUND
  Severity of a previous reaction, adult age, male gender and honeybee sting are risk factors for severe systemic reactions after hymenoptera stings. The aim of the study was to assess the association between the Vespa crabro sting and severe systemic reactions.
  
  
  METHODS
  One hundred fifty seven hymenoptera allergic patients with a positive case history for systemic reactions were selected on the basis of unequivocal identification of the stinging insect. In 97 patients the culprit insect was Vespula spp., in 35 was Vespa crabro in the remaining 25 patients was Apis mellifera. The relative risk for a life-threatening reactions after a sting was evaluated for each hymenoptera species.
  
  
  RESULTS
  While the percentage of life-threatening reactions was similar both in Apis mellifera (24%) and in Vespula spp. Allergic patients groups (27.8%), a very high prevalence (81.2%) was documented in Vespa crabro allergic patients group. The relative risk for life-threatening reactions after a Vespa crabro sting was about three times higher (RR = 2.74--CI 95% 1.93-3.89--R < 0.0001) than it was for a honeybee or yellow jacket sting. The increase of the risk for life-threatening reactions after a Vespa crabro sting was independent from the age of patients.
  
  
  CONCLUSIONS
  Vespa crabro sting seems to be a new risk factor for life-threatening reactions after hymenoptera sting.
authors.affiliation: Medical Clinic, Immunology-Hematology Center-Faculty of Medicine, Lisbon University, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Antonicelli
authors.forename: M B
authors.initials: MB
authors.lastname: Bilò
authors.forename: G
authors.initials: G
authors.lastname: Napoli
authors.forename: B
authors.initials: B
authors.lastname: Farabollini
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
mesh_terms: D000328:Adult; D000367:Age Factors; D000707:Anaphylaxis / Q000453:epidemiology* / Q000209:etiology; D000818:Animals; D001516:Bees; D003429:Cross Reactions; D005260:Female; D006306:Health Surveys; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012306:Risk; D012307:Risk Factors; D013045:Species Specificity; D014862:Wasp Venoms / Q000009:adverse effects* / Q000276:immunology; D014863:Wasps / Q000145:classification
chemical_list: D014862:Wasp Venoms