title: Allergic reactions to insect stings: results from a national survey of 10,000 junior high school children in Israel.
abstract: BACKGROUND
  Insect sting allergy is a medical condition the magnitude of which has not been fully estimated in children.
  
  
  OBJECTIVE
  We sought to evaluate the prevalence of insect stings among schoolchildren in Israel, the rate of allergic reactions, and hospital attendance.
  
  
  METHODS
  A self-report questionnaire of the International Study of Asthma and Allergies in Childhood was administered to a national sample of schoolchildren aged 13 to 14 years across Israel. Questions regarding insect stings, allergic reactions, and hospital attendance were added.
  
  
  RESULTS
  Ten thousand twenty-one questionnaires were available for analysis. Most (56.3%) had been stung at least once in their lifetime. Of these, 20.5% had a large local reaction (LLR), 11.6% had a mild (cutaneous) systemic reaction (MSR), and 4.4% had a moderate-to-severe systemic reaction (SSR); 11.5%, 6.5%, and 2.5% of the study group, respectively. Arabs had significantly more allergic reactions of all 3 types than Jews (P < .0001). On multivariate analysis, LLR was associated with SSR (odds ratio, 6.25; 95% CI, 4.66-8.41) and MSR (odds ratio, 5.15; 95% CI, 4.24-6.25). More than 10% of the children with an LLR only attended a hospital compared with 7.5% of those with an MSR only and 14.5% with an SSR only.
  
  
  CONCLUSIONS
  The frequency of reported allergic sting reactions in children might be higher than previously estimated. Arab children reported significantly more allergic reactions than Jews. Hospital attendance does not correlate with the severity of the allergic reaction, and only a minority of children with SSRs are treated in hospital.
  
  
  CONCLUSIONS
  The improper care of severe reactions highlights the need for better public and physician education.
authors.affiliation: Allergy and Immunology Clinic, Pulmonary Institute, Rabin Medical Center, Petah Tiqva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel. graif@post.tau.ac.il
authors.forename: Yael
authors.initials: Y
authors.lastname: Graif
authors.forename: Orly
authors.initials: O
authors.lastname: Romano-Zelekha
authors.forename: Irit
authors.initials: I
authors.lastname: Livne
authors.forename: Manfred S
authors.initials: MS
authors.lastname: Green
authors.forename: Tamy
authors.initials: T
authors.lastname: Shohat
mesh_terms: D000293:Adolescent; D004630:Emergencies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000276:immunology*; D007299:Insect Bites and Stings / Q000453:epidemiology / Q000276:immunology*; D007557:Israel / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011795:Surveys and Questionnaires