Management of imported fire ant allergy: results of a survey

Background: Fire ant allergy is a significant health problem in the southern United States. Management of fire ant allergy is less clearly defined than management of allergy to the winged Hymenoptera. Objective: To determine how fire ant allergy is managed by practicing allergists. Methods: A survey form was developed and distributed to American College of Allergy, Asthma st Immunology members practicing in fire ant endemic states. Completed forms were returned to the American College of Allergy, Asthma & Immunology central office and forwarded to the authors for analysis. Results: Three hundred twenty-nine of 879 (37.4%) surveys were returned; 81% of respondents have evaluated patients with imported fire ant allergy. Immunotherapy is used by 96.7% of respondents to treat fire ant allergy. A wide range of maintenance dosages are prescribed. Skin testing is the most common diagnostic method. Systemic reactions to stings while on maintenance immunotherapy were reported by 19%. Allergists utilize different criteria in consideration for stopping immunotherapy; 19% continue it indefinitely. Conclusions: There are many areas of general uniformity and other areas of divergence in how allergists manage imported fire ant allergy. These findings suggest continued need for further investigation regarding the efficacy, dosage, and duration of immunotherapy, as well as further elucidation of the natural history of fire ant allergy.