CLINICAL SYMPTOMS AND IMMUNOLOGICAL REACTIVITY TO BEE AND WASP STINGS IN BEEKEEPERS

We compared the history of sting reactions with venom skin prick test (SPT) and CAP PAST reactions in beekeepers in order to assess the value of structured questions and symptom backgrounds. The study population consisted of 102 beekeepers, who were 25-75 years of age. Bee and wasp venom SPT was performed with concentrations of 10, 100, and 300 mu g/ml. The CAP Phadiatop(R) test was used in the screening of IgE antibodies against common inhalant allergens. Forty-two beekeepers had never experienced large local or systemic reactions after a bee sting. Of the 31 subjects with a history of systemic reactions, 13 had experienced these during the previous year. A significant difference (P<0.01) between systemic reactors and nonreactors was found in bee venom CAP and SPT (300 mu g/ml). However, due to considerable overlap, these tests are unable to discriminate between allergic and nonallergic beekeepers. Both bee venom SPT (300 mu g/ml) and CAP tests were positive in 65% of systemic reactors and in 34% of nonreactors (P = 0.008). Venom SPT (300 mu g/ml) correlated significantly with CAP for both venoms. No correlation was observed between venom allergy and atopy. Clinically, the most practical concentration for evaluating bee and wasp venom sensitization by SPT proved to be 300 mu g/ml.