Causes of ant sting anaphylaxis in Australia: the Australian Ant Venom Allergy Study
Date
2011
Authors
Brown, Simon GA
van Eeden, Pauline
Wiese, Michael D
Mullins, Raymond
Solley, Graham
Puy, Robert
Taylor, Robert
Heddle, Robert J
Journal Title
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Volume Title
Publisher
Australasian Medical Association
Abstract
Objective: To determine the Australian native ant species associated with ant sting anaphylaxis, geographical distribution of allergic reactions, and feasibility of diagnostic venom-specific IgE (sIgE) testing. Design, setting and participants: Descriptive clinical, entomological and immunological study of Australians with a history of ant sting anaphylaxis, recruited in 2006-2007 through media exposure and referrals from allergy practices and emergency physicians nationwide. We interviewed participants, collected entomological specimens, prepared reference venom extracts, and conducted serum sIgE testing against ant venom panels relevant to the species found in each geographical region. Main outcome measures: Reaction causation attributed using a combination of ant identification and sIgE testing. Results: 376 participants reported 735 systemic reactions. Of 299 participants for whom a cause was determined, 265 (89%; 95% CI, 84%-92%) had reacted clinically to Myrmecia species and 34 (11%; 95% CI, 8%-16%) to green-head ant (Rhytidoponera metallica). Of those with reactions to Myrmecia species, 176 reacted to jack jumper ant (Myrmecia pilosula species complex), 18 to other jumper ants (15 to Myrmecia nigrocincta, three to Myrmecia ludlowi) and 56 to a variety of bulldog ants, with some participants reacting to more than one type of bulldog ant. Variable serological cross-reactivity between bulldog ant species was observed, and sera from patients with bulldog ant allergy were all positive to one or more venoms extracted from Myrmecia forficata, Myrmecia pyriformis and Myrmecia nigriceps. Conclusion: Four main groups of Australian ants cause anaphylaxis. Serum sIgE testing enhances the accuracy of diagnosis and is a prerequisite for administering species- specific venom immunotherapy.
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Keywords
Keywords: ant venom; immunoglobulin E; adult; allergic reaction; anaphylaxis; ant sting anaphylaxis; article; Australia; bites and stings; clinical article; controlled study; cross reaction; descriptive research; female; geographic distribution; human; immunoassay;
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Source
Medical Journal of Australia
Type
Journal article
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Open Access
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