Geitunga- og býflugnaofnæmi - nýr vágestur á Íslandi?

Abstract

In this article we review allergic reactions to stinging insects (hymenoptera) and biting insects (mosquitoes). We describe the first proven case of sensitization and anaphylaxis to hymenoptera in an Icelander. Yellow jackets, honeybees, paper wasps and hornets cause most sting reactions. The vespidae species were first seen in Iceland in 1973. Since that time, these insects have inhabited the island in ever increasing numbers. Symptoms range from local reactions to systemic anaphylaxis and even death. Accurate diagnosis is important as treatment with venom immunotherapy can prevent repeated reactions by at least 95%. Local reactions in children and adults and even widespread urticaria in children should not be treated with immunotherapy. Practical measures to avoid these insects and the characteristics of each species are discussed. Physicians and other health care workers must recognize the symptoms of insect sting allergy and know when to refer to an allergist for skin testing and possible immunotherapy.

Lýst er fyrsta staðfesta ofnæminu fyrir æðvængjum hjá Íslendingi. Hann var stunginn af geitungi og fékk lífshættulegt ofnæmislost, en skjót og rétt meðferð varð honum til bjargar. Hérlendis eru bæði skordýr sem stinga, til dæmis geitungar og býflugur, og skordýr sem bíta (mýflugur). Sjúkdómseinkenni eftir skordýrastungu/bit geta verið allt frá staðbundnum óþægindum til lífshættulegs ofnæmislosts. Sagt er frá helstu skordýrum sem valdið geta þessum einkennum. Mikilvægt er að greina skordýrin rétt. Fái sjúklingur sértæka afnæmingu fyrir geitungum eða býflugum er hægt að koma í veg fyrir ofnæmislost við endurstungu í yfir 95% tilfella.