Prevalence of Hymenoptera venom allergy and sensitization in the population-representative German KORA cohort
Allergic reactions to Hymenoptera venoms represent potentially life-threatening conditions. However, studies on their prevalence in Germany and their relation to specific IgE sensitization are rare. The aim of this study was to evaluate the prevalence of Hymenoptera venom allergy as well as the frequency of venom-specific IgE sensitization in a large population-based adult German cohort.
Questionnaire data were collected from the participants of the German population-based KORA (Cooperative Health Research in the Region of Augsburg) S4 baseline study population (n = 4,261) and the follow-up F4 study population (n = 3,074), which was conducted seven years later. Moreover, sIgE antibodies to honeybee (HBV) and yellow jacket venom (HJV) as well as to common aeroallergens were measured in the S4 study population.
The prevalence of systemic sting reactions ranged between 2.3 % and 2.6 %. sIgE sensitization (≥ 0.35 kUA/L) to HBV and YJV was demonstrated in 23.1 % and 31.7 % of the population, respectively (41.6 % to HBV and/or YJV). Double-sensitization to both venoms occurred in 13.2 % of the individuals. Approximately 53 % and 77 % of the individuals who reported shock symptoms after honeybee and yellow jacket stings, respectively, exhibited sIgE ≥ 0.35 kUA/L to the culprit venom. In contrast, only 2.8 % of the venom-sensitized individuals reported symptoms exceeding local reactions. Local reactions were reported by 4.4 to 4.8 % of the population.
Self-reported Hymenoptera sting reactions and venom sensitization are frequent in the general German population. In many cases, sensitization and clinically relevant allergy are not observed in the same individual, indicating that comprehensive diagnostic approaches are a prerequisite for the identification of patients at risk for severe reactions.
Keywordsanaphylaxis honeybee venom insect venom allergy specific IgE systemic reaction venom sensitization yellow jacket venom
German ministry of education and research
Cross-reactive carbohydrate determinant
German Center of Lung Research
Cooperative Health Research in the Region of Augsburg
Luxembourg institute of health
Large local reactions
German national genome research network
Specific immunoglobulin E
Total immunoglobulin E
Yellow jacket venom
Center of allergy and environment
We are extremely grateful to all the individuals and families who took part in this study, the professionals who helped in recruiting them, and the KORA team, which includes interviewers, computer and laboratory technicians, research scientists, volunteers, managers, receptionists and nurses. Moreover, we gratefully acknowledge the KORA study group for providing us with all the sera and information of the surveys. We also gratefully acknowledge the technical contributions by Birgit Halter and Johanna Grosch.
The study was partially funded by grant 01GC0104 from the German Ministry of Education and Research (BMBF; to MO) and by grant UW-S15T03 from the German National Genome Research Network (NGFN) of the BMBF (to MO and JR). The IgE assays for the Immulite 2000® platform were kindly provided through an unrestricted grant by Siemens Healthcare Diagnostics.
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