Anaphylactic Reaction to Bee Stings in the Rural Areas of Gorgan City: Iran’s First Epidemiological Study of Hymenoptera-Induced Anaphylaxis

Background: We aimed to determine the epidemiology of anaphylaxis to bee stings in the rural areas of Gorgan City, Iran.  Objectives: Anaphylaxis is a severe, life-threatening, diffuse or systemic hypersensitivity reaction with rapidly progressive problems such as airway (throat or laryngeal edema) or bronchospasm, tachypnea and hypotension .The systemic response to bee stings is ۱% in children and ۳% in adults. Anaphylaxis due to bee stings is very dangerous in many cases, and may even be fatal at the initial stage. Methods: In this cross-sectional study, we analyzed some of the epidemiological characteristics of the study participants, such as demographic information, bee type, the cause of anaphylaxis, the time of bee sting, the onset of symptoms of anaphylaxis after a bee sting, the number of bee stings, symptoms during anaphylaxis, and therapeutic and prophylactic measures. Results: In total, ۲۰۱ patients were diagnosed with anaphylaxis caused by bee stings. Of these, ۱۲۹(۶۴%) were male, and ۷۲(۳۶%) were female with the Mean±SD age of ۳۴.۳۳±۳۲ and ۳۵.۲۵±۳۴ years, respectively. Anaphylaxis incidents occurred in ۱۰۸ men, and ۱۰۳ women out of ۱۰۰۰۰۰; ۱۶۹ of whom were adults and ۴۶ were children. Anaphylaxis occurred in ۱۰۵(۵۲.۲%) cases in <۵ minutes after being stung (very severe attack) and in ۹۴(۴۶.۸%) cases, between ۵-۶۰ minutes after being stung (rapid attack) (P=۰.۴۵). The patients’ involved organs were skin (۸۵.۶%), respiratory system (۷۸.۶%), cardiovascular system (۳۵.۸%), nervous system (۱۷.۴%), and gastrointestinal tract (۱۰.۹%). Among these stings, ۷۸(۳۸.۸%), ۱۰۷(۵۳.۲%), and ۱۶(۸%) occurred indoors, outdoors, and at home, respectively (P=۰.۰۵). ۷(۹.۵%) children and ۶۷(۳۹.۶%) adults had hypotensive symptoms (P=۰.۰۵). Ninety five percent of cases have been stung for <۱۰ times, and ۸۰% of those who have experienced more than ۱۰ stings experienced severe anaphylactic attacks (P=۰.۰۰۳). Conclusions: Case finding was successful through the rural health network. To obtain accurate epidemiological data on the prevalence of anaphylaxis due to bee stings, an anaphylaxis registry and healthcare service packages are recommended. In this integrated model, a service package, including raising awareness and the knowledge of people, and treatment for anaphylaxis can be employed.

Keywords:

Epidemiology , Bites and stings