It has been well documented, worldwide, that inhalation and/or contact with airborne particulate insect products has resulted in sensitivity to insect proteins and is manifested by such common entities as dermatitis, conjunctivitis, rhinitis, and asthma. However, the deliberate ingestion of a variety of insects (undertaken to prove their edibility and nutrient value) resulted in subsequent sensitization of some individuals. Such an outcome has not previously been reported in the literature. The objective was to document the anaphylactic reaction to the purposeful ingestion of mealworm in an individual known to be sensitized to the inhalation of beetle larvae. We used the occasion of the Centennial Celebration of The New York Entomological Society to expose members and guests of the Society to the ingestion of various insects. The subjects of the study consisted of: 1) Three members were adversely affected; 2) One individual with Baker's asthma; and 3) A number of controls with no known hypersensitivity to insect products. The investigation was undertaken by food challenges, inhalation challenges, skin testing to the individual insect allergens, a) Tenebrio molitor (TM), b) Zophobas morio (ZM), c) Blattella germanica (BG), skin testing to common indoors and outdoor allergens, and direct bind ELISA and ELISA inhibition. One individual manifesting hypersensitivity both by ingestion and inhalation to mealworm was identified. This sensitivity was documented clinically as well as by objective testing.

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A total of248 patients with systemic reactions to Hymenoptera envenomation were studied. There were 138 adults and 110 children. Twenty-eight of these 248 (11.3%) had family members with histories consistent with Hymeno[Jlera anaphylaxis. These included jive mothers and sons, two sister pairs, three pairs of sister-brother, one pair brother-brother, and one pair father-daughter. In one extendedfami/y, afather, mother, son, and mother's sister had Hymenoptera sensitivity. Ninetysix consecutive allergic patients without Hymenoptera sensitivity served as controls, and of these, 3.1% had family members with Hymenoptera sensitivity. The occurrence of Hymenoptera sensitivity in families of patients with Hymenoptera sensitivity is statistically different from our controls (11.3% vs 3.1%, p = 0.0195). There appears to be a hereditary aspect for Hymenoptera sting sensitivity. (Allergy Proc 15:53-56, 1994)