Rate and quantity of delivery of venom from honeybee stings

Schumacher, Michael J.; Tveten, Michael; Egen, Ned B.

doi:10.1016/0091-6749(94)90373-5

Cited by 115 publications

(67 citation statements)

References 10 publications

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“…Der Bienenstachel bleibt meist stecken, der Wespenstachel nicht selten auch. Das Gift ist erst innerhalb von 1 min komplett injiziert[23], weswegen der Giftsack oder das Insekt so lange belassen werden sollen. Kommt es zu einer systemischen Reaktion, wird der Stachel sofort entfernt.…”

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Stichprovokation

Ruëff

Przybilla²

2014

Hautarzt

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For the majority of patients quality of life will significantly improve after tolerated sting challenge. A sting challenge test is particularly important in those patients who are at increased risk due their increased risk of treatment failure. If in patients with risk factors for treatment failure, VIT is done with elevated dose or if no risk factors are present, a sting challenge may not be needed. VIT with an elevated dose may prevent or correct treatment failure.

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unclassified

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Ruëff

Przybilla²

2014

Hautarzt

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“…4,5,8,11 Each Africanized bee injects an average of 94 g of venom in less than a minute, compared with 147 g for the slightly larger European bee, and circulating venom levels in patients of up to 3.8 mg/L have been recorded. 4,14,15 The venom contains many biologically active components such as melittin, phospholipase A 2 , apamin, mast cell degranulating peptide, hyaluronidase, histamine, and dopamine. 16 Of these, melittin is predominant (ϳ50% by dry weight) and can disrupt cell membranes and produce pores even at low concentrations.…”

mentioning

confidence: 99%

A novel Fab-based antivenom for the treatment of mass bee attacks.

Jones

Corteling²,

Bhogal³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. The frequency of mass bee attacks has dramatically increased in the Americas following the introduction and spread of the aggressive Africanized 'killer' bee (Apis mellifera scutellata). As yet no specific therapy is available, which led us to develop an ovine Fab-based antivenom as a potential new treatment. Sera from sheep immunized against the venom contained high levels of specific antibodies, as demonstrated by ELISA and by small-scale affinity chromatography, against both whole (A. m. mellifera) venom and purified melittin. A nerve muscle preparation was used to show the myotoxic effects of the venom and neutralization by the antivenom. Antivenom neutralizing ability was also demonstrated using assays for venom phospholipase A 2 and in vivo activities. Venom from both European and Africanized bees appeared identical when analyzed by acid-urea gel electrophoresis. This antivenom may therefore provide the first specific therapy for the treatment of mass envenomation by either European or Africanized 'killer' bees.The accidental introduction of the native African bee Apis mellifera scutellata into Brazil in 1957 and its subsequent displacement and hybridization of the long-established European bees A. m. mellifera and A. m. ligustica has resulted in the highly aggressive Africanized 'killer' bee. 1,2 It is better adapted to warmer climates than its European counterparts and, as a result, has been highly successful and spread rapidly throughout Latin America. In 1992, the Africanized bee crossed the border into the United States and is now found in Texas, Arizona, New Mexico, and southern California. 3 It is predicted to eventually be distributed as far east as North Carolina. 2 These bees attack much more readily and in greater numbers than the European varieties, 1 and thousands of stings may be inflicted on a single individual. 4,5 About 50 simultaneous stings can cause systemic envenoming and about 500 are probably necessary to cause death by direct toxicity, 4,6-10 although one death in Arizona was due to only ϳ125 stings. 11 By 1985, it was estimated that these bees had caused between 700 and 1,000 deaths, 12 and in Mexico there have been more than 190 such deaths between 1988 and 1993, with future estimates of 60 deaths per year. 13 Clinical features can include rhabdomyolysis, intravascular hemolysis, respiratory distress, hepatic dysfunction, hypertension, myocardial damage, shock, and/or renal failure. 4,5,8,11 Each Africanized bee injects an average of 94 g of venom in less than a minute, compared with 147 g for the slightly larger European bee, and circulating venom levels in patients of up to 3.8 mg/L have been recorded. 4,14,15 The venom contains many biologically active components such as melittin, phospholipase A 2 , apamin, mast cell degranulating peptide, hyaluronidase, histamine, and dopamine. 16 Of these, melittin is predominant (ϳ50% by dry weight) and can disrupt cell membranes and produce pores even at low concentrations. 16,17 Phospholipase A 2 enhances this membrane disruptio...

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“…9,10 The management of massive bee envenomation is mainly supportive with no specific anti-venom being available 1,3 . Rapid removal of stingers is advocated as 90% of the venom sac contents are delivered in 20 seconds with delivery completed in one minute 11 . Delay in removal leads to increased weal size and increase in envenomation.…”

Section: Discussionmentioning

confidence: 99%

A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

Jimoh¹,

Akuse²,

Bugaje³

et al. 2016

Nig. J. Paed.

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Acute Kidney Injury in children following bee sting envenomation is rare and survival is hinged on early recognition and prompt appropriate management. This report is aimed at raising awareness among healthcare workers, of one of the systemic effects of massive bee sting and the need to develop sting treatment protocol. A three year old preschooler was attacked by a swarm of bees, receiving over 150stings. Initial clinical features were allergic response involving the head, face and tongue for which he had first aid in a primary healthcare facility and thereafter sent home. Few hours later he developed clinical features of intravascular haemolysis, rhabdomyolysis, hypertension and acute renal failure. Laboratory findings were in keeping with clinical presentation. Despite supportive management, serum biochemistry worsened necessitating haemodialysis. Massive bee sting envenomation can cause systemic reactions and organ dysfunctions. To improve the overall clinical outcome, sting treatment protocol is advocated.

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Rate and quantity of delivery of venom from honeybee stings

Cited by 115 publications

References 10 publications

Stichprovokation

Stichprovokation

A novel Fab-based antivenom for the treatment of mass bee attacks.

A Call for sting treatment protocol: Case report of a 3 year old with massive bee sting resulting in acute kidney injury

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