Allergy to bumblebees.

PURPOSE OF REVIEW: Field stings by bumblebees are uncommon because of the habitat and nonaggressiveness of these insects. More stings have been reported in the Netherlands because of the increasing use of bumblebees in flowering industries such as tomato growing. The purpose of this review is to summarize the recent literature concerning bumblebee anaphylaxis and describe our own experience with immunotherapy in an occupational group of bumblebee-venom-allergic workers.

RECENT FINDINGS: Two distinct categories of patients are sensitized to bumblebee venom. First are patients with IgE highly cross-reactive with honeybee venom allergens. Venom immunotherapy with honeybee venom will be adequate in these nonprofessionally exposed bumblebee-allergic patients. These patients react to bumblebee venom as a result of a primary earlier exposure and sensitization to honeybee venom. Secondly, with heavily exposed greenhouse workers or bumblebee workers, frequently stung only by bumblebees, it is recommended to use immunotherapy with purified bumblebee venom, due to the low or absent degree of cross-reactivity with honeybee venom. Otherwise, the best preventive therapy is to avoid further exposure, which means changing profession.

SUMMARY: Immunotherapy with purified bumblebee venom is as well tolerated and effective as immunotherapy with other Hymenoptera venoms.