Bee venom allergy in beekeepers and their family members

Purpose of review To analyze prevalence of allergic sting reaction, including the clinical and diagnostic features as well as management options in a population heavily exposed to honeybee stings such as beekeepers and their family members. Recent findings The higher sting frequency is associated with an increased prevalence of allergic sting reactions. Major risk factors for allergic sting reactions in beekepers are: fewer than 10 annual stings, an atopic constitution and symptoms of upper respiratory allergy during work in the beehive. Bee venom allergic beekeepers have higher levels of bee venom-specific IgG but lower skin sensitivity and bee venom-specific IgE than normally exposed bee venom allergic patients. Safety of bee venom immunotherapy is higher in beekeepers than in allergic controls, while efficacy of this treatment is similar in both groups. Summary Beekeepers and their family members are at an increased risk of severe sting anaphylaxis and therefore need especially careful instruction with regard to avoidance of re-exposure, emergency treatment and specific immunotherapy with bee venom.