Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis

BackgroundStinging Hymenoptera can induce fatal anaphylaxis, especially in patients with systemic mastocytosis. Fire ants, Solenopsis invicta and S. richteri, from South America have recently colonized three continents. Prevalence of fire ant-venom anaphylaxis in the general population and in system...

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Main Authors: Jeremy C. McMurray, Brandon J. Schornack, Karla E. Adams, Robert L. McCoy, Amanda K. Marshall, Janet A. Brunader, Irina Maric, Dean D. Metcalfe, Nathan A. Boggs
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Allergy
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Online Access:https://www.frontiersin.org/articles/10.3389/falgy.2025.1570123/full
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author Jeremy C. McMurray
Jeremy C. McMurray
Brandon J. Schornack
Brandon J. Schornack
Karla E. Adams
Robert L. McCoy
Amanda K. Marshall
Janet A. Brunader
Irina Maric
Dean D. Metcalfe
Nathan A. Boggs
Nathan A. Boggs
author_facet Jeremy C. McMurray
Jeremy C. McMurray
Brandon J. Schornack
Brandon J. Schornack
Karla E. Adams
Robert L. McCoy
Amanda K. Marshall
Janet A. Brunader
Irina Maric
Dean D. Metcalfe
Nathan A. Boggs
Nathan A. Boggs
author_sort Jeremy C. McMurray
collection DOAJ
description BackgroundStinging Hymenoptera can induce fatal anaphylaxis, especially in patients with systemic mastocytosis. Fire ants, Solenopsis invicta and S. richteri, from South America have recently colonized three continents. Prevalence of fire ant-venom anaphylaxis in the general population and in systemic mastocytosis is unknown. The aim was to determine fire ant-venom anaphylaxis prevalence among Tricare beneficiaries and those with systemic mastocytosis.MethodsWe queried the beneficiary immunotherapy prescription database for patients who received immunotherapy with Hymenoptera venom or fire ant whole-body extract and the Tricare beneficiary population health registry database for patients with an ICD−10 code for Hymenoptera venom allergy (HVA). Greater than 95% of the beneficiary population were patients living in the United States. Chart review of a random sample of 150 patients linked to a HVA ICD-10 code was performed to determine the percent of patients with Hymenoptera-venom anaphylaxis. Retrospective review of a systemic mastocytosis cohort was performed to assess fire ant-venom anaphylaxis rate and treatment patterns.ResultsFire ant immunotherapy was the most frequently ordered individual immunotherapy prescription 45.9% (n = 878). Fire ant prescriptions surpassed all flying Hymenoptera immunotherapy prescriptions combined in six states. Fire ant and flying Hymenoptera-venom anaphylaxis prevalence in the general population was 0.048% and 0.083%, respectively. Fire ant-venom anaphylaxis prevalence in the 14 colonized states was 0.085%. More patients with systemic mastocytosis had anaphylaxis triggered by fire ant than all flying Hymenoptera combined.ConclusionFire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis is higher than all flying Hymenoptera-venom anaphylaxis combined in colonized states. Fire ant-venom anaphylaxis in systemic mastocytosis is frequently misdiagnosed and not treated with epinephrine.
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spelling doaj-art-12838ff618474f1dbbb5e12478a59ae02025-08-20T02:10:50ZengFrontiers Media S.A.Frontiers in Allergy2673-61012025-03-01610.3389/falgy.2025.15701231570123Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosisJeremy C. McMurray0Jeremy C. McMurray1Brandon J. Schornack2Brandon J. Schornack3Karla E. Adams4Robert L. McCoy5Amanda K. Marshall6Janet A. Brunader7Irina Maric8Dean D. Metcalfe9Nathan A. Boggs10Nathan A. Boggs11Allergy & Immunology Service, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Pediatrics, Uniformed Services University, Bethesda, MD, United StatesAllergy & Immunology Service, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Pediatrics, Uniformed Services University, Bethesda, MD, United StatesAllergy & Immunology Service, Wilford Hall Ambulatory Surgical Center, San Antonio, TX, United StatesThe United States Army Centralized Allergen Extract Laboratory (USACAEL), Silver Spring, MD, United StatesDefense Health Agency, Defense Healthcare Management Systems, Falls Church, VA, United StatesDefense Health Agency Immunization Healthcare Division, Falls Church, VA, United StatesHematology Section, Department of Laboratory Medicine, National Institutes of Health, Bethesda, MD, United StatesLaboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United StatesAllergy & Immunology Service, Walter Reed National Military Medical Center, Bethesda, MD, United StatesDepartment of Medicine, Uniformed Services University, Bethesda, MD, United StatesBackgroundStinging Hymenoptera can induce fatal anaphylaxis, especially in patients with systemic mastocytosis. Fire ants, Solenopsis invicta and S. richteri, from South America have recently colonized three continents. Prevalence of fire ant-venom anaphylaxis in the general population and in systemic mastocytosis is unknown. The aim was to determine fire ant-venom anaphylaxis prevalence among Tricare beneficiaries and those with systemic mastocytosis.MethodsWe queried the beneficiary immunotherapy prescription database for patients who received immunotherapy with Hymenoptera venom or fire ant whole-body extract and the Tricare beneficiary population health registry database for patients with an ICD−10 code for Hymenoptera venom allergy (HVA). Greater than 95% of the beneficiary population were patients living in the United States. Chart review of a random sample of 150 patients linked to a HVA ICD-10 code was performed to determine the percent of patients with Hymenoptera-venom anaphylaxis. Retrospective review of a systemic mastocytosis cohort was performed to assess fire ant-venom anaphylaxis rate and treatment patterns.ResultsFire ant immunotherapy was the most frequently ordered individual immunotherapy prescription 45.9% (n = 878). Fire ant prescriptions surpassed all flying Hymenoptera immunotherapy prescriptions combined in six states. Fire ant and flying Hymenoptera-venom anaphylaxis prevalence in the general population was 0.048% and 0.083%, respectively. Fire ant-venom anaphylaxis prevalence in the 14 colonized states was 0.085%. More patients with systemic mastocytosis had anaphylaxis triggered by fire ant than all flying Hymenoptera combined.ConclusionFire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis is higher than all flying Hymenoptera-venom anaphylaxis combined in colonized states. Fire ant-venom anaphylaxis in systemic mastocytosis is frequently misdiagnosed and not treated with epinephrine.https://www.frontiersin.org/articles/10.3389/falgy.2025.1570123/fullred and black fire antsSolenopsis invicta and richterifire ant-venom anaphylaxis prevalenceflying hymenoptera-venom anaphylaxis prevalencesystemic mastocytosis (SM)
spellingShingle Jeremy C. McMurray
Jeremy C. McMurray
Brandon J. Schornack
Brandon J. Schornack
Karla E. Adams
Robert L. McCoy
Amanda K. Marshall
Janet A. Brunader
Irina Maric
Dean D. Metcalfe
Nathan A. Boggs
Nathan A. Boggs
Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
Frontiers in Allergy
red and black fire ants
Solenopsis invicta and richteri
fire ant-venom anaphylaxis prevalence
flying hymenoptera-venom anaphylaxis prevalence
systemic mastocytosis (SM)
title Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
title_full Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
title_fullStr Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
title_full_unstemmed Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
title_short Fire ant-venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
title_sort fire ant venom anaphylaxis prevalence in the general population and patients with systemic mastocytosis
topic red and black fire ants
Solenopsis invicta and richteri
fire ant-venom anaphylaxis prevalence
flying hymenoptera-venom anaphylaxis prevalence
systemic mastocytosis (SM)
url https://www.frontiersin.org/articles/10.3389/falgy.2025.1570123/full
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