Honeybee, wasp and hornet venom extract shortage concerns allergists

Millions of Floridians will celebrate the Fourth of July holiday outdoors with family, fireworks, barbecues and some irksome, uninvited guests: stinging, flying insects.

Allergists in Florida and across the nation are particularly concerned about those party crashers this year because of a shortage of venom extract used to protect people who are allergic to the stings of honeybees, wasps, yellowjackets and yellow and bald-faced hornets. The extract is used in immunotherapy shots to help build up tolerance to the stings for those prone to allergic reactions, which can be life-threatening in severe cases.

University of Florida Health allergists said the shortage of the extract is expected to continue through the summer — peak sting season — as production ramps up to meet the shortfall.

Manufacturing problems with one of the two companies that produce the extract has led to up to a 35 percent drop in supply, according to a recent CNN report.

Juan C. Guarderas, M.D., an allergist-immunologist with UF Health Allergy – Medical Specialties – Medical Plaza, said the shortage is worrying some patients.

“Allergy immunotherapy is one of the best therapies that we have,” he said. “This treatment can be protective in 99 percent of patients. So, for those patients who cannot be treated or whose treatment is delayed, it’s scary and they may limit their levels of outdoor activity and enjoyment of life in Florida, which depends on nature.”

But UF Health allergists say the shortage, while causing consternation, is nonetheless being managed and patients are still getting treatment.

“There’s no need to panic,” said Mario Rodenas, M.D., a UF Health allergist-immunologist who is a clinical assistant professor in the division of allergy and clinical immunology in the UF College of Medicine. “Patient care has not been affected. We just need to be aware that there are resources despite the shortage.”

UF Health, like many health care providers, is following a series of recommendations jointly issued by the American Academy of Allergy, Asthma & Immunology and the American College of Allergy, Asthma and Immunology.

Rodenas said those recommendations can be safely implemented. They include reducing maintenance doses of the extracts, increasing the time between shots and delaying treatment for those patients at the lowest risk of a bad reaction.

“So, basically, we have to be diligent and we have to be careful about misuse of these extracts because they’re highly valuable right now,” he said.

The venom extracts are taken by hand from the venom of millions of bees, hornets and wasps. The shots using that extract work like a vaccination, as the body forms antibodies that then protect the patient.

Rodenas said the shortage shouldn’t cause people to stop enjoying the outdoors. Shortage or not, he said people prone to reactions should take common-sense steps to avoid putting themselves at extra risk. That includes avoiding carrying food outdoors in insect-rich areas.

“During holidays like July 4th, we’re easy targets for insects,” Rodenas said. “We’re carrying food. Nature has to feed on something. Very simple precautions can be taken, from avoiding the park or outdoors (if you suffer severe reactions), particularly carrying foods. So, you don't want to be hanging out with a burger and a soda in a park with a flowery shirt and cologne or perfume that is sweet and attracts these insects.”

Patients allergic to venoms should keep up-to-date epinephrine auto-injectors handy in case of a life-threatening reaction.

Rodenas said people should consult with an allergist-immunologist if they think they may have an allergy to stinging bugs in order to be tested.

For more information about insect sting allergies, visit http://acaai.org/allergies/types/insect-sting-allergies.