Prevalence of Hymenoptera venom allergy and sensitization in the population-representative German KORA cohort

Purpose: Allergic reactions to Hymenoptera venoms represent potentially life-threatening conditions. However, studies on their prevalence in Germany and their relation to specific IgE sensitization are rare. The aim of this study was to evaluate the prevalence of Hymenoptera venom allergy as well as the frequency of venom-specific IgE sensitization in a large population-based adult German cohort. Methods: Questionnaire data were collected from the participants of the German population-based KORA (Cooperative Health Research in the Region of Augsburg) S4 baseline study population (n = 4261) and the follow-up F4 study population (n = 3074), which was conducted seven years later. Moreover, sIgE antibodies to honeybee (HBV) and yellow jacket venom (HJV) as well as to common aeroallergens were measured in the S4 study population. Results: The prevalence of systemic sting reactions ranged between 2.3% and 2.6%. sIgE sensitization (≥0.35kU_A/L) to HBV and YJV was demonstrated in 23.1% and 31.7% of the population, respectively (41.6% to HBV and/or YJV). Double-sensitization to both venoms occurred in 13.2% of the individuals. Approximately 53% and 77% of the individuals who reported shock symptoms after honeybee and yellow jacket stings, respectively, exhibited sIgE ≥ 0.35kU_A/L to the culprit venom. In contrast, only 2.8% of the venom-sensitized individuals reported symptoms exceeding local reactions. Local reactions were reported by 4.4 to 4.8% of the population. Conclusions: Self-reported Hymenoptera sting reactions and venom sensitization are frequent in the general German population. In many cases, sensitization and clinically relevant allergy are not observed in the same individual, indicating that comprehensive diagnostic approaches are a prerequisite for the identification of patients at risk for severe reactions.