Underuse of allergy services for patients having systemic reactions to Hymenoptera venom stings

National mortality data in the United States from 1980 to 1999 indicate that serious anaphylactic Hymenoptera sting reactions account for at least 40 deaths each year.1 On the basis of the Internal Classification of Diseases, Ninth Revision coding in emergency departments, this mortality rate may be underestimated.2 Most insect stings result in a transient local reaction that can last several days, and the risk of a systemic reaction in these patients ranges from 5% to 10%.3 Potentially life-threatening systemic reactions to insect stings occur in approximately 0.4% to 0.8% of children and 3% of adults.

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