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Query: UMLS:C0042109 (urticaria)
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The Africanized honeybee, popularly known as the "killer bee," is already well established in Texas and has recently entered California and Arizona. As the Africanized honeybee spreads in North America, the medical community must become aware of the problems associated with this insect and ensure that sting emergencies can be handled quickly and appropriately. The major differences between Africanized and European honeybees are that the former are more irritable, they swarm more readily and frequently, they defend their hives more vehemently, and they sting more collectively. It is not the composition nor the volume of an individual bee's venom, but rather the cumulative dose of multiple stings that accounts for the morbidity and mortality associated with Africanized honeybee-sting incidents. Even nonallergic persons are susceptible to the toxic effects of these large combined venom loads. Africanized honeybee-sting victims are treated the same as victims of European honeybee stings. Authorities will prepare for the bees' arrival by expanding public awareness, teaching risk-avoidance behavior, providing for the removal of troublesome hives, and developing sting treatment protocols that can be initiated rapidly in the field or emergency departments. Health care professionals should participate in the educational efforts and in the development of needed emergency response protocols so that the effects of the Africanized honeybee will be merely a nuisance rather than a plague.
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PMID:What physicians should know about Africanized honeybees. 855 37

Two groups of eight honey bee colonies were fed with two different concentrations of imidacloprid in saccharose syrup during summer (each colony was given 1 litre of saccharose syrup containing 0.5 microg litre(-1) or 5 microg litre(-1) of imidacloprid on 13 occasions). Their development and survival were followed in parallel with control hives (unfed or fed with saccharose syrup) until the end of the following winter. The parameters followed were: adult bee activity (number of bee entering the hive and pollen carrying activity), adult bee population level, capped brood area, frequency of parasitic and other diseases, mortality, number of frames with brood after wintering and a global score of colonies after wintering. The only parameters linked to feeding with imidacloprid-supplemented saccharose syrup when compared with feeding with non-supplemented syrup were: a statistically non-significant higher activity index of adult bees, a significantly higher frequency of pollen carrying during the feeding period and a larger number of capped brood cells. When imidacloprid was no longer applied, activity and pollen carrying were re-established at a similar level for all groups. Repeated feeding with syrup supplemented with imidacloprid did not provoke any immediate or any delayed mortality before, during or following the next winter, whereas such severe effects are described by several French bee keepers as a consequence of imidacloprid use for seed dressing in neighbouring cultures. In any case, during the whole study, mortality was very low in all groups, with no difference between imidacloprid-fed and control colonies. Further research should now address several hypotheses: the troubles described by bee keepers have causes other than imidacloprid; if such troubles are really due to this insecticide, they may only be observed either when bees consume contaminated pollen, when no other sources of food are available, in the presence of synergic factors (that still need to be identified), with some particular races of bees or when colonies are not strong and healthy.
Pest Manag Sci 2005 Feb
PMID:Experimental study on the toxicity of imidacloprid given in syrup to honey bee (Apis mellifera) colonies. 1561 15

During the anthrax outbreak and threat in Trenton (2001), our allergy practice experienced increased visits from approximately 50 of our regular patients with symptoms they believed resulted from anthrax exposure. In all cases, their symptoms were caused by a combination of an exacerbation of their underlying allergic disease and anxiety because of possible exposure to anthrax. Our objective is to present an orderly approach to the allergist's outpatients presenting with possible exposure to a bioterrorist's agent. The 10 precepts of approach to the management of a biological casualty (index of suspicion, protect yourself, patient assessment, decontaminate, diagnose, treat, infection control, alert authorities, assist in investigation, and maintain proficiency) and the epidemiological characteristics of a biological attack are discussed. In table form, we compared the signs and symptoms of the most common outpatient consultations to an allergist's office practice (chronic rhinitis, asthma, food allergy, venom allergy, atopic dermatitis, drug allergy, chronic urticaria, acute urticaria, immunodeficiency, and anaphylaxis) with those of likely bioterrorism threats. Descriptions of smallpox, plague, tularemia, anthrax, viral hemorrhagic fevers, Q fever, brucellosis, Venezuelan equine encephalitis, glanders, and melioidosis are presented. Patients may readily mistake their allergic symptoms with those of infection with a bioterrorist's agent. At the same time, the allergist may be faced with one of his own chronic patients presenting with symptoms resembling their allergic disease but actually caused by one of the aforementioned pathogens.
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PMID:Biological terrorism and the allergist's office practice. 2178 3