Arthropods are important in medicine for a multitude of reasons. Their bites and stings may induce allergic reactions, ranging from annoying to life-threatening. Many arthropod products are also capable of inciting allergic responses in sensitized persons. In recent years, bites and stings have gained greater attention owing to increased concern about disease transmission. A common hypersensitivity response to arthropod bites, stings, and products is papular urticaria. This eruption occurs primarily in children, who eventually "outgrow" this disease, probably through desensitization after multiple arthropod exposures. Papular urticaria is most often caused by fleas or bedbugs, but virtually any arthropod is capable of inducing such a reaction. Two arthropod classes of medical importance are the Arachnida (spiders, scorpions, ticks, and mites) and the Insecta (lice, fleas, bedbugs, flies, bees, and ants). Animals in these two classes are probably responsible for more morbidity and mortality worldwide than are any other group of venomous creatures. In general, the diagnosis of arthropod bites and stings is dependent on maintenance of a high index of suspicion and familiarity with the arthropod fauna not only in one's region of practice, but also in the travel regions of one's patients. Learning objective At the completion of this learning activity, participants should be familiar with the clinical manifestations caused by a variety of arthropods as well as the treatment and possible sequelae of arthropod attacks.

https://www.jaad.org/article/S0190-9622(04)00267-1/pdf

Arthropods in dermatology

COEXISTENCE with the pugnacious imported fire ant has become a necessary evil for residents of both the rural and the urban Gulf South.1 The spread of these insects has produced agricultural problems,2 and their stings have resulted in increasing numbers of persons with hypersensitivity reactions, secondary infections, and neurologic sequelae.1 , 3 , 4 Two recent evolutionary changes in the ants may make the expansion of their geographical range more likely.5 , 6 Imported Fire Ants in the United States Both the black imported fire ant, Solenopsis richteri (native to Argentina and Uruguay), and the red imported fire ant, Solenopsis invicta (native to northern Argentina, Paraguay, . . .

Reactions to the stings of the imported fire ant.

I. The Chemical and Toxinological World of Ants . . . 425 II. Taxonomy 426 III. Biological Roles of Ant Venoms 428 A. Offense 430 B. Defense 434 C. Chemical Communication 440 IV. Ant Venom Collection and Purity 441 V. Venom Biochemistry and Chemistry 442 A. Predominantly Nonproteinaceous Venoms . . . 443 B. Proteinaceous Venoms 472 VI. Physiological and Pharmacological Activities of Ant Venoms 478 A. Paralytic and Lethal Activities of Ant Venoms against Arthropods 479 B. Lethal Toxicity and Paralytic Activities against Vertebrates 481 C. Algogenicity 484 D. Membrane Activity 488 E. Neurotoxicity 490 F. Other Activities 492 VII. Potential Pharmacological and Physiological Uses of Venoms 493 VIII. A Caveat: Ant Venoms and People 494 IX. Ants: Venom Chemists and Toxinologists par Excellence 497 References 498

9 – Chemistry, Pharmacology, and Chemical Ecology of Ant Venoms*

A physician questionnaire survey was conducted by the Fire Ant Subcommittee of the American Academy of Allergy and Immunology to document deaths caused by imported fire ant stings From the 29,300 physicians surveyed, reports of 83 fatal and two near-fatal fire ant-sting reactions were received Most anaphylactic deaths were reported from Florida (22) and Texas (19) After excluding duplicate reports, four confirmed deaths were documented in Alabama, 10 in Florida, two in Georgia, two in Louisiana, and 14 in Texas

Survey of fatal anaphylactic reactions to imported fire ant stings

Learning objectives Reading this article will reinforce the reader's knowledge of the taxonomy, origin, and distribution of fire ants and will increase his ability to diagnose and manage reactions caused by the two imported species, Solenopsis invicta and richteri . This review will also enhance the reader's knowledge of the available diagnostic methods and therapeutic measures, including the role of fire ant venom versus whole body extract in the management of fire ant allergy. Data sources Information for this review was obtained primarily from abstracts and articles written by investigators recognized for their expertise in fire ant venom research. Study selection References were selected based on their clinical applicability and relevance to the epidemiology and pathophysiology of imported fire ant hypersensitivity. Conclusions The imported fire ant represents a significant health hazard for persons living in fire ant endemic areas in the southern United States. Sting reactions range from local pustules and large, late-phase responses to life-threatening anaphylaxis. Fire ant allergen-specific immunotherapy can reduce the risk of subsequent systemic reactions. Four important Sol i venom allergens have been isolated and characterized. Clinical studies have been designed to compare the safety and efficacy of fire ant venom with whole body extract for diagnosis and treatment of fire ant allergy.

Hypersensitivity to Fire Ant Venom

Although the imported fire ant is a known rural problem, the problem it may pose to urban dwellers has not been documented. A telephone survey of 240 households selected by a probability sample of an upper middle class suburb of New Orleans was carried out to ascertain the experiences of residents with fire ants from June to August 1973. Overall, ant stings were reported for 29% of the study population, with sting rates of 55% among children under 10 years old. Among those stung, at least minimal allergic reactions were reported for 17%, and 4.4% required medical consultation. Of households with outdoor premises, 55% reported fire ant infestation, 86% of these used pesticides for fire ant control, and few felt that community assistance was needed for private property. Half of the respondents, however, favored a community control program for public grounds. These data may provide a basis for decision as to the need for community efforts in fire ant control.

R. E. Serfling

Papers

The imported fire ant: dimensions of the urban problem.