Mandi Baker wants everyone to know just how dangerous stinging insect allergies can be. And if you have such an allergy to wasps or bees, she wants to urge you to find out about a desensitizing treatment of allergy shots called venom immunotherapy (or VIT).
Unfortunately, Mandi and Brian Baker had never been informed about VIT, and at only 34 years old, Brian tragically died on July 18, a few days after he was stung by yellow jackets. Despite her grief, Mandi Baker is determined to warn others, to prevent other stinging insect allergy tragedies.
On July 14, Brian was outside doing electrical work on a screened-in porch at the couple’s home in Winchester, New Hampshire when it began raining. As he was packing up, he was stung on the wrist and ankle by yellow jackets. Since an allergist had diagnosed him with an allergy to most stinging insects following a previous severe reaction, Brian knew he needed help. He came into the kitchen, calling out to his wife, who says she grabbed the epinephrine auto-injector and “immediately administered.” She then called 911.
Brian was tested for his allergies in 2017, but the Bakers hadn’t been told about VIT. “I wish I knew there was such a thing. I wish I had researched,” Mandi Baker told Allergic Living. She only found out about the treatment when her husband was in critical care at the Catholic Medical Center in Manchester, New Hampshire.
Baltimore allergist Dr. David Golden says there simply isn’t enough awareness – among both doctors and the public – about VIT and its success rate. “We want the public to know that allergic reactions to stings can be life-threatening and they can and will happen again,” he told Allergic Living. “There is a treatment that can protect and even cure the allergy in most people. It’s a regular allergy shot.”
Golden, the lead author of sting allergy practice guidelines for allergists, says that VIT is effective as much as 95 percent of time in preventing future anaphylaxis in people with severe stinging insect allergies. He stresses the importance of visiting an allergist, since they are trained in sting reactions and determining who is a candidate for immunotherapy.
“This is a severe allergy and no one should have to go through this heartache over a bee sting,” Mandi Baker says wistfully. The recent widow describes her late husband as “an all-around great man – fun to be around, heart of gold, always smiled, loved to tinker and be outdoors.”
On July 14, after Mandi administered epinephrine auto-injections, her husband’s anaphylaxis symptoms worsened as they waited for the ambulance to arrive, and he appeared to stop breathing. The 911 operator was giving Mandi CPR instructions, when the paramedics arrived. They worked to stabilize the man, who was a carpenter, for 45 minutes.
“They finally got his heartbeat back and a pulse and that’s when they took him to a local hospital,” says his wife. He was later transferred to the bigger medical center. After a weekend in which he it became apparent he’d suffered significant brain damage, “we had to make the worst decision ever – to take him off the machine,” she says.
“I want people to know just how dangerous [sting allergy] really is,” Mandi Baker stresses. The grieving woman is on a mission to educate and make people aware: “Immunotherapy can help. Research and go to an allergist and get answers.”
All About Venom Immunotherapy (Allergy Shots)
Golden, an associate professor at Johns Hopkins University, says we need “more general and medical awareness of VIT.” He compares it to “other allergy shots (grass, cat, dust), but actually simpler and more reliable.”
“If you came to me with this allergy today, I can have you protected before Labor Day,” Golden told Allergic Living. “In fact, I can have you protected in three days if you wanted because we can do a rush program.”
For the average treatment, a patient visits a board-certified allergist to receive one allergy shot weekly for seven weeks. After that, there’s a booster shot every month or two for a few years. After five years, the majority of people have completed treatment. “It sounds like a long time, but after seven weeks, you’re only getting the shots every few months,” Golden says. Whether a patient wishes to continue carrying an epinephrine auto-injector after treatment can be discussed with the allergist, though “the chance of needing it is really very small.”
Should You Look into Venom Immunotherapy?
Golden says it is important to know when to worry and when not to worry about your risk of a severe venom reaction. He categorizes the three types of reactions you can have to a wasp, bee or other stinging insect.
Local reaction – This happens at the site of the sting and involves the skin only, so it’s not anaphylaxis, which is systemic and involves more than one body system. “If you get stung and 12 hours later, it’s swollen as big as a football, that’s a large local reaction. It’s an allergic swelling and it’s not dangerous,” says Golden. The patient can be treated with ice packs and antihistamines. If the swelling is extremely large, the person may need to take prescribed oral steroid medication for a few days.
The appearance of significant inflammation “scares people, but statistically speaking, there is a less than 3 percent chance that a future sting will cause anaphylaxis for those people,” he says.
Mild systematic reaction – “If you get stung and break out in hives all over, but you don’t have trouble breathing or there’s no dizziness, then it’s a mild systematic reaction. It’s not a multi-system reaction; it’s only on the skin.” This reaction can be treated with antihistamines and should clear up within a few hours.
Golden says it’s important to monitor closely for 30 minutes to an hour, to make sure this doesn’t progress to a more severe reaction. “Some people may choose VIT to give them more security, especially if they have frequent exposure to stinging insects, but it is not required.” People at this level of risk often carry an epinephrine auto-injector just as a precaution.
Severe systematic reaction – “If you got stung and experience the following symptoms: hives with swelling of the tongue or throat, trouble breathing, dizziness or near-unconsciousness, then you have a higher chance of experiencing anaphylaxis again.” A person with this level of allergy will likely benefit from VIT.
“If you think you’ve had a severe reaction to a sting, you should see an allergist,” Golden stresses.