European wasps: an emerging hazard in Australia

MJA 1997; 167: 650  

To the Editor: The Victorian Department of Natural Resources and Environment has predicted a surge in European wasp (Vespula germanica) numbers this summer (6 August 1997, press release).1 This is expected to result in an increase in serious and potentially life-threatening injuries from wasp stings.2 Since arriving in mainland Australia in 1977, the European wasp has spread dramatically,3 and is now found in all States and Norfolk Island. It has so far resisted biological and chemical control measures, and the wasp population is expected to explode.3 The toxicity of wasp venom, their multiple stinging capacity, aggressiveness and tendency to build hidden subterranean nests2,3 mean that increased morbidity from wasp stings is likely. According to the Victorian Minimum Inpatient Dataset, hospitalisations as a result of wasp stings have increased in Victoria in recent years (1992-1996),4 and wasp stings were among the top 10 poisons exposure inquiries in Victoria for 1996.4 Fatalities have been reported in other countries.5 The current paradigm is that most serious reactions to wasp stings are allergic in nature, so that only a small percentage of the population is at risk. However, as in the case of a Melbourne child who disturbed a wasp nest,2 the large number of stings sustained from an attack by a swarm of wasps (often 30 to 200 stings) can result in a massive life-threatening envenomation. Therefore, not only those with wasp allergy are at risk. Unfortunately, this issue has not been studied, despite the important implications for patient management. Allergic effects, which may be managed by immunotherapy and early administration of adrenaline, need to be distinguished from the toxic effects of envenomation, which require alternative management. We support the initiative of the Victorian Conservation Minister to develop a national European wasp strategy and recommend that it include a national surveillance system, through the Australian Venom Research Unit (AVRU), to monitor the health impact of the growing wasp population. We also encourage doctors to report serious wasp-related injuries to the AVRU: telephone (03) 9344 7753 or facsimile (03) 9348 2048. Interdisciplinary collaborative research involving entomological, toxicological, public health and emergency medicine professionals is needed to address this increasing threat to our health and enjoyment of the great outdoors. Nadine R Levick Faculty, Division Pediatric Emergency Medicine, Johns Hopkins Medical Institutions 600 North Wolfe Street, CMSC 144, Baltimore, MD, USA 21287-3144 E-mail: nlevickATwelchlink.welch.jhu.edu Ken D Winkel Deputy Director, Australian Venom Research Unit, Department of Pharmacology University of Melbourne, VIC Gordon Smith Associate Professor, Center for Injury Research and Policy, School of Hygiene and Public Health Johns Hopkins University, Baltimore, MD, USA Alexander C. Wasp plague on the way. Herald Sun 1997 Aug 8. Levick N, Braitburg G. Massive European wasp envenomation of a child. Emerg Med 1996; 8: 239-245. Spradbery JP, Maywald GF. The distribution of the European or German wasp in Australia, past, present and future. Aust J Zool 1992; 40: 495-510. Royal Children's Hospital, Pharmacy Department. Keeping tabs. Newsletter. Melbourne: Royal Children's Hospital, 1997; 3: 1. Man dies after attack by wasps. The Washington Post 1997 Aug 29: D06.