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Ant venom immunotherapy in Australia: the unmet need

Jack jumper ant (JJA) venom extract is available through the Therapeutic Goods Administration (TGA) Special Access Scheme, and it is now time to provide this treatment alongside other insect venom immunotherapies (VITs) to allergic patients in areas of Australia where JJAs are prevalent.

The risk of insect sting anaphylaxis depends on complex interactions between the likelihood of human contact, insect aggression and regional distribution of the causative insect. Whereas venom allergy prevalence and presentation rates may be relatively low in highly urbanised areas, in rural areas and highly exposed populations, the prevalence of previous systemic reactions to stings can approach 3%–4%,1,2 and up to 30% of cases of anaphylaxis presenting to emergency departments (EDs) are triggered by insect stings.3 There were 20 deaths attributed to insect stings in Australia between 1997 and 2005.4

The Australian JJA (Myrmecia pilosula) (Box) is an aggressive species with patchy distribution around Australia, causing severe anaphylaxis, mainly in the south-eastern states.5 A Tasmanian allergist, Paul Clarke, first highlighted the extent of this problem in the Journal in 1986,6