The risk of severe systemic reaction to Hymenoptera stings cannot be sufficiently and accurately predicted by "diagnostic" tests such as the skin-prick test or the determination of specific IgE to the venom of the stinging insect.

Several controlled trials and observational studies investigated the risk of recurrent systemic reactions after Hymenoptera re-stings in subjects with a history of systemic reactions. The reported recurrence rate ranged from 14% to 76%.1,13,14,18-20,22-27 The risk of systemic reactions after a re-sting varied according to the severity of the initial reaction. If the initial reaction was severe, a risk of recurrent systemic reactions of 49-76% was observed,1,18,28 compared with 14-41% after mild initial reactions.1,13,18,21 For children, the risk of recurrent allergic symptoms is lower.29

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