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Indian J Public Health. 2019 Apr-Jun;63(2):154-156. doi: 10.4103/ijph.IJPH_222_18.

Mortality due to mass Hymenoptera attacks: A serious but underrecognized public health problem in a mountainous state of India.

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Professor and Head, Assistant Professor, Department of Nephrology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
Professor, Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.


Most deaths related to Hymenoptera are a result of immediate hypersensitivity reactions causing anaphylaxis to one or few stings. However, if the patient is exposed to a large quantity of the venom due to mass/multiple stings, massive envenomation can cause death in nonallergic individuals. Thirty-nine cases of acute kidney injury (AKI) who followed mass attacks by Hymenoptera were seen over 15 years, with a reference period between 2003 and 2017. AKI was severe; most (85%) of them required dialysis and one-third died. Mass attacks by Hymenoptera have become a serious public health problem in tropics. There is no antivenom, and treatment in such cases is supportive. Early hospitalization is vital to reduce morbidity and mortality.


Hymenoptera; mass envenomation; mortality; tropics

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