Venom shortage could sting allergy sufferers

As summer begins, signaling peak time for insect stings, allergists across the U.S. are warning of a shortage of a little-known but crucial product — honeybee, hornet and wasp venom extracts used in shots that prevent life-threatening reactions.

Supplies of the extracts — which are made from venom gathered by hand from millions of individual insects — have been scarce since October. That’s when one of two manufacturers in the U.S. shut down production after contamination problems. Doctors say they hope the situation will be resolved, but that’s not likely before next year. For now, they’re rationing doses for patients who need them most.

“It’s going to be a rough summer,” said Dr. David Golden, an allergy expert and associate professor of medicine at Johns Hopkins University.

Golden estimates he’s seen a 25 to 35 percent drop in the supply of venom extracts aimed at preventing dozens, perhaps hundreds, of deaths in the U.S. each year. Between 1 and 3 percent of the country’s adult population — up to 7.4 million people — may have systemic reactions to insect stings, and a smaller proportion have life-threatening responses, experts say.

Most of those vulnerable people carry portable epinephrine — often EpiPens — to quickly counteract symptoms. But a smaller number use what’s known as venom immunotherapy, or VIT, to dramatically reduce the risk of reactions. The treatment, authorized for nearly 40 years, injects small doses of venom under the skin to reduce sensitivity to the allergens that can trigger dangerous symptoms.

“It’s one of the few things that allergists do that actually save lives,” said Dr. Stephen Tilles, a Seattle allergist who is president of the American College of Allergy, Asthma and Immunology (ACAAI). “It’s about 98 percent effective.”

The shortage started last fall, when ALK Laboratories of Denmark shut down production of six types of venom proteins — honeybee, wasp, white-faced hornet, yellow hornet, yellow jacket and “mixed vespid,” a cocktail of venoms.

The move followed a 2016 letter from the Food and Drug Administration citing problems with microbiological contamination. ALK officials didn’t respond to requests for comment.