Anaphylaxis and insect allergy: Edited by Theodore Freeman and Gideon LackSeasonal inhalant insect allergy: Harmonia axyridis ladybugGoetz, David W Author Information Exemplar Allergy & Asthma, Morgantown, West Virginia, USA Correspondence to Dr David W. Goetz, MD. PhD, Exemplar Allergy & Asthma, 1063 Maple Drive, Suite 1A, Morgantown, WV 26505, USA Tel: +1 304 598 2992; fax: +1 304 598 5901; e-mail: [email protected] Current Opinion in Allergy and Clinical Immunology: August 2009 - Volume 9 - Issue 4 - p 329-333 doi: 10.1097/ACI.0b013e32832d5173 Buy Metrics Abstract Purpose of review The exotic Asian lady beetle, Harmonia axyridis, has become a prominent cause of seasonal inhalant allergy (allergic rhinitis, asthma, and urticaria) in the last two decades in North America and Europe after being introduced into the environment as an agricultural pest-control predator. Recent findings Seeking winter hibernation sites, ladybug swarms will invade human habitats in the fall. Large fall swarms and smaller spring dispersions produce corresponding peaks in ladybug allergy. Ladybug allergy prevalence in endemic areas has been reported as high as 10%. For some individuals ladybug allergy is their first expression of allergic disease. Exposures at home, work, school, and in other settings may be sensitizing. Ladybug hemolymph is the primary source of allergens. Har a 1 and Har a 2 major ladybug allergens have been characterized. ‘Reflex bleeding’ from tibiofemoral joints (for communication and during alarm) disperses these allergens. Summary Ladybug skin testing should be routine in endemic areas. Avoidance continues to be the first step in treatment. Allergen vaccine therapy may be effective, but a commercial extract of H. axyridis is needed. Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.