Lack of Anaphylaxis Preparedness Can Be Deadly

The shocking death of a Canadian politician who was stung by wasps has drawn renewed attention to the dangers of anaphylaxis.

On July 20, 2014, Lucie F. Roussel, the mayor of a Montreal suburb called La Prairie, stepped on a wasp’s nest outside her vacation home and suffered more than a dozen stings. She died before an ambulance could get her to the local hospital.

Reports of her death (along with information about the causes of and treatments for severe allergic reactions) appeared on local media and quickly spread to Canada’s national press and then international news outlets such as CNN.

Most of the stories noted that actual deaths from insect stings are rare. Indeed, stings typically kill fewer than 60 Americans per year, according to the Centers for Disease Control. In Canada, where the population is smaller and the cold weather shortens the stinging season, they only kill about 35 people per decade.

Still, many stories noted, studies estimate that about 2% of all people in both countries are allergic to some sort of insect venom, so stings trigger many thousands of cases of anaphylaxis and send many thousands of people to the hospital each year.

The coverage also provided anaphylaxis experts with an unexpectedly large microphone to advocate major improvements to both individual and collective preparedness.

An allergist from McMaster’s university described how feelings of constriction in the throat and tingling in the tongue were the earliest signs of anaphylaxis and a good reason to seek medical help. Several public health officials argued that epinephrine injectors and people trained to use them are far too rare at offices, restaurants, schools, and other places where attacks of anaphylaxis often begin. A spokeswoman for the advocacy group Anaphylaxis Canada, emphasized the need for people to get themselves tested for allergies and for those who know they have an allergy to carry two epinephrine auto-injectors.

Roussel’s death may actually provide a particularly vivid illustration of that last point, the need for people with known allergies to carry epinephrine auto-injectors at all times.

An early report in the Globe and Mail quoted one of the mayor’s neighbors as saying that she had been diagnosed with a sting allergy. The same story noted that, soon after Roussel died, officials found an epinephrine injector in her vacation home but not on her person.

A La Prairie spokeswoman, however, denied that the mayor had been diagnosed with any allergy and said that the auto-injector found in the home had been prescribed for her husband after he learned of an allergy.

Experts quoted in several stories hoped that news of the mayor’s death would lead more organizations to prepare themselves to deal with anaphylaxis, inspire more people to get tested for allergies, and convince those who tested positive to acquire auto-injectors. They warned, however, that auto-injectors are not a substitute for medical treatment but merely a tool to reduce the severity of an attack and buy patients time to get to a doctor for proper care and supervision.