<snip> Attributing deaths due to Kounis Syndrome to wasps looks like a very dodgy thing to do. <snip>
Why?
We attribute deaths to smoking, alcohol, drugs and even car accidents.
Kounis is an emerging story. The nature of it means that it has gone largely undetected until recently thanks to Professor Kounis. Now that we are starting to understand more and recognise it better what should we do?
Stick our heads in the sand?
Stents are a relatively recent medical advance that give a new lease of life to many patients. If wasp stings represent an elevated risk to these patients then surely the responsible thing is to make such patients aware so that they don't take unnecessary risks because they aren't well informed.
We teach the green cross code to children because of the dangers of crossing the road. Is that inducing panic? Hardly!
I suspect that Kounis is not as rare as some commentators make out. This is a story that I have been following since late 2009 when I started to see a pattern emerging in medical cases being filed across the globe sufficiently so to start an awareness campaign (within the health care professions and the pest control industry). It has to be understood that just because something hasn't been reported doesn't mean it's not there. Quite often it's because it hasn't been looked for that there hasn't been the accumulation of evidence. If someone dies suddenly of a heart attack with symptoms of a heart attack, no medic is going to conduct expensive investigations to determine whether a wasp was responsible (or any other agent for that matter) if they don't associate the wasp as probable cause.
What makes wasps different is that they have venom which works on purpose to destabilise mast cells and therefore have the potential to precipitate Kounis type reactions. Now that medics are starting to get their head around this I think we will see more similar reports. Have a look at these:
http://www.casesjournal.com/content/2/1/7800
http://www.hindawi.com/crim/cardiology/2012/701753/
http://www.ncbi.nlm.nih.gov/pubmed/23363947
http://www.koreancircj.kr/DOIx.php?id=10.4070/kcj.2013.43.8.561
If you read this small selection of papers then you might notice something interesting. All the papers are recent and they all make claims to be 'first time' observations of wasp sting induced Kounis or report Kounis as something that is very rare. In another paper Brown et al reports that up to 10% of patients (healthy volunteers) suffered Kounis type reactions after stings:
This paper is interesting;
http://www.szd.si/user_files/vsebina/Zdravniski_Vestnik/2012/junij/500-4.pdf
especially the quote;
"Although the syndrome has been encountered
increasingly in clinical practice,
its true frequency is difficult to determine
due to inadequate reporting.4 However, in
a recent study two of 21 healthy volunteers
developed chest pain with ischemic electrocardiographic
changes during a diagnostic
insect sting challenge."
I repeat that this is not about scaring people. It's about education and raising awareness so that people can take simple steps to reduce unnecessary risks.