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Howard S. Rubenstein, MD
Harvard University University Health Services Cambridge, Mass

JAMA. 1980;244(15):1672.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Regarding the COMMENTARY by Lichtenstein et al elsewhere in this issue (p 1683), the basic question is can one justify immunotherapy to protect against the following:

1. A disease with an almost zero mortality when those at mortal risk have not been identified? The National Institutes of Health Consensus Development Conference on Insect Sting reported in 1979: "A person's previous reaction to an insect sting is not a reliable indicator of the severity of future reactions" (panelist Robert E. Reisman, MD) and "everyone is a potential victim of life-threatening or fatal allergic reactions from stinging insects" (entire panel).¹

2. A morbidity that resembles experimental anaphylaxis and is frightening but unlike anaphylaxis is rarely life-threatening, even when bronchospasm or hypotension accompanies the hives? Do we therefore best serve a patient who once sustained such a reaction by saying, "You experienced a frightening reaction, but almost no one . . . [Full Text PDF of this Article]

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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