A beekeeper with a life-threatening bee allergy and the consultant who saved her
St Mary’s Hospital at Imperial College Healthcare NHS Trust is home to the UK’s oldest allergy clinic. The clinic provided the first allergen immunotherapy treatment in 1911 and since then has helped many thousands of people cope with allergies. Recently, beekeeper Lucy Zaichenko found her livelihood threatened when she developed a life-threatening allergy to bees. Thanks to allergy consultant Dr Sophie Farooque, she has been placed on a programme of desensitisation to bee venom in our allergy clinic and Lucy has her life back. Here, Lucy and Dr Farooque discuss the challenges of living with an allergy and how immunotherapy can change lives.
Q: Lucy, you’re allergic to bees and married to a beekeeper?
Lucy: Yes, I found out I was allergic to bees five years ago. My husband is a beekeeper and we set up our business in Oxfordshire. I had been stung a few times, at first with no real reaction, and then my reactions began to increase in severity with increased swelling and itching where I had been stung.
My first life-threatening reaction occurred when I was tidying up, and picked up a pair of shoes to put them away. There were bees inside my shoes and as I reached to pick up my shoe, a bee stung me on the tip of my finger. I did not think anything of it because having bees everywhere is just a part of life when you live on a bee farm but suddenly I was itching everywhere, was covered in a rash and I could not breathe. It was incredibly frightening; and it felt like I lost control of my body. Luckily my husband was there and he rushed me to A&E and by the time I arrived, I had collapsed.
Q: You had been stung before and hadn’t reacted. Dr Farooque, is it common for people to develop an allergy to bees instead of being born with it?
Sophie: Yes, as we get older, we are more likely to be stung by bees or wasps and this increases our chance of developing an allergic reaction. Fortunately life-threatening reactions to bee and wasp venom are still relatively rare. The people who are most at risk of anaphylaxis to bees are bee-keepers and their families because they are at increased risk of being stung.
Q: Lucy, when you found out you were allergic, what was your reaction?
Lucy: It was quite devastating. I mean, this is my husband and my livelihood, we had invested all of our savings in it and it’s our lifestyle as well. I wasn’t aware of immunotherapy treatment at that point, so I didn’t think I had any options. I went back to work, but instead of handling the bees directly I worked with the customers.
Then I hit a low point one day when my husband gave me a hug and looked down and said that there were bees in my hair. It really drove home how precarious and dangerous my situation was, being surrounded by something I was deathly allergic to.
Q: How did you find out about the immunotherapy service at St Mary’s?
Lucy: One of my customers told me about it actually; he kept bees as a hobby and had suffered from a life-threatening reaction to bees as well. He told me that the team here at St Mary’s allergy clinic were fantastic, so I went to my GP and asked to be referred.
Sophie: So many people are unaware of the service we offer, which is a real shame.
Q: What is venom immunotherapy?
Sophie: Immunotherapy is a fantastic treatment that saves lives and completely revolutionises the life of our patients. It builds up tolerance in patients who have suffered anaphylaxis to bee and wasp venom. We start by injecting very small doses of purified wasp or bee venom, (1/10,000th of a bee sting initially) and then each week we increase the size of the dose until the patient is receiving the equivalent of two stings. The treatment is amazing – it changes a person’s allergy from being life threatening to being manageable. It means our patients can go outside to a park or a zoo or their garden without fear. It’s the closest thing to a cure.
Q: And how is Lucy’s treatment going?
Sophie: Lucy’s treatment is going very well. She’s now built up the ability to tolerate at least two simultaneous bee stings.
Lucy: Very surprisingly, despite living with up to 150 million bees, I haven’t been stung since the time when I found out I was allergic. But it’s very reassuring to know that I have a higher level of tolerance.
The treatment allows me to have a life. When you’re allergic to bees, you’re not in control. Unlike a food allergy where you can avoid what you’re allergic to by cooking for yourself, you never know when you might come into contact with a bee.
Not a day goes by that I don’t think of the irony of my situation. But I cope, and the reason I cope and can maintain my lifestyle is thanks to the service at St Mary’s. It’s saved my life.
Q: Who is eligible for wasp and bee venom immunotherapy?
Sophie: There are two types of reactions to wasp and bee stings: generalised (rare) and local (more common). Anyone who has had a generalised reaction to a wasp or bee sting should ask their GP about being referred to our service for consideration of immunotherapy. An example of a general reaction is if you are stung on you hand and you develop a wide-spread rash and/or find it hard to breathe and/or feel faint. Fortunately this type of reaction is still quite rare. Patients who have developed a local reaction to a sting i.e. they are stung on their hand their hand and their wrist swells are not at risk of life-threatening allergy and immunotherapy is not needed.