History The earliest known account of ant sting fatalities in Australia was first recorded in 1931; two adults and an infant girl from New South Wales died from ant stings, possibly from the jack jumper ant or
M. pyriformis. Thirty years later, another fatality was reported in 1963 in Tasmania. Historical and
IgE results have suggested these two species or perhaps another species were responsible for all recorded deaths. All known patients who died from jack jumper stings were at least 40 years old and had cardiopulmonary
comorbidities. Before venom immunotherapy, whole body extract immunotherapy was widely used due to its apparent effectiveness, and it was the only immunotherapy used on ants. However, fatal failures were reported and this led to scientists researching for alternative methods of desensitisation. Whole body extract immunotherapy was later proven to be ineffective, and venom immunotherapy was found to be safe and effective to use. Paul Clarke first drew medical attention to the jack jumper ant in 1986, and before this, there had been no history of records of allergic reactions or study on their sting venom. The identification of venom allergens began in the early 1990s in preparation for therapeutic use. Whole body extracts were first used to desensitize patients, but it was found to be ineffective and later withdrawn. Venom immunotherapy was shown to reduce the risk of systemic reactions, demonstrating that immunotherapy can be provided for ant-sting allergies. The ant is a significant cause of major insect allergies, responsible for most anaphylaxis cases in Australia, One in three million annually die of general anaphalaxis in Australia alone. Over 90% of Australian ant venom allergies have been caused by the jack jumper. The ant is notorious in Tasmania, where most fatalities have been recorded. In 2005, over a quarter of all jack jumper sting incidents were sustained in Tasmania; excessive in comparison to its 2006 population of only 476,000 people. Jack jumper stings are the single most common cause of anaphylaxis in patients at the
Royal Hobart Hospital. The jack jumper have been compared to other highly aggressive ant species, such as
Brachyponera chinensis,
Brachyponera sennaarensis, and the
red imported fire ant (
Solenopsis invicta). The retractable sting is located in their abdomen, attached to a single venom gland connected by the venom sac, which is where the venom is accumulated.
Exocrine glands are known in jack jumpers, which produce the venom compounds later used to inject into their victims. Their venom contains
haemolytic and
eicosanoid elements and
histamines. It contains a range of
active ingredients and
enzymatic activity, which includes
phospholipase A2 and B,
hyaluronidase, acid and alkaline
phosphatase. The venom of the ant also contains several
peptides; one being
pilosulin 1, which causes
cytotoxic effects,
pilosulin 2, which has
antihypertensive properties and
pilosulin 3, which is known to be a major allergen. Other pilosulins include
pilosulin 4 and
pilosulin 5. The peptides have known
molecular weights. The
LD50 (lethal dose) occurs at a
lower concentration than for
melittin, a peptide found in bee venom. Its LD50 value is 3.6 mg/kg (injected intravenously in mice). Loss of
cell viability in the jack jumper's venom was researched through
cytometry, which measures the proportions of cells that glow in the presence of
fluorescent dye and
7-Aminoactinomycin D. Examinations of the rapidly reproducing Epstein–Barr B-cells showed that the cells lost viability within minutes when exposed to pilosulin 1. Normal
white blood cells were also found to alter easily when exposed to pilosulin 1. However, partial peptides of pilosulin 1 were less efficient at lowering cell viability; the
residue 22 N-terminal plays a critical role in the cytotoxic activity of pilosulin 1. An
East Carolina University study which summarised the knowledge about ant stings and their venom showed that only the fire ant and jack jumper had the allergenic components of their venom extensively investigated. These allergenic components include peptides found as
heterodimers,
homodimers and pilosulin 3. Due to the vast differentiation of venom produced in each
Myrmecia species, and other species sharing similar characteristics to the jack jumper ant, diagnosing which ant is responsible for an anaphylactic reaction is difficult. People most commonly feel a sharp pain after these stings, similar to that from an electric shock. Some patients develop a systemic skin reaction after being stung. Localised
envenomation occurs with every sting, but severe envenoming only occurs if someone has been stung many times (as many as 50 to 300 stings in adults). The heart rate increases, and blood pressure falls rapidly. Most people will only experience mild skin irritation after being stung. Those who suffer from a severe allergic reaction will show a wide variety of symptoms. This includes
difficulty breathing and talking, the
tongue and
throat will swell up, and
coughing,
chest tightness,
abdominal pain,
nausea and
vomiting may occur. Others may lose consciousness and collapse (sometimes people may not collapse), and confusion. Children who get stung will show symptoms such as floppiness and paleness if a severe allergic reaction occurs. In individuals
allergic to the venom (about 2–3% of the population), a sting sometimes causes anaphylactic shock. In comparison to other insects such as the
western honeybee (
Apis mellifera) and the
European wasp (
Vespula germanica), their rates are only 1.4% and 0.6%. The annual sting exposure rates in Tasmania for the jack jumper ant, Western honeybee and European wasp are 12%, 7% and 2%. About half of these reactions were life-threatening and occurred predominantly in people who had had previous incidents with the sting. The sensitivity to stings is persistent for many years. Most people recover uneventfully following a mild local reaction and up to about 3% of individuals suffer a severe localised reaction. Other treatments include washing the stung area with soap and water, and if continuous pain remains for several days,
antihistamine tablets are taken for one to three days. Emergency treatment is needed in a case of a severe allergic reaction. Before calling for help, have the person lie down and elevate their legs. Depending on a patient's needs, they will be given an
EpiPen or an Anapen to use in case they are stung. In a scenario of experiencing anaphylaxis, further doses of
adrenaline and
intravenous infusions may be required. Some with severe anaphylaxis may suffer
cardiac arrest and will need
resuscitation. Another plant used as a bush remedy is
Carpobrotus glaucescens (known as angular sea-fig or pigface).
Desensitisation and prevention in Hobart, Tasmania offers a
desensitisation program for people who are prone to severe
anaphylactic reactions to jack jumper ant stings Desensitisation (also called
allergy immunotherapy) to the jack jumper sting venom has shown effectiveness in preventing anaphylaxis, but the standardisation of jack jumper venom is yet to be validated. Unlike bee and wasp sting immunotherapy, jack jumper immunotherapy lacks funding and no government
rebate is available. Venom is available; however, no commercial venom extract is available that can be used for skin testing. Venom extract is only available through the
Therapeutic Goods Administration Special Access Scheme. Professor Simon Brown, who founded the program, commented, "Closing the program will leave 300 patients hanging in the lurch". The
Royal Adelaide Hospital runs a small-scale program that desensitises patients to the ant's venom. Patients are given an injection of venom under the skin in small amounts. During immunotherapy, the first dose is small, but will gradually increase per injection. This sort of immunotherapy is designed to change how the immune system reacts to increased doses of venom entering the body. Both rapid and slow doses can be done safely during immunotherapy. The
efficacy (capacity to induce a
therapeutic effect) of ant venom immunotherapy is effective in reducing systemic reactions in comparison to
placebo and whole body extract immunotherapy, where patients were more likely to suffer from a systemic reaction. Despite immunotherapy being successful, only ten percent of patients do not have any response to desensitisation. It is suggested that people should avoid jack jumpers, but this is difficult to do. Closed footwear (boots and shoes) along with socks reduce the chances of encountering a sting, but wearing thongs or sandals will put the person at risk. With this said, they are still capable of stinging through fabric, and can find their way through gaps in clothing. Most stings occur when people are gardening, so taking extra caution or avoiding gardening altogether is recommended. People can also avoid encountering jack jumpers by moving to locations where jack jumper populations are either low or absent, or eliminate nearby nests. Since
Myrmecia ants have different venoms, people who are allergic to them are advised to stay away from all
Myrmecia ants, especially to ones they have not encountered before. ==See also==