Hypersensitivity to larvae of chironomids (non-biting midges). Cross-sensitization with crustaceans

In 2,368 consecutive adult patients with asthma and/or rhinitis the incidence of positive skin prick test (SPT) with a chironomid extract (CHIR) (produced from "red feather mosquito larvae" used as fish food) was 14% (26% in atopics and 4% in non-atopics). RAST with chironomid was positive in 4% of 110 consecutive sera (8% in atopic sera). Significant correlations were found between RAST and SPT results with chironomid and between SPT results with CHIR and with various crustaceans. Correlations were also found reciprocally among SPT results with different crustaceans and between some crustaceans and moluscs (clam and oyster) as well as among RAST results with chironomid, shrimp and crab. Inhibition experiments showed that chironomid extracts inhibited RAST with shrimp, and vice versa. It is concluded that Chironomidae might be allergens of clinical importance in asthma and rhinitis in Sweden, that cross-allergy exists between chironomids and shrimp and that cross-allergy also might occur among chironomids, crustaceans and molluscs.