Vespa
Vespa crabro (VC ) (European hornet) is widely distributed across Europe and Asia and has been introduced in the USA. Stings are rare, and systemic sting reactions usually follow previous stings from other vespids, especially Vespula .14 However, one small study suggested that the risk of a life-threatening reaction after a VC sting was higher compared to honey bee orVespula stings in Mediterranean countries.15
Vespa velutina (VV ) is endemic to Southeast Asia and has rapidly spread across Europe after accidental introductions in France from China in 2004.16 They are known for their large colonies, an extensive foraging radius, and intense predation on honey bees at the hive.17,18 The first case of anaphylaxis due to VV in Spain was reported in 2014.19 Since then, VV has become the most common cause of Hymenoptera anaphylaxis in the Northwest of Spain because of their more aggressive behavior. Seventy-seven percent of patients identified VV as the culprit insect for the reaction; most cases report no previous Vespula stings. More than 47,000 nests have been identified in 2018 compared to 769 in 2014.20
Vespa affinis (lesser banded hornet), is a common hornet in tropical and subtropical Asia. Anaphylaxis appears to be rare21 although a case of fatal anaphylaxis in a child has been published.22 However, multiple stings with resulting acute renal failure occur frequently.23Vespa orientalis (VO) is located in Southwest Asia and Northeast Africa. Similar to Vespa affinis, anaphylaxis is rare but multiorgan dysfunction after multiple stings has been documented.24