B.Y. THONG1, S.C.TAN1, J.W.TAN1, G.Y.CHAN1, F.L.CHIA1, T.C.TAN1, S.M.LEE1, X.R.LIM1, C.M.TEO1, J.F.HOU1, L.L.XIE1, V.H.GOH1, K.P. LEONG1
Tan Tock Seng Hospital1
Venom immunotherapy (VIT) is the definitive treatment for hymenoptera anaphylaxis and could impact the future deployability and careers of regular military servicemen.
The demographic profile, VIT outcomes and impact on physical employment standards (PES) and deployability were studied in servicemen initiating VIT between 1 January 2005 and 30 June 2021.
There were 13 servicemen, all males from the Singapore Army, 9 (69.2%) regulars, median age (interquartile range, IQR) 26(6) years when VIT was initiated. VIT most commonly administered was for paper wasp (92.3%), yellow jacket (84.6%), mixed vespid and honeybee (38.5% each). VIT was completed (5 years) among 5 (38.5%), and not completed median (IQR) 3 (1) years among 4 (30.8%) servicemen. At the last review, 3 inflight VIT servicemen had completed median ≥3 years of maintenance, and 1 (7.7%) had completed 12 weeks of induction VIT. Despite worldwide VIT supply disruption necessitating a switch from ALK to Diater® products in 2017 and adjustment of dosing and dose intervals, there were no major systemic adverse reactions in all cases. Five (38.5%) regular servicemen maintained their original PES status upon completing VIT, with 4/5 permitted to resume outfield training. This was contingent upon the absence of systemic reactions occurring during induction and maintenance VIT, for those completing VIT after January 2018.
Successful completion of induction and maintenance VIT without systemic reactions offers regular army servicemen an opportunity for maintenance of pre-anaphylaxis PES grading, resumption of outfield deployment, with minimal disruption to career progression.