Ocular Lesions Other Than Stings Following Yellow-Legged Hornet (Vespa velutina nigrithorax) Projections, as Reported to French Poison Control Centers

Importance Since the accidental introduction of the yellow-legged hornet (Vespa velutina nigrithorax) in France in 2004, there have been reports of this insect unexpectedly projecting a liquid toward the human face, but ocular morbidity associated with this is unknown, to our knowledge. Objective To describe a case series of ocular lesions after exposure to a liquid projection emitted by a hornet. Design, Setting, and Participants This was an analysis of all cases of ocular exposure to a projection by a yellow-legged hornet (excluding stings in the eye) collected by French poison control centers between January 1, 2004, and December 31, 2019. Main Outcomes and Measures Symptoms were evaluated, and a fluorescein eye stain test was used. Results Twenty-nine cases were recorded (24 in male and 5 in female patients; median age, 40 [interquartile range, 11] years); the first occurred in 2009. Most cases (20 [80%]) were occupational exposure among professionals dealing with hornet nests (eg, firefighters, wasp exterminators). Symptoms consistent with conjunctivitis often resolved quickly after ocular decontamination, but 5 patients developed a periorbital edema, 2 experienced radiating neuropathic pain, and 2 experienced keratitis. Conclusions and Relevance These findings suggest that the projection of a liquid into the eyes by the yellow-legged hornet presents a new risk to human health, but its precise nature remains to be determined. Ocular lesions had a favorable outcome. For professionals who deal with these insects, adaptation of the usual protections designed for native hymenopterans may be warranted. This case series describes ocular lesions occurring after exposure to a liquid projection emitted by a hornet (excluding stings in the eye). Question What lesions from yellow-legged hornets, other than stings, have been reported to French poison control centers in France? Findings A retrospective series of 29 cases of yellow-legged hornet ocular exposure, excluding stings in the eye, from French poison control centers found that the exposure was reported to be likely associated with the projection of a liquid by the hornet. Most patients reported a favorable outcome; 2 developed keratitis and another 2 presented with neuropathic pain, presumably associated with the projection of the hornet's liquid. Meaning These findings suggest liquid projections from yellow-legged hornets can cause eye damage, warranting attempts at prevention.

Automated summary

A retrospective analysis of cases of ocular exposure to liquid projection by yellow-legged hornets in France found that most patients had a favorable outcome, but some developed complications such as periorbital edema, neuropathic pain, and keratitis. The findings suggest that liquid projections from yellow-legged hornets can cause eye damage and emphasize the need for prevention.