StingReady: A Novel Device for Controlled Insect Sting Challenge-From Field Capture to Clinical Application

Abstract

Reliable assessment of protection in venom immunotherapy (VIT) patients remains a clinical challenge, especially due to the limitations of conventional sting challenge tests (SCTs), which require complex insect handling and may compromise test accuracy. This study introduces StingReady, a novel, user-friendly device designed to streamline the SCT process by enabling safe, efficient, and minimally manipulative exposure to hymenopteran stings. For the first time, StingReady was applied to conduct SCTs with Vespa velutina, an invasive hornet species of increasing clinical relevance. The device was tested in a real-world setting at Belvís Park in Santiago de Compostela, Spain, where hornets were successfully captured and transported to the hospital without anesthesia or limb removal. The design features adjustable mesh sizes, allowing compatibility with various hymenopteran taxa. Using StingReady, nine patients underwent SCTs with no need for direct insect handling during the hospital procedure. The process improved patient safety and comfort while preserving the insect's natural stinging behavior, thereby enhancing test reliability. This study demonstrates that StingReady significantly improves SCT methodology, offering a practical, reproducible, and ethically sound alternative for evaluating VIT efficacy across diverse hymenopteran species.

Keywords: Vespa velutina; allergy testing; hymenoptera; insect handling; medical device; sting challenge; venom immunotherapy.

Figure 1

Sequential capture process of Vespa velutina using the StingReady device in the field. (a) The hornet feeds at the bait station as the containment chamber (CCh) is carefully positioned nearby. (b) The chamber encloses the insect, encouraging it to move upwards toward the mesh area. (c) The gliding component (GC) is inserted with both hands to fully secure the hornet. (d) The V. velutina is now safely confined within the StingReady device, which is held securely in one hand. Photo author: A. Martín.

Figure 2

Close-up views of insect species captured within the StingReady device. (a) A Vespa velutina queen (gyne) in containment. (b) Top: Polistes spp. with a modified chamber mesh size of 3 mm; bottom: Bombus spp. specimen. (c) Top: Vespa velutina male; bottom: Vespa velutina worker. (d) Detail of the mesh showing the insect’s stinger and part of the abdomen extending through, as seen with a Vespa velutina worker, allowing safe sting access to the skin. Photo author: X. Feás.

Figure 3

Procedure for applying a controlled sting using the StingReady device. (a) Initial positioning of the device on the inner forearm over the flexor muscles, with the mesh in contact with the skin. (b) The Vespa velutina is carefully guided into position for stinging by lowering the gliding component. (c) Close-up immediately after the sting, showing the characteristic red puncture mark from the stinger (Time 0). (d) 15 min after the sting, (e) 31 min, (f) 46 min, (g) 71 min, and (h) 130 min post-sting. Photo author: X. Feás.

Figure 4

Progression of sting reactions from Vespa velutina stings in different patients. (a) Patient with localized reaction immediately after a single sting. (b) Patient with three distinct stings. (c) Initial sting reaction in a patient directly post-sting, and (d) after 1 h. (e) Immediate reaction in a different patient, (f) 8 min post-sting, (g) 12 days post-sting, and (h) 19 days post-sting. Photo author: X. Feás.

Figure 5

Cross-sectional and perspective views of the StingReady device: (a) the collection chamber (Cch), illustrating the device dimensions and detailed structure, including a close-up of the mesh securing feature; (b) side and perspective views of the gliding component (GC), highlighting the containment area at the terminal end designed to safely hold the insect in place for a controlled sting.

Figure 6

Collection points for Vespa velutina and other hymenopterans in Belvís Park. The left side of the figure (a) shows part of Parque de Belvís with numbered collection sites (1–4) for insect sampling. The right side (b) displays images of the specific flowering plants associated with each point: (1) Liriodendron tulipifera (tulip tree), (2) Eucalyptus spp. (eucalyptus), (3) Hedera helix (ivy), and (4) Sechium edule (chayote). Each site corresponds to periods of plant flowering which attract hymenopterans. Photo Author: X. Feás.

Figure 7

Details of bait station and insect visitation. (a) Close-up of the bait station, hung 1 m above ground from Liriodendron tulipifera (tulip tree) branches. (b) Images of several Bombus spp. (bumblebee) visiting the station. (c) Vespa velutina (top) and Vespula spp. (bottom) observed at the bait, illustrating the range of hymenopteran species attracted to the station. Photo Author: X. Feás.

Figure 8

Vespa velutina specimens observed on four different flowering plant species within Belvís Park, each corresponding to a specific stage or caste of the species. (a) Founder queen on Liriodendron tulipifera (tulip tree); (b) workers on Sechium edule (chayote); (c) male on Hedera helix (common ivy); and (d) gyne on Eucalyptus sp. Photo Author: X. Feás.

Figure 9

Step-by-step capture of a Vespa velutina specimen using the StingReady device. (a) The hornet feeding at a bait station. (b) The device enclosing the hornet. (c) The GC being deployed to confine the insect. (d) The hornet securely confined within the StingReady device. (e) Feeding of the captured hornet using a 2.5 mL syringe inserted through the mesh, providing a honey–water solution (20%) to maintain hydration and energy levels.

Figure 10

Procedure for using the StingReady device to induce a controlled sting. (a) The initial placement of the device in contact with the patient’s skin. (b) The activation of the gliding mechanism to position the insect for stinging; the device is held in place for 15 s after the initial sting occurs. (c) Marking the area after removing the device to document the sting location. (d) Euthanasia of the insect by placing the device in a freezer at −18 °C for five minutes.