Published online September 5, 2006
PEDIATRICS Vol. 118 Supplement August 2006, pp. S18 (doi:10.1542/peds.2006-0900DD)
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Allergic Reactions in the Community: A Questionnaire Survey of Members of the Anaphylaxis Campaign

Anna Nowak-Wegrzyn, MD

New York, NY

ABSTRACT

PURPOSE OF THE STUDY.: To investigate the circumstances and clinical characteristics of food allergies in adults and children in the community.

STUDY POPULATION.: Six thousand of the United Kingdom Anaphylaxis Campaign members, both children and adults. The Anaphylaxis Campaign is the major British patient resource group for people who have suffered severe allergic reactions.

METHODS.: The Anaphylaxis Campaign members were asked via a newsletter to report any food reactions during the 6-month period.

RESULTS.: One hundred nine respondents reported 126 reactions during the study period; 75 were children (<16 years old; median: 6 years old at the time of reaction). More boys than girls were reported to have had reactions, but more women reported reactions than men (P < .05). Specific foods were identified in 112 (89%) of the reports; peanut and tree nuts were responsible for most reactions in both children and adults. Children with asthma reported more severe reactions than those without asthma (P = .008), although frequency or severity of recent asthma symptoms was not associated with severity of allergic reaction reported. One fifth of the children reported a reaction in school or day care. Self-injectable epinephrine was used in 35% of the severe reactions and 13% of the nonsevere reactions (P = .01). One quarter of the adults (3 of 12) who received a dose of epinephrine also received a second dose, whereas only 10% of the children (one of 10) required a second dose of epinephrine.

CONCLUSIONS.: The allergens implicated in this report reflect previous data from similar patient groups in North America. Asthmatic children suffer more severe reactions than nonasthmatic children. Even when it is prescribed and available, self-injectable adrenaline seems underused in severe reactions. The incidence of severe but nonfatal allergic reactions in the United Kingdom may have been underestimated in the past.

REVIEWER COMMENTS.: Limited data are available regarding details of treatment of food allergic reactions in the community, but published experience consistently demonstrates underuse of epinephrine for treatment of food anaphylaxis. This underscores the need to continually educate food-allergic patients on the indications for epinephrine administration. In addition, although the availability of the second dose of self-injectable epinephrine should be recommended to all food-allergic patients, children seem to be at lower risk for having severe reactions requiring treatment with multiple doses of epinephrine.

Uguz A, Lack G, Pumphrey R, et al. Clin Exp Allergy. 2005;35:746–750[CrossRef][ISI][Medline]