A Population-Based Study of Fish Allergy in the Philippines, Singapore and Thailand

Connett, Gary; Gerez, Irvin; Cabrera-Morales, Elizabeth Ann; Yuenyongviwat, Araya; Ngamphaiboon, Jarungchit; Chatchatee, Pantipa; Sangsupawanich, Pasuree; Soh, Shu‐E; Yap, Gaik-Chin; Shek, Lynette Pei‐Chi; Lee, Bee-Wah

doi:10.1159/000338940

Cited by 56 publications

(44 citation statements)

References 47 publications

(29 reference statements)

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“…Comparing with other Southeast Asian countries, our prevalence rate is similar to that of Thailand (0.29% based on convincing history). (12) The low prevalence in some countries was initially thought to be associated with early introduction of fish to the diet as compared to the West. (32) However, in Connet et al's study, the rate of fish allergy in the Philippines, where fish is similarly introduced to the diet at an early age, was found to be surprisingly high at 2.29%.…”

Section: Fishmentioning

confidence: 99%

“…(32) However, in Connet et al's study, the rate of fish allergy in the Philippines, where fish is similarly introduced to the diet at an early age, was found to be surprisingly high at 2.29%. (12) In addition, the allergic profile of the Filipino group demonstrated a late-onset-type of fish allergy, unlike in Singapore where fish allergy usually occurs in the first year of life. (33) It was proposed by the authors that this entity in the Philippines could be due to differences in fish preparation methods, with the high availability of dried and salted fish as opposed to cooked fish, possibly promoting immunogenicity.…”

Section: Fishmentioning

confidence: 99%

“…(33) It was proposed by the authors that this entity in the Philippines could be due to differences in fish preparation methods, with the high availability of dried and salted fish as opposed to cooked fish, possibly promoting immunogenicity. (12) Outside the Southeast Asian region, the prevalence rates of fish allergy in ethnically similar countries are also variable.…”

Section: Fishmentioning

confidence: 99%

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Food allergy in Singapore: opening a new chapter

Lee¹

2014

smedj

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R ev iew A r tic le 244 I NTRO D U C TIO NSingapore has rapidly evolved into a modernised city state and currently faces the health burden of noncommunicable diseases (NCDs), resembling that of developed Western nations.(1) In children, allergic diseases, including food allergy, are among the most common NCDs.(2) Food allergy rates are reported to be more than 10% in challenge-proven studies among Australian infants, (3) while in the United Kingdom (UK) (4) and the United States of America (USA), Singapore have not met the expected rise experienced by other highly industrialised countries, it is also uncertain whether the food allergy epidemic will hit our nation. This unclear prediction, together with ever-changing cultural practices and eating habits due to immigration and overseas influence, has opened a new chapter of food allergy in Singapore.A PubMed search of the terms "food allergy" and "Singapore" generated a total of 45 results from January 1999 to January 2014. All the articles generated are in English. Of these, 12 articles are not food-allergy focused, and two are focused on food testing methodology that is not unique to Singapore. Of the remaining 31 articles found, 16 are studies conducted on children, and 9 are review articles on food allergy in Asia or Singapore. EPID EM IO LO GYIn Asia, food allergy data is just beginning to emerge, providing no satisfactory trend. One study from Chongqing, China, reported a doubling in the challenge-proven prevalence rates from 3.5% to 7.7% among 0-2-year-olds over a ten-year period. (8) Conversely, a South Korean study reported that the prevalence of food allergy symptoms in 6-12-year-olds had decreased from 10.9% to 8.9% over five years.(9) Preliminary findings in an ongoing study of young Singaporean children aged 11-30 months demonstrated that overall, self-reported food allergy prevalence could be as high as 5.4% (Lee AJ, unpublished). Unfortunately, the only prior data for comparison was in 6-12-year-olds, where the rates (also by questionnaire) were estimated to be 4%-5% in 1999.Given that the prevalence of food allergy tends to decrease with age, using this data, we surmise that food allergy has probably not increased in Singapore over a 14-year period. SPECIFIC FOOD ALLERGIES IN SINGAPOREWorldwide and regional differences in food allergies mainly depend on diet and culture (although this may not always be the case). For example, shellfish is the most common food allergen in Singapore and is ubiquitous in Southeast Asia, likely by virtue of its high consumption. However, fish, also eaten abundantly in Singapore, is a rare allergen here. Allergy to egg and cow's milk, despite their high consumption worldwide, is comparatively lower in Singapore than in the West. The reverse is true of peanut allergy, which is epidemic in the West compared to Asia. However, the pattern of food allergy in Singapore appears to have changed over the last decade, with peanut allergy increasing in prevalence and being the most common cause of anaphylaxis in Singaporean childr...

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Section: Fishmentioning

confidence: 99%

Section: Fishmentioning

confidence: 99%

Section: Fishmentioning

confidence: 99%

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Food allergy in Singapore: opening a new chapter

Lee¹

2014

smedj

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“…Higher rates of self-reported allergic reactions were observed in some Asian countries, both for adults (24.5 %; China) (Sai et al, 2011) and children (8.7 % and 11.6 %, respectively; Philippines) (Connett et al, 2012). However, the only study which used OFC to confirm diagnosis reported a prevalence of clinical allergy to crab and shrimp of 0.2 % and 0.9 %, respectively, among three-to seven-year-olds in Thailand (Lao-araya and Trakultivakorn, 2011).…”

Section: Outside Europementioning

confidence: 96%

Untitled

2014

EFSA Journal

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Following a request from the Food Safety Authority of Ireland, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) was asked to deliver a scientific opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. In view of the request, the NDA Panel decided to update its previous opinions relative to food ingredients or substances with known allergenic potential listed in Annex IIIa of 2003/89/EC, as amended. These include cereals containing gluten, milk and dairy products, eggs, nuts, peanuts, soy, fish, crustaceans, molluscs, celery, lupin, sesame, mustard and sulphites. The opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. It includes information on the prevalence of food allergy in unselected populations, proteins identified as food allergens, cross-reactivities, the effects of food processing on the allergenicity of foods and ingredients, methods for the detection of allergens and allergenic foods, doses observed to trigger adverse reactions in sensitive individuals and risk assessment methodologies that have been used to derive individual and population thresholds for selected allergenic foods. The present opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. For each food ingredient or substance listed in Annex IIIa, it includes information on the prevalence of food allergy in unselected populations, on proteins identified as food allergens, on cross-reactivities, on the effects of food processing on the allergenicity of foods and ingredients, on methods for the detection of allergens and allergenic foods, and on doses observed to trigger adverse reactions in sensitive individuals.Immune-mediated adverse reactions to foods manifest with clinical signs and symptoms of variable severity and duration, which may affect different organs and systems. Anaphylactic reactions to food are IgE mediated and may occur at any age. Non-IgE-mediated food allergy includes a wide range of diseases, including protein-induced enterocolitis and eosinophilic oesophagitis.A careful family and clinical history are the basis for diagnosis of food allergy. Food diaries, skin prick tests (SPTs), allergen-specific IgE measurements, food elimination diets and food challenges are part of the standard protocol for the diagnosis of food allergy. A positive SPT indicates sensitisation to the tested food, but it is not diagnostic of food allergy. Allergen-specific serum IgE antibodies similarly denote sensitisation to a particular food, but they are not diagnostic without a clinical history or food challenge. The use of atopy patch tests for the diagnosis of food allergy is controversial. Other available tests have no current role in the diagnosis of food allergy. Diag...

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“…In children from Spain, fish allergy starts in the second year of life and is the third most prevalent food allergy after egg and milk [48]. A recent population-based study in southeast Asia in children 14e16 years old has shown a prevalence of fish allergy of 2.29% in the Philippines, whereas in Singapore and Thailand it is 10 times lower [49].…”

Section: Fishmentioning

confidence: 99%