Adult food-induced anaphylaxis hospital presentations in New Zealand

Abstract

BackgroundFood allergy including anaphylaxis is an increasing clinical problem in many countries. Little information is available regarding prevalence, causative foods and time trends in the New Zealand adult population.ObjectiveThis cross-sectional study investigated the incidence of hospital presentation with food-induced anaphylaxis in New Zealand among adults and adolescents over a 10-year period.MethodsMinistry of Health hospital discharge data from 2002 to 2011 were analysed using food allergy and anaphylaxis-related International Classification of Diseases (ICD) codes to identify acute hospital presentations.ResultsThere was an average annualised rate of hospital food-induced anaphylaxis presentations of 4.8 per 100 000 adults (aged ≥15 years) for the period reviewed. Subgroup analyses revealed significant differences by gender, age group and ethnicity, notably higher rates in females, younger adults (15–34 years) and Pacific Island populations. Seafood was the most common food allergen group, followed by nuts. Time trend analysis revealed a 1.7-fold increase in the 10-year period, mainly attributable to an increase in rates in the Pacific Island population.ConclusionsThese data confirm food-induced anaphylaxis as an increasing problem in New Zealand and show significant differences in incidence of hospital presentation in different ethnic populations. Future research will be required to understand and address disparities in the incidence of these conditions.

Paediatric food‐induced anaphylaxis hospital presentations in New Zealand

“…14 An analysis of 20 years of UK FIA trends (1992-2012) found paediatric admissions (0-14 years) rose by 137% (rate ratio 1.05; 95% confidence interval (CI) 1.05-1.06; P < 0.001). 25 This study showed an increased rate over the 10-year period from 3.3 per 100 000 people in 2002 to 5.8 per 100 000 people in 2011 with the greatest increase in attendances seen in Pacific peoples. 23 This geographical gradation has previously been reported in the USA and Australia and has raised the question of the role of vitamin D deficiency in food allergy.…”

“…25 M aori (1.4 to 5.7 per 100 000 people), Asians (4.1 to 5.5 per 100 000 people) and people of NZ European and 'Other' ethnicities (3.5 to 5.2 per 100 000 people) had more modest increases over the 10-year period reviewed. 25 M aori (1.4 to 5.7 per 100 000 people), Asians (4.1 to 5.5 per 100 000 people) and people of NZ European and 'Other' ethnicities (3.5 to 5.2 per 100 000 people) had more modest increases over the 10-year period reviewed.…”

“…The predominance of nuts as the most common allergen in this study is consistent with international studies that have identified peanuts and tree nuts as the leading cause of FIA among children 3 and indeed across all ages. 25 The strengths of this study include the use of routinely collected population-based data, and the use of internationally recognised diagnostic codes to identify cases. 25 The strengths of this study include the use of routinely collected population-based data, and the use of internationally recognised diagnostic codes to identify cases.…”

“…8,14,20 US data indicate rates of paediatric FIA-related ED visits in recent years have increased up to twofold, 8,21 with similar patterns seen for hospital admissions. 25 Very little is known about the incidence of FIA among New Zealand (NZ) children (<15 years of age). 14 An analysis of 20 years of UK FIA trends (1992-2012) found paediatric admissions (0-14 years) rose by 137% (rate ratio 1.05; 95% confidence interval (CI) 1.05-1.06; P < 0.001).…”

“…20 Hospital admission data for FIA from the Italian Ministry of Health for the 6 years from 2006 to 2011 revealed an FIA admission rate of 4.4 per 100 000 children/year, with a north-south gradation apparent. 25 In the current study, we have examined the incidence of FIA resulting in public hospital attendance/admission in children in NZ, detailing patient characteristics, food allergens and time trends with the aim of adding to the international body of evidence providing insight into rates and causes of FIA. 5,24 Comparing rates of FIA between different populations can be complex as a result of the heterogeneity of diagnostic criteria, study designs and methodologies employed.…”