Anaphylaxis and reactions to foods in children – a population‐based case study of emergency department visits

Vetander, Mirja; Helander, Daiva; Flodström, Charlotta; Östblom, Eva; Alfvén, Tobias; Ly, D. H.; Hedlin, Gunilla; Lilja, G.; Nilsson, Caroline; Wickman, Magnus

doi:10.1111/j.1365-2222.2011.03954.x

Cited by 140 publications

(132 citation statements)

References 29 publications

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“…Food allergy, particularly to peanuts, tree nuts, egg, and milk, is the leading cause of anaphylaxis (7)(8)(9)(10). Allergen avoidance education is often targeted at avoidance within the home, with less emphasis on how to avoid community exposure.…”

Section: Why the Community Is Importantmentioning

confidence: 99%

EAACI Food Allergy and Anaphylaxis Guidelines: managing patients with food allergy in the community

Muraro¹,

Agache²,

Clark³

et al. 2014

Allergy

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140

155

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The European Academy of Allergy and Clinical Immunology (EAACI) Food Allergy and Anaphylaxis Guidelines, managing patients with food allergy (FA) in the community, intend to provide guidance to reduce the risk of accidental allergic reactions to foods in the community. This document is intended to meet the needs of early-childhood and school settings as well as providers of non-prepackaged food (e.g., restaurants, bakeries, takeaway, deli counters, and fast-food outlets) and targets the audience of individuals with FA, their families, patient organizations, the general public, policymakers, and allergists. Food allergy is the most common trigger of anaphylaxis in the community. Providing children and caregivers with comprehensive information on food allergen avoidance and prompt recognition and management of allergic reactions are of the utmost importance. Provision of adrenaline auto-injector devices and education on how and when to use these are essential components of a comprehensive management plan. Managing patients at risk of anaphylaxis raises many challenges, which are specific to the community. This includes the need to interact with third parties providing food (e.g., school teachers and restaurant staff) to avoid accidental exposure and to help individuals with FA to make safe and appropriate food choices. Education of individuals at risk and their families, their peers, school nurses and teachers as well as restaurant and other food retail staff can reduce the risk of severe/fatal reactions. Increased awareness among policymakers may improve decision-making on legislation at local and national level.

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Section: Why the Community Is Importantmentioning

confidence: 99%

EAACI Food Allergy and Anaphylaxis Guidelines: managing patients with food allergy in the community

Muraro¹,

Agache²,

Clark³

et al. 2014

Allergy

Self Cite

140

155

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“…In a retrospective study of 371 infants, children, and teenagers with acute allergic reactions to food, the importance of underlying asthma was confirmed. During anaphylaxis, 72% of those with concomitant asthma had lower airway symptoms, compared with only 49% of those without concomitant asthma (p < 0.01) [13]. …”

Section: Patient Risk Factorsmentioning

confidence: 99%

“…The possibility of cofactor amplification of anaphylaxis should be considered when assessing reactions to foods, nonsteroidal anti-inflammatory drugs (NSAIDs), exercise, and alcohol [21]. Pollinosis has been identified as an external cofactor on the basis of peak hospital admissions for anaphylaxis during the tree pollen season (p = 0.015) [13]. …”

Section: Patient Risk Factorsmentioning

confidence: 99%

World Allergy Organization Anaphylaxis Guidelines: 2013 Update of the Evidence Base

Simons

Ardusso

Dimov

et al. 2013

Int Arch Allergy Immunol

244

181

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The World Allergy Organization (WAO) Guidelines for the assessment and management of anaphylaxis are a widely disseminated and used resource for information about anaphylaxis. They focus on patients at risk, triggers, clinical diagnosis, treatment in health care settings, self-treatment in the community, and prevention of recurrences. Their unique strengths include a global perspective informed by prior research on the global availability of essentials for anaphylaxis assessment and management and a global agenda for anaphylaxis research. Additionally, detailed colored illustrations are linked to key concepts in the text [Simons et al.: J Allergy Clin Immunol 2011;127:593.e1-e22]. The recommendations in the original WAO Anaphylaxis Guidelines for management of anaphylaxis in health care settings and community settings were based on evidence published in peer-reviewed, indexed medical journals to the end of 2010. These recommendations remain unchanged and clinically relevant. An update of the evidence base was published in 2012 [Simons et al.: Curr Opin Allergy Clin Immunol 2012;12:389-399]. In 2012 and early 2013, major advances were reported in the following areas: further characterization of patient phenotypes; development of in vitro tests (for some allergens) that help distinguish clinical risk of anaphylaxis from asymptomatic sensitization; epinephrine (adrenaline) research, including studies of a new epinephrine auto-injector for use in community settings, and randomized controlled trials of immunotherapy to prevent food-induced anaphylaxis. Despite these advances, the need for additional prospective studies, including randomized controlled trials of interventions in anaphylaxis is increasingly apparent. This 2013 Update highlights publications from 2012 and 2013 that further contribute to the evidence base for the recommendations made in the original WAO Anaphylaxis Guidelines. Ideally, it should be used in conjunction with these Guidelines and with the 2012 Guidelines Update.

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“…It is proposed that environmental factors have significant effect on this phenomenon and that "westernization" plays a role [95]. The most serious allergic response to food allergy is anaphylaxis [96,97]. More than 3 million Americans are allergic to peanuts and this is the leading cause of death by anaphylaxis [98].…”

Section: Food Allergymentioning

confidence: 99%

Animal Models of Allergic Diseases

Santoro

Marsella

2014

Veterinary Sciences

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Allergic diseases have great impact on the quality of life of both people and domestic animals. They are increasing in prevalence in both animals and humans, possibly due to the changed lifestyle conditions and the decreased exposure to beneficial microorganisms. Dogs, in particular, suffer from environmental skin allergies and develop a clinical presentation which is very similar to the one of children with eczema. Thus, dogs are a very useful species to improve our understanding on the mechanisms involved in people's allergies and a natural model to study eczema. Animal models are frequently used to elucidate mechanisms of disease and to control for confounding factors which are present in studies with patients with spontaneously occurring disease and to test new therapies that can be beneficial in both species. It has been found that drugs useful in one species can also have benefits in other species highlighting the importance of a comprehensive understanding of diseases across species and the value of comparative studies. The purpose of the current article is to review allergic diseases across species and to focus on how these diseases compare to the counterpart in people.

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Anaphylaxis and reactions to foods in children – a population‐based case study of emergency department visits

Abstract: Reactions to peanut and tree nuts are as common as reactions to milk and egg in early life. Concomitant exposure to airborne allergens seems to increase the risk of anaphylaxis to foods. Among children with anaphylaxis, wheeze is prevalent even in children without asthma diagnosis.

Cited by 140 publications

References 29 publications

EAACI Food Allergy and Anaphylaxis Guidelines: managing patients with food allergy in the community

EAACI Food Allergy and Anaphylaxis Guidelines: managing patients with food allergy in the community

World Allergy Organization Anaphylaxis Guidelines: 2013 Update of the Evidence Base

Animal Models of Allergic Diseases

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