Anaphylaxis – Lessons learnt when East meets West

Abstract

The rapidly increasing prevalence of allergic disorders over the past 2 decades highlights the need to understand the epidemiology of anaphylaxis. In Europe, the United States, and Australia, the incidence of anaphylaxis is estimated to be between 60 and 950 cases per 100 000 population, with a lifetime prevalence of anaphylaxis of 0.05%‐2%. The incidence appears to be increasing over time. Although the existing Asian literature is heterogeneous and limited by under‐reporting, it also suggests a similar increasing trend in anaphylaxis incidence in Asia. Anaphylaxis triggers in Asia, such as the predominance of shellfish and wheat in older children and adolescents, differ from those seen in Western populations. Triggers unique to Asia such as traditional Chinese medications, galacto‐oligosaccharides, and food delicacies have also been reported. Low usage of adrenaline as first‐line treatment of anaphylaxis is evident across all countries and is particularly concerning. There is a need to establish prospective, standardized protocols for anaphylaxis data collection and reporting, to enhance the collective understanding of anaphylaxis and its burden, gaps in management and to identify areas for future research and intervention in each region. Understanding of the underlying reasons explaining the difference between East and West will facilitate future primary preventive strategies.

Intervention in anaphylaxis: the experience of one paediatric centre based on NORA reports

“…In the presented material, only several percent of physicians prescribed adrenaline to a paediatric patient. It appeared to be a worldwide issue, also observed by other Polish authors with respect to venom anaphylaxis in adults [27,29]. The data summarized indicated that physicians performing first intervention presented limited familiarity with anaphylaxis, recommended management during acute symptoms and follow-up visits.…”

Fecal metabolites and early sensitization influence asthma, and how to prevent anaphylaxis in the community

“…The APAPARI Anaphylaxis Study Group has looked into such differences, and they present their views in the review article which opens this issue nicely. 1 They have seen an increasing trend in the prevalence of anaphylaxis over the last decades, similar to Western countries. Nevertheless, they encounter unique triggers for reactions, such as Chinese traditional medicine, or galacto-oligosaccharides (carbohydrates added to commercially available food products and beverages).…”

“…In particular, we may see differences between Asia, and Europe or North America. The APAPARI Anaphylaxis Study Group has looked into such differences, and they present their views in the review article which opens this issue nicely . They have seen an increasing trend in the prevalence of anaphylaxis over the last decades, similar to Western countries.…”

Feasibility of a 3-step protocol of wheat oral immunotherapy in children with severe wheat allergy

“…IgE-mediated reactions to wheat, particularly anaphylaxis and exercise-induced anaphylaxis has been increasingly observed worldwide [1]. In Japan, wheat allergy has become the third leading cause of anaphylaxis in children following egg and cow's milk [2].…”