Impact of public health interventions for food allergy prevention on rates of infant anaphylaxis

Vale, Sandra; Murray, Kevin; Netting, Merryn; Ong, Royston; Clifford, Rhonda; Stiles, Samantha L.; Campbell, Dianne; Salter, Sandra

doi:10.1016/j.anai.2022.09.006

Cited by 7 publications

(1 citation statement)

References 29 publications

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“…In Australia, the incidence of anaphylaxis presenting to the emergency medical services jumped 19‐fold in children below 12 months and the main foods were egg (37.9%), milk (30.2%) and nuts (31.9%) [18]. Australia's public health campaign on early introduction of allergenic foods was not a clear contributor to this increase [25]. In our study, egg was the top cause of food anaphylaxis in children 0–4 years, and in infants below 1 year, food anaphylaxis was mainly caused by eggs (50%) and milk (23.5%).…”

Section: Discussionmentioning

confidence: 99%

Trends in Childhood Anaphylaxis in Singapore: 2015–2022

Goh,

Yap,

Cheng

et al. 2024

Clin Experimental Allergy

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BackgroundThere has been limited data regarding the incidence of anaphylaxis in Asia. We aim to describe patterns in patient characteristics, triggers and clinical presentation of childhood anaphylaxis in Singapore.MethodsThis was a retrospective review of emergency electronic medical records of children with anaphylaxis. Patients with the allergy‐related diagnoses of anaphylaxis, angioedema, allergy and urticaria based on ICD‐9 codes were screened. Cases fulfilling the World Allergy Organization criteria for anaphylaxis were included.ResultsA total of 1188 cases of anaphylaxis were identified with a median age of 6.3 years. Extrapolating data from the study sites, from 2015 to 2022, the incidence rate of childhood anaphylaxis emergency visits in Singapore doubled from 18.9 to 38.8 per 100,000 person‐years, with an incidence rate ratio (IRR) of 2.06 (95% confidence interval [CI] 1.70–2.49). In 2022, the incidence rate of food anaphylaxis was 30.1 per 100,000 person‐years, IRR 2.39 (95% CI 1.90–3.01) and drug anaphylaxis was 4.6 per 100,000 person‐years, IRR 1.89 (95% CI 1.11–3.25). The incidence rate in children aged 0–4 years quadrupled during the study period. Common triggers were egg (10.4%), peanut (9.3%), tree nut (8.8%), milk (8%), shellfish (7.8%) and non‐steroidal anti‐inflammatory drug (4.4%). The majority (88.6%) of patients were treated with intramuscular adrenaline. Total number of allergy‐related visits did not increase over time between 2015 and 2019. Rates of severe anaphylaxis, namely anaphylactic shock and admission to high‐dependency and intensive care, did not increase over time, with a mean incidence of 1.6, IRR 0.85 (95% CI 0.40–1.83) and 0.7, IRR 1.77 (95% CI 0.54–5.76) per 100,000 person‐years, respectively.ConclusionWhile the number of emergency visits due to childhood anaphylaxis has increased, the number of cases of allergy‐related visits, anaphylactic shock and anaphylaxis requiring high‐dependency and intensive care did not rise.

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Section: Discussionmentioning

confidence: 99%