The Epidemiology of Anaphylaxis

Abstract

Anaphylaxis is a dramatic expression of systemic allergy. The lifetime prevalence of anaphylaxis is currently estimated at 0.05-2 % in the USA and ~3 % in Europe. Several population-specific studies have noted a rise in the incidence, particularly in the hospitalizations and ER visits due to anaphylaxis. The variable signs and symptoms that constitute the diagnostic criteria for anaphylaxis, the differences in diagnostic algorithms, and the limitations in the current coding systems have made summarizing epidemiologic data and comparing study results challenging. Nevertheless, across all studies, the most common triggers continue to be medications, food, and venom. Various risk factors for more severe reactions generally include older age, history of asthma, and having more comorbid diseases. Interesting seasonal, geographic, and latitude differences have been observed in anaphylaxis prevalence and incidence rates, suggesting a possible role of vitamin D and sun exposure in modifying anaphylaxis risk. While the incidence and prevalence of anaphylaxis appear to be increasing in certain populations, the overall fatality rate remains relatively low.

Anaphylaxis to foods in a population of adolescents: incidence, characteristics and associated risks

“…The incidence of anaphylaxis in our study population is high also when compared to earlier estimates of the incidence in the general population . This may be partly explained by age, given that risk‐taking behaviours are common among food‐allergic adolescents .…”

Anaphylaxis in a food allergy outpatient department: one-year review

“…As in their study, our results may be due to the lower size of our sample in comparison with the other studies in this area. Cutaneous (urticarial and/or angioedema) symptoms were the most common clinical manifestations, as has been previously described (4), followed by respiratory tract symptoms and gastrointestinal symptoms (19). The mainstay of treatment of any kind of anaphylactic reaction is the timely administration of epinephrine.…”

Outpatient Emergencies

“…The frequent and at times fatal error that is made by professionals and patients is to delay the administration of epinephrine while waiting for the antihistamines to relieve symptoms. 8,20,22,39,51–54 When administered as adjunctive treatment for severe anaphylaxis, only sedating antihistamines (eg, diphenhydramine) are available for intravenous administration. The dose for diphenhydramine is 25 to 50 mg in adults administered intravenously over 10 to 15 minutes.…”