As a parent of a child with food allergies you know the feeling: You pack them up for school and pray you don’t get “the call”, the one telling you to meet your child at the hospital because they’ve been rushed to the ER with anaphylaxis.
But where do children actually suffer the majority of anaphylactic reactions?
A small sample of results from a presentation at the American College of Allergy, Asthma and Immunology’s Annual (ACAAI) Scientific Meeting last week may shed some light on that question.
Researchers at Texas Children’s Hospital and Baylor College of Medicine conducted a retrospective case note review of anaphylactic events in their patient population collected from children aged 0 to 18 years between January and December 2016.
Dr Sara Anvari, assistant professor of pediatrics in immunology, allergy and rheumatology, presented their findings for the first 46 children in the review, which ranged in age between 4 months and 16 years with the median age being 8.5 years.
They found that food was the cause of 43% of all anaphylactic events triggered by tree nuts (40%), eggs (15%), drugs (17%), venom (13%), immunotherapy (4%), vaccinations (2%) and unknown (19%). 26% of these children had previously experienced anaphylaxis and 21% had epinephrine available to them at the time of the incident.
The majority of anaphylactic events occurred in the home (61%), with the other events occurring in medical facilities (15%), school or day care (11%), restaurants (4%), cinemas (2%) and churches (2%) and unrecorded locations (2%).
Skin reactions were the most commonly reported symptom reported in 91% of cases. Other reported symptoms included respiratory (69%), gastrointestinal (17%) and cardiovascular (8%) symptoms. Reactions typically occurred within 5 minutes (46%), whereas 8% occurred within 5 to 30 minutes, 4% within 30 to 120 minutes, 6% in more than 2 hours, and time to onset not recorded in 35% of cases.
Epinephrine was administered to 91% of the children with 17% requiring a second dose.
It should be noted that these results are from a relatively small sample of patients not exclusive to those diagnosed with food allergies.
It will be especially interesting to learn what the data indicates for the subset of children diagnosed with a food allergy extracted from the full case note review. We look forward to more results in the future.