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Food allergy affects up to 10% of children and is the most frequent cause of anaphylaxis. Persistent fear of a food-related anaphylactic reaction (especially to peanuts) is associated with parental anxiety and lower quality of life. Researchers examined the risk for fatal food-related anaphylaxis in a meta-analysis of 13 international registry, database, or cohort studies.
During an estimated 165 million food-allergic person-years, 240 deaths from food anaphylaxis were reported. In food-allergic people of all ages, the incidence rate of fatal food anaphylaxis was 1.81 per million person-years. Among children and adolescents, the incidence rate was 3.25 per million person-years (10 studies), and 2.13 per million person-years for peanut allergy (7 studies). In four studies that recorded nonfatal food anaphylaxis rates in the same population and time period, fatality rates ranged from 33% of patients admitted to an intensive care unit to 0.14% of patients admitted to a hospital. The authors calculated that the incidence of fatal food anaphylaxis in a food-allergic person is ≥100 times lower than the incidence of accidental death in the general population. Incidence is ≥10 times lower in food-allergic children and adolescents aged 0–19 years.
Umasunthar T et al. Incidence of fatal food anaphylaxis in people with food allergy: A systematic review and meta-analysis. Clin Exp Allergy 2013 Dec; 43:1333. (http://dx.doi.org/10.1111/cea.12211)
Comment
The authors note the possibility that specific groups of food-allergic people have higher incidences of fatal food anaphylaxis, but these patients have not been identified in clinical practice. The finding that the rate of fatal food anaphylaxis in food-allergic children is lower than the rate of accidental death might be reassuring to parents who are anxious about their child developing a severe allergic reaction to a food. Pediatricians can use the results to allay excessive fear among parents of food-allergic children.