OBJECTIVE: To examine circumstances of allergic reactions to foods in a cohort of preschool-aged children. METHODS: We conducted a prospective, 5-site observational study of 512 infants aged 3 to 15 months with documented or likely allergy to milk or egg, and collected data prospectively examining allergic reactions. RESULTS: Over a median follow-up of 36 months (range: 0-48.4), the annualized reaction rate was 0.81 per year (367/512 subjects reporting 1171 reactions [95% confidence interval: 0.76-0.85]). Overall, 269/512 (52.5%) reported >1 reaction. The majority of reactions (71.2%) were triggered by milk (495 [42.3%]), egg (246 [21.0%]), and peanut (93 [7.9%]), with accidental exposures attributed to unintentional ingestion, label-reading errors, and cross-contact. Foods were provided by persons other than parents in 50.6% of reactions. Of 834 reactions to milk, egg, or peanut, 93 (11.2%) were attributed to purposeful exposures to these avoided foods. A higher number of food allergies (P < .0001) and higher food-specific immunoglobulin E (P < .0001) were associated with reactions. Of the 11.4% of reactions (n = 134) that were severe, 29.9% were treated with epinephrine. Factors resulting in undertreatment included lack of recognition of severity, epinephrine being unavailable, and fears about epinephrine administration. CONCLUSIONS: There was a high frequency of reactions caused by accidental and nonaccidental exposures. Undertreatment of severe reactions with epinephrine was a substantial problem. Areas for improved education include the need for constant vigilance, accurate label reading, avoidance of nonaccidental exposure, prevention of cross-contamination, appropriate epinephrine administration, and education of all caretakers.
OBJECTIVE: To examine circumstances of allergic reactions to foods in a cohort of preschool-aged children. METHODS: We conducted a prospective, 5-site observational study of 512 infants aged 3 to 15 months with documented or likely allergy to milk or egg, and collected data prospectively examining allergic reactions. RESULTS: Over a median follow-up of 36 months (range: 0-48.4), the annualized reaction rate was 0.81 per year (367/512 subjects reporting 1171 reactions [95% confidence interval: 0.76-0.85]). Overall, 269/512 (52.5%) reported >1 reaction. The majority of reactions (71.2%) were triggered by milk (495 [42.3%]), egg (246 [21.0%]), and peanut (93 [7.9%]), with accidental exposures attributed to unintentional ingestion, label-reading errors, and cross-contact. Foods were provided by persons other than parents in 50.6% of reactions. Of 834 reactions to milk, egg, or peanut, 93 (11.2%) were attributed to purposeful exposures to these avoided foods. A higher number of food allergies (P < .0001) and higher food-specific immunoglobulin E (P < .0001) were associated with reactions. Of the 11.4% of reactions (n = 134) that were severe, 29.9% were treated with epinephrine. Factors resulting in undertreatment included lack of recognition of severity, epinephrine being unavailable, and fears about epinephrine administration. CONCLUSIONS: There was a high frequency of reactions caused by accidental and nonaccidental exposures. Undertreatment of severe reactions with epinephrine was a substantial problem. Areas for improved education include the need for constant vigilance, accurate label reading, avoidance of nonaccidental exposure, prevention of cross-contamination, appropriate epinephrine administration, and education of all caretakers.
Authors: Tamara T Perry; Mary Kay Conover-Walker; Anna Pomés; Martin D Chapman; Robert A Wood Journal: J Allergy Clin Immunol Date: 2004-05 Impact factor: 10.793
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Authors: Stacie M Jones; A Wesley Burks; Corinne Keet; Brian P Vickery; Amy M Scurlock; Robert A Wood; Andrew H Liu; Scott H Sicherer; Alice K Henning; Robert W Lindblad; Peter Dawson; Cecilia Berin; David M Fleischer; Donald Y M Leung; Marshall Plaut; Hugh A Sampson Journal: J Allergy Clin Immunol Date: 2016-03-09 Impact factor: 10.793
Authors: Scott H Sicherer; Robert A Wood; Tamara T Perry; Stacie M Jones; Donald Y M Leung; Alice K Henning; Peter Dawson; A Wesley Burks; Robert Lindblad; Hugh A Sampson Journal: Allergy Date: 2019-07-15 Impact factor: 13.146
Authors: Yamini V Virkud; A Wesley Burks; Pamela H Steele; Lloyd J Edwards; Jelena P Berglund; Stacie M Jones; Amy M Scurlock; Tamara T Perry; Robert D Pesek; Brian P Vickery Journal: J Allergy Clin Immunol Date: 2016-09-05 Impact factor: 10.793
Authors: Robert A Wood; Scott H Sicherer; Brian P Vickery; Stacie M Jones; Andrew H Liu; David M Fleischer; Alice K Henning; Lloyd Mayer; A Wesley Burks; Alexander Grishin; Donald Stablein; Hugh A Sampson Journal: J Allergy Clin Immunol Date: 2012-12-28 Impact factor: 10.793