Food-allergy anaphylaxis and epinephrine autoinjector prescription fills, active component service members, U.S. Armed Forces, 2007-2016.

Food-allergy anaphylaxis is an immunoglobulin E-mediated, systemic reaction that is often unanticipated and can rapidly lead to death. Active duty service members with a history of food-allergy anaphylaxis or a systemic reaction to food do not meet military accession or retention standards. In spite of this, the incidence rate of food-allergy anaphylaxis among active component service members approximates that found in the general population and appears to be increasing. The overall incidence of food-allergy anaphylaxis among active component service members was 39.1 cases per 100,000 person-years (p-yrs) during the 2007-2016 surveillance period. The incidence increased over the surveillance period from 32.0 per 100,000 p-yrs in 2007 to 55.8 per 100,000 p-yrs in 2016. First-line treatment of anaphylaxis includes rapid administration of epinephrine. In this study, 29% and 58% of incident anaphylaxis cases had filled a prescription for an epinephrine autoinjector (EAI) within 18 months before or 3 months after the incident diagnosis, respectively. Increasing awareness of food-allergy anaphylaxis, properly identifying at-risk individuals, and ensuring availability of EAIs have the potential to mitigate the risk associated with anaphylaxis.