Sarah A Lyons1, Peter G J Burney2, Barbara K Ballmer-Weber3, Montserrat Fernandez-Rivas4, Laura Barreales5, Michael Clausen6, Ruta Dubakiene7, Cristina Fernandez-Perez5, Philipp Fritsche8, Monika Jedrzejczak-Czechowicz9, Marek L Kowalski9, Tanya Kralimarkova10, Ischa Kummeling11, Tihomir B Mustakov10, Ans F M Lebens11, Harmieke van Os-Medendorp11, Nikolaos G Papadopoulos12, Todor A Popov13, Alexandros Sakellariou14, Paco M J Welsing15, James Potts2, E N Clare Mills16, Ronald van Ree17, André C Knulst11, Thuy-My Le11. 1. Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: s.a.lyons-2@umcutrecht.nl. 2. Population Health & Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom. 3. Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland; Clinic for Dermatology and Allergology, Kantonsspital St Gallen, St Gallen, Switzerland. 4. Allergy Department, Hospital Clinico San Carlos, IdISSC, ARADyAL, Center RD16/0006/0009, Madrid, Spain. 5. Servicio de Medicina Preventiva, Epidemiology Unit, Hospital Clinico San Carlos, IdISSC, Madrid, Spain. 6. Children's Hospital, Landspitali University Hospital, Reykjavik, Iceland. 7. Medical Faculty, Vilnius University, Vilnius, Lithuania. 8. Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland. 9. Department of Allergy and Immunology, Medical University of Lodz, Lodz, Poland. 10. Clinical Center of Allergology of the Alexandrovska Hospital, Medical University of Sofia, Sofia, Bulgaria. 11. Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht, The Netherlands. 12. Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece; Division of Infection, Immunity and Respiratory Medicine, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom. 13. University Hospital Sv. Ivan Rilski, Sofia, Bulgaria. 14. Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece. 15. Division of Internal Medicine and Dermatology, University Medical Center Utrecht, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 16. Division of Infection, Immunity and Respiratory Medicine, Manchester Institute of Biotechnology & Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, United Kingdom. 17. Department of Experimental Immunology and Department of Otorhinolaryngology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: According to the community-based EuroPrevall surveys, prevalence of self-reported food allergy (FA) in adults across Europe ranges from 2% to 37% for any food and 1% to 19% for 24 selected foods. OBJECTIVE: To determine the prevalence of probable FA (symptoms plus specific IgE-sensitization) and challenge-confirmed FA in European adults, along with symptoms and causative foods. METHODS: In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in 8 European centers. Phase II consisted of an extensive questionnaire on reactions to 24 preselected commonly implicated foods, and measurement of specific IgE levels. Multiple imputation was performed to estimate missing symptom and serology information for nonresponders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge. RESULTS: Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid, and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3%, and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhinoconjunctivitis (29.5%). Hazelnut, peach, and apple were the most common causative foods in Lodz, Utrecht, and Zurich. Peach was also among the top 3 causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% were classified as positive. CONCLUSIONS: FA shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches almost 6% in parts of Europe.
BACKGROUND: According to the community-based EuroPrevall surveys, prevalence of self-reported food allergy (FA) in adults across Europe ranges from 2% to 37% for any food and 1% to 19% for 24 selected foods. OBJECTIVE: To determine the prevalence of probable FA (symptoms plus specific IgE-sensitization) and challenge-confirmed FA in European adults, along with symptoms and causative foods. METHODS: In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in 8 European centers. Phase II consisted of an extensive questionnaire on reactions to 24 preselected commonly implicated foods, and measurement of specific IgE levels. Multiple imputation was performed to estimate missing symptom and serology information for nonresponders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge. RESULTS: Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid, and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3%, and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhinoconjunctivitis (29.5%). Hazelnut, peach, and apple were the most common causative foods in Lodz, Utrecht, and Zurich. Peach was also among the top 3 causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% were classified as positive. CONCLUSIONS: FA shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches almost 6% in parts of Europe.
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Authors: Sarah A Lyons; André C Knulst; Peter G J Burney; Montserrat Fernandez-Rivas; Barbara K Ballmer-Weber; Laura Barreales; Christian Bieli; Michael Clausen; Ruta Dubakiene; Cristina Fernandez-Perez; Monika Jedrzejczak-Czechowicz; Marek L Kowalski; Ischa Kummeling; Tanya Kralimarkova; Tihomir B Mustakov; Harmieke van Os-Medendorp; Nikolaos G Papadopoulos; Todor A Popov; James Potts; Serge A Versteeg; Paraskevi Xepapadaki; Paco M J Welsing; Clare Mills; Ronald van Ree; Thuy-My Le Journal: Allergy Date: 2020-09-24 Impact factor: 13.146
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