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J Allergy Clin Immunol. 2014 Feb;133(2):461-7. doi: 10.1016/j.jaci.2013.08.016. Epub 2013 Oct 18.

Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States.

Author information

1
Department of Pediatrics, Division of Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: rwood@jhmi.edu.
2
Departments of Medicine and Epidemiology, Massachusetts General Hospital, Boston, Mass.
3
Departments of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Memphis, Tenn.
4
Department of Pediatrics, Division of Allergy and Immunology, Mount Sinai School of Medicine, New York, NY.
5
Department of Medicine, Division of Rheumatology, Allergy and Immunology, Virginia Commonwealth University, Richmond, Va.
6
Department of Medicine, State University of New York Stony Brook, Stony Brook, NY.
7
Asthma and Allergy Foundation of America, Landover, Md.
8
Abt SRBI, Silver Spring, Md.
9
ICF International, Calverton, Md.
10
Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

BACKGROUND:

Although anaphylaxis is recognized as an important life-threatening condition, data are limited regarding its prevalence and characteristics in the general population.

OBJECTIVE:

We sought to estimate the lifetime prevalence and overall characteristics of anaphylaxis.

METHODS:

Two nationwide, cross-sectional random-digit-dial surveys were conducted. The public survey included unselected adults, whereas the patient survey captured information from household members reporting a prior reaction to medications, foods, insect stings, or latex and idiopathic reactions in the previous 10 years. In both surveys standardized questionnaires queried anaphylaxis symptoms, treatments, knowledge, and behaviors.

RESULTS:

The public survey included 1,000 adults, of whom 7.7% (95% CI, 5.7% to 9.7%) reported a prior anaphylactic reaction. Using increasingly stringent criteria, we estimate that 5.1% (95% CI, 3.4% to 6.8%) and 1.6% (95% CI, 0.8% to 2.4%) had probable and very likely anaphylaxis, respectively. The patient survey included 1,059 respondents, of whom 344 reported a history of anaphylaxis. The most common triggers reported were medications (34%), foods (31%), and insect stings (20%). Forty-two percent sought treatment within 15 minutes of onset, 34% went to the hospital, 27% self-treated with antihistamines, 10% called 911, 11% self-administered epinephrine, and 6.4% received no treatment. Although most respondents with anaphylaxis reported 2 or more prior episodes (19% reporting ≥5 episodes), 52% had never received a self-injectable epinephrine prescription, and 60% did not currently have epinephrine available.

CONCLUSIONS:

The prevalence of anaphylaxis in the general population is at least 1.6% and probably higher. Patients do not appear adequately equipped to deal with future episodes, indicating the need for public health initiatives to improve anaphylaxis recognition and treatment.

KEYWORDS:

Anaphylaxis; RDD; Random-digit-dial; epinephrine; prevalence

PMID:
24144575
DOI:
10.1016/j.jaci.2013.08.016
[Indexed for MEDLINE]
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