Send to

Choose Destination
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

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



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


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


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.


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.


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.


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

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center