The American Academy of Allergy, Asthma & Immunology recently released research on fatal anaphylaxis based upon research of deaths in the UK, France, Canada, Australia and the USA. They looked at fatalities from drug and venom anaphylaxis in addition to food anaphylaxis.

The research found that “Up to 5% of the US population has suffered anaphylaxis.” They found that fatal anaphylaxis is rare, and while drug anaphylaxis is increasing, fatal anaphylaxis to venom and food is stable. The time periods looked at for each country varied, but was at least for a time span of 10 years.

The research found that “infants and young children have the highest reported rates of food-related anaphylaxis and subsequent hospitalization, fatal food anaphylaxis in this age group is very rare indeed.” The highest risk for fatal food anaphylaxis occurs in the second or third decades (10-19 years old; and 20-29 years old). Most of the fatal food anaphylaxis occurred in people with a known food allergy where many of the previous reactions were not severe.

Another risk factor was the delayed use of epinephrine. This risk factor is the easiest to correct. Always carry your epinephrine autoinjector if you have been prescribed one!

Asthma is a risk factor for fatal food anaphylaxis, which was noted in approximately 70 to 75% of fatalities in the UK and Australia data. Yet, the data didn’t distinguish whether poor asthma control was associated with a fatal outcome.

Other risk factors were alcohol, recreations drugs and remaining standing upright in anaphylaxis. The researchers postulated that alcohol “or recreational drugs may, through disinhibition, increase the likelihood of accidental allergen exposure, mask the early warning signs of anaphylaxis, or suppress physiological responses to hypotension.” Also, alcohol can increase the absorption of food allergens into the intestine because of increased permeability.

In this research,  which foods caused the fatal anaphylaxis was not reviewed.

What are the takeaways for food allergy families from this research?

1. Always have an epinephrine autoinjector within arm’s reach!
2. Be very mindful of teens and young adults and whether they are practicing a vigilant lifestyle around their food allergies. This training starts young, and children watch what we parents do, not what we say.
3. In our son’s school Health Care Plan, our doctor stipulated that should he experience any type of reaction, he should be laid down flat with his knees bent. She also stated that he should never be sent to the office, walking down the hallway, should he be feeling the beginning of an allergic reaction.
4. If your child has asthma, we have always been told that it’s important to keep it well managed to afford the best possible outcome if an allergic reaction occurs.
5. Have a frank, honest talk with your child about alcohol and drugs and the impact on all the areas of their life, but especially the consequences when managing food allergies.

If you’d like to read the full text of the research you can do so here.