Anaphylaxis in America
Published Online: October 15, 2013
While anaphylaxis is widely recognized as an important, life-threatening condition, data are limited regarding its prevalence and characteristics in the general population. In this study recently published in The Journal of Allergy and Clinical Immunology (JACI), Wood et al report the results of two nationwide surveys conducted to estimate the lifetime prevalence of anaphylaxis as well as its overall characteristics.
The first survey, referred to as the public survey, included 1,000 unselected adults, of whom 7.7% reported a history of a prior anaphylactic reaction. Using increasingly stringent criteria, the authors estimated that 5.1% had a history of probable anaphylaxis and 1.6% had a history of very likely anaphylaxis. The second survey, referred to as the patient survey, was designed to better define the characteristics of anaphylaxis and patient behaviors related to anaphylactic reactions. This survey included both children and adults with a total of 1,059 respondents, of whom 344 reported a history of anaphylaxis.
The most common reaction triggers reported in the patient survey included medications (34%), foods (31%), and insect stings (20%). The surveys further revealed that with reactions, 42% of patients sought treatment within 15 minutes of reaction onset, 34% went to the hospital, 27% self-treated with antihistamines, 10% called 911, 11% self-administered epinephrine, and 6.4% received no treatment. Of particular concern, although most respondents with anaphylaxis reported at least 2 prior episodes (19% reporting at least 5 prior episodes), 52% had never received a prescription for self-injectable epinephrine, and 60% did not currently have epinephrine available.
This study provides the first estimate of the prevalence of anaphylaxis in the United States using a large, unbiased survey. The authors concluded that anaphylaxis is common, with an estimated prevalence of at least 1.6% and probably higher, and that patients do not appear adequately equipped to deal with future episodes. These findings indicate the need for public health initiatives to improve anaphylaxis recognition and treatment.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.