Accidental peanut ingestion rate on the decline, from JACI

MILWAUKEE – Accidental ingestion of peanut rates may be down for people suffering from peanut allergies, but there's still room for improvement, according to a new study.

The study, entitled "Accidental ingestions in children with peanut allergy", can be found in the Articles in Press area of the Journal of Allergy and Clinical Immunology (JACI) Web site located at www.jacionline.org. The JACI is the peer-reviewed journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Joyce W. Yu, MD, FRCPC, McGill University Health Centre, Montreal, Quebec, Canada, and colleagues looked to determine if, due to public awareness and food labeling, the incidence of accidental peanut ingestion had been lessened.

The authors noted while peanut consumption in Canada is similar to the United States, many Canadian schools have peanut-safe areas and the country also has some of the strictest food labeling regulations in the world.

Children ages 4 to 17 who had been diagnosed with peanut allergy at Montreal Children's Hospital between January 2000 and February 2005 participated in the study by completing a questionnaire that asked questions ranging from duration of breast-feeding to details about any accidental exposure to peanut in the past year.

Two hundred fifty-two children participated in the study; there were 35 accidental exposures to peanut in 29 children over a period of 244 patient years for an annual incidence rate of 14.3%. This rate, according to the authors, was lower than a rate in a study published in the JACI in 1989 (50% percent in the preceding year) and in a British study published in 2005 (55% annual incidence rate before an allergy management plan).

The study authors also learned that:

• There were 16 moderate and 4 severe reactions. Of those, only 2 moderate and 2 severe reactions were treated with epinephrine, the standard medication administered during anaphylactic shock. Anaphylaxis is a systemic allergic reaction that can result in trouble breathing, loss of consciousness and even death.
• Twelve of the reactions came from a food overtly containing peanut.
• Twenty-two of the reactions came from foods where the peanut content was unknown.
• A majority of the exposures occurred at home (14) or at the home of a friend or relative (12).
• Only 1 exposure occurred at school. The authors hypothesized this was because 80% of the Montreal schools are peanut-free.

The authors concluded that although the percentage of accidental exposure to peanut had decreased, the rate can still be lowered. They suggested that can be achieved through enhanced patient and parental education on peanut avoidance, enforcement of more stringent food manufacturing standards, and more accurate food labeling.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information and a physician referral directory through its Web site at www.aaaai.org.

EDITOR'S NOTE: To receive a copy of the study, contact Karen Janka (kjanka@aaaai.org) or Natalie Lemke (nlemke@aaaai.org) at (414) 272-6071. For more information and access to the archive of past JACI news releases, visit the Media Center of the AAAAI Web site, www.aaaai.org.

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