Food-allergic summer camp attendees need pre-camp preparedness

Published Online: December 3, 2016

Millions of children attend summer camps yearly, including children with severe food allergies. Pediatric campers with food allergies are likely at greater risk for exposure and anaphylaxis compared to the school environment because of the different supervisory environment, increased opportunity for food sharing, the potential unavailability of stock epinephrine autoinjectors, and the lack of close proximity to emergency medical services for camps located in remote locations. The prevalence of food allergies in summer camps and the proportion of these campers that are at highest risk for anaphylaxis had not been previously assessed.

A recent study by Schellpfeffer and colleagues, published in The Journal of Allergy and Clinical Immunology: In Practice estimated food allergy prevalence in the camp population nationally by partnering with, a national web-based electronic health record (EHR) system created specifically for camps. At the time of this study, this EHR represented 122,424 campers in 170 camps across the United States and Canada. Deidentified data including food allergy, history of asthma, and current medication lists were extracted and analyzed. Medication lists was also reviewed for asthma medications and epinephrine autoinjector presence.  

Overall, 2.5% of campers were found to have food allergies, with 22% of this group having more than one documented food allergy. The top five allergies reported were nuts, seafood, egg, fruit, and seeds.  Of campers with food allergies, 44.3% also had a diagnosis of asthma, a risk factor for severe anaphylaxis. Most strikingly, only 39.7% of campers with food allergies were found to have brought an epinephrine autoinjector to camp. Children with a history of asthma and those attending an overnight camp were more likely to have had an epinephrine autoinjector on their medication list.

This study demonstrates that food allergies are present in a substantial number of children attending summer camps. Over one third of these food-allergic children are potentially at higher risk for anaphylaxis based on their concurrent asthma diagnosis. A majority of campers with food allergies may not necessarily carry a life-saving epinephrine autoinjector. Given that state-based legislation for the availability of stock unassigned epinephrine autoinjectors at summer camps remains variable, medical providers must ensure that the child’s anaphylaxis emergency action plan is updated and that campers have access to life-saving epinephrine prior to attending summer camps.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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