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An Epidemiological Approach to Reducing the Risk of Fatal Anaphylaxis

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Anaphylaxis and Hypersensitivity Reactions

Abstract

Estimates of the population prevalence of anaphylaxis range from 0.03% to 0.95% with immediately-life-threatening reactions affecting <0.1% of the population; wide differences in ­published statistics are due to differing inclusion criteria and imprecise use of terms such as incidence and prevalence. Expected symptoms in anaphylaxis vary according to the trigger and population studied. The severity of reactions is determined by interaction between genetic and ­environmental factors and cannot yet be predicted accurately. Whether a reaction is fatal or not depends as much on comorbidity such as asthma or heart disease as it does on severity of allergy or dose and route of exposure to the trigger.

The UK fatal anaphylaxis register is the longest-running and most comprehensive attempt at epidemiology of fatal anaphylaxis; it has recorded around 1 anaphylactic death per 3 million ­population each year since 1992, about half of these were iatrogenic (predominantly older people) and the rest divided between sting reactions and (mostly in younger people) food allergy. Most deaths were first reactions: fatal recurrent reactions occurred through avoidance failure combined with failure of rescue treatment – lessons from these failures can teach how to reduce future fatalities.

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  1. Honorary Consultant Immunologist, Department of Immunology, Manchester Royal Infirmary, Manchester, UK, M13 9WL

    Richard S. H. Pumphrey

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Correspondence to Richard S. H. Pumphrey .

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  1. Harvard Medical School, Ambulatory Center, Brigham and Women’s Hospital, Boyleston Street, Route 9 850, Chestnut Hill, 02467, Massachusetts, USA

    Mariana C. Castells

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Pumphrey, R.S.H. (2011). An Epidemiological Approach to Reducing the Risk of Fatal Anaphylaxis. In: Castells, M. (eds) Anaphylaxis and Hypersensitivity Reactions. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-951-2_2

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