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Current Trends in Prevalence and Mortality of Anaphylaxis

  • Anaphylaxis (M Sánchez-Borges, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Opinion Statement

It has not been until the last decade that we have gained insight to the global epidemiology of anaphylaxis, due to the methodological difficulties of such studies. Heterogeneity in definitions, severity grading and study designs have hampered compiling robust data which can be consistently analysed and compared. Also, previous International Classification of Diseases coding for anaphylaxis has been suboptimal further hindering epidemiological studies. Under-diagnosis is still a major pitfall in anaphylaxis, despite the efforts of national and international scientific societies to improve education of all health care professionals and implement clinical practice guidelines. Further collaborative projects are needed to overcome this gap. Currently, it seems that worldwide incidence of anaphylaxis and admission rates are increasing both in children and adults, according to recent studies. This may be partly due to an improvement in recognition, but most likely, due to a rise in allergic diseases in general and of food and drug allergy in particular. On the other hand, fatality rates seem to remain stable or to decrease slightly. We optimistically could hypothesize that this is a result of improved management, both acutely and in the long-term, but published data are still scarce. Prevention strategies are needed in order to halt this scaling trend; ongoing education on recognition and treatment will aid to improve anaphylaxis outcomes.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Simons FER, Ardusso LR, Bilò MB, Cardona V, Ebisawa M, El-Gamal YM, et al. International consensus on (ICON) anaphylaxis. World Allergy Organ J. 2014;7:9. This document reviews and compares the major anaphylaxis guidelines developed and published independently by AAAAI/ ACAAI, EAACI & WAO

    Article  PubMed  PubMed Central  Google Scholar 

  2. Simons FER, Ardusso LRF, Bilò MB, Dimov V, Ebisawa M, El-Gamal YM, et al. World allergy organization guidelines for the assessment and management of anaphylaxis. World Allergy Organ J. 2011;4:13–37.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lieberman P, Nicklas RA, Oppenheimer J, Kemp SF, Lang DM, Bernstein DI, et al. The diagnosis and management of anaphylaxis practice parameter: 2010 update. J Allergy Clin Immunol. 2010;126:477–80 .e1–e42

    Article  PubMed  Google Scholar 

  4. Muraro A, Roberts G, Worm M, Bilò MB, Brockow K, Fernández Rivas M, et al. Anaphylaxis: guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69:1026–45.

    Article  CAS  PubMed  Google Scholar 

  5. Calderón E, Méndez J, Nazario S. Anaphylaxis diagnosis and treatment at an emergency department in Puerto Rico. P R Health Sci J. 2013;32:170–4.

    PubMed  Google Scholar 

  6. Wang J, Young MC, Nowak-Wegrzyn A. International survey of knowledge of food-induced anaphylaxis. Pediatr Allergy Immunol. 2014;25:644–50.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Tanno LK, Calderon MA, Goldberg BJ, Akdis CA, Papadopoulos NG. Demoly P. Categorization of allergic disorders in the new World Health Organization International Classification of Diseases. Clin Transl Allergy. 2014;4:42.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Tanno LK, Calderon MA, Goldberg BJ, Gayraud J, Bircher AJ, Casale T, et al. Constructing a classification of hypersensitivity/allergic diseases for ICD-11 by crowdsourcing the allergist community. Allergy Eur J Allergy Clin Immunol. 2015;70:609–15 .This article sows a proposal for new classification of allergic diseases to be included in the new International Classification of Diseases (ICD-11)

    Article  CAS  Google Scholar 

  9. Last JM. A dictionary of epidemiology. 4th edition. New York: Oxford University Press; 2000.

    Google Scholar 

  10. Panesar SS, Javad S, de Silva D, Nwaru BI, Hickstein L, Muraro A, et al. The epidemiology of anaphylaxis in Europe: a systematic review. Allergy. 2013;68:1353–61.

    Article  CAS  PubMed  Google Scholar 

  11. Tejedor Alonso MA, Moro Moro M, Múgica García MV. Epidemiology of anaphylaxis. Clin Exp Allergy. 2015;45:1027–39 .Excellent review on Epidemiology of Anaphylaxis

    Article  CAS  PubMed  Google Scholar 

  12. Helbling A, Hurni T, Mueller UR, Pichler WJ. Incidence of anaphylaxis with circulatory symptoms: a study over a 3-year period comprising 940 000 inhabitants of the Swiss Canton Bern. Clin Exp Allergy. 2004;34:285–90.

    Article  CAS  PubMed  Google Scholar 

  13. Bohlke K, Davis RL, DeStefano F, Marcy SM, Braun MM, Thompson RS. Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization. J Allergy Clin Immunol. 2004;113:536–42.

    Article  PubMed  Google Scholar 

  14. Sheikh A, Hippisley-Cox J, Newton J, Fenty J. Trends in national incidence, lifetime prevalence and adrenaline prescribing for anaphylaxis in England. J R Soc Med. 2008;101:139–43.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Peng MM, Jick H. A population-based study of the incidence, cause, and severity of anaphylaxis in the United Kingdom. Arch Intern Med. 2004;164:317–9.

    Article  PubMed  Google Scholar 

  16. Decker WW, Campbell RL, Manivannan V, Luke A. St. Sauver JL, Weaver A et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol. 2008;122:1161–5.

    Article  PubMed  PubMed Central  Google Scholar 

  17. González-Pérez A, Aponte Z, Vidaurre CF, Rodríguez LAG. Anaphylaxis epidemiology in patients with and patients without asthma: a United Kingdom database review. J Allergy Clin Immunol. 2010;125:1098–1104.e1.

    Article  PubMed  Google Scholar 

  18. Tejedor Alonso M A, Moro Moro M, Múgica García M V, Esteban Hernández J, Rosado Ingelmo A, al. VAC e. Incidence of anaphylaxis in the city of Alcorcon (Spain): a population-based study. Clin Exp Allergy. 2012;42:578–89.

    Article  PubMed  Google Scholar 

  19. Tejedor-Alonso MA, Moro-Moro M, Múgica-García M V. Epidemiology of anaphylaxis: contributions from the last 10 years. J Investig Allergol Clin Immunol. 2015;25:163–75.

    CAS  Google Scholar 

  20. Sala-Cunill A, Cardona V. Definition, epidemiology, and pathogenesis. Curr Treat Options Allergy. 2015;2:207–17.

    Article  Google Scholar 

  21. Wood R A, Camargo C A, Lieberman P, Sampson H A, LB S, al. ZM e. Anaphylaxis in America: the prevalence and characteristics of anaphylaxis in the United States. J Allergy Clin Immunol. 2014;133:461–7.

    Article  PubMed  Google Scholar 

  22. Rudders SA, Arias SA, Camargo CA. Trends in hospitalizations for food-induced anaphylaxis in US children, 2000-2009. J Allergy Clin Immunol. 2014;134:960–2 .This article reports the increase of hospitalizations for food-induced anaphylaxis in US children over a decade

    Article  PubMed  Google Scholar 

  23. Nocerino R, Leone L, Cosenza L, Berni CR. Increasing rate of hospitalizations for food-induced anaphylaxis in Italian children: an analysis of the Italian Ministry of Health database. J Allergy Clin Immunol. 2015;135:833–835.e3 .This study shows the increase of hospitalizations for food-induced anaphylaxis in Italian children

    Article  PubMed  Google Scholar 

  24. Mullins RJ, Dear KBG, Tang MLK. Time trends in Australian hospital anaphylaxis admissions in 1998-1999 to 2011-2012. J Allergy Clin Immunol. 2015;136:367–75 .This article reports the increase burden of anaphylaxis among adolescents and adults in Australia. It also includes data of fatal anaphylaxis

    Article  PubMed  Google Scholar 

  25. Turner PJ, Gowland MH, Sharma V, Ierodiakonou D, Harper N, Garcez T, et al. Increase in anaphylaxis-related hospitalizations but no increase in fatalities: an analysis of United Kingdom national anaphylaxis data, 1992-2012. J Allergy Clin Immunol. 2015;135:956–963.e1 .This study analyses the trends in anaphylaxis admissions and fatalities by age, sex, and cause in England and Wales over a 20-year period in a large population

    Article  PubMed  PubMed Central  Google Scholar 

  26. Ma L, Danoff TM, Borish L. Case fatality and population mortality associated with anaphylaxis in the United States. J Allergy Clin Immunol. 2014;133:1075–83.

    Article  PubMed  Google Scholar 

  27. Jerschow E, Lin RY, Scaperotti MM, McGinn AP. Fatal anaphylaxis in the United States, 1999-2010: temporal patterns and demographic associations. J Allergy Clin Immunol. 2014;134:1318–1328.e7 .This article analyses the epidemiologic features and time trends of fatal anaphylaxis in the United States from 1999 to 2010

    Article  PubMed  PubMed Central  Google Scholar 

  28. Simons FER, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J. 2015;8:32 .Update of the WAO Guidelines regarding epidemiology, clinical diagnosis, risk factors and management in healthcare and community settings

    Article  PubMed  PubMed Central  Google Scholar 

  29. Simons FE, Peterson S, Black CD. Epinephrine dispensing patterns for an out-of-hospital population: a novel approach to studying the epidemiology of anaphylaxis. J Allergy Clin Immunol. 2002;110:647–51.

    Article  PubMed  Google Scholar 

  30. Vetander M, Helander D, Flodström C, Ostblom E, Alfvén T, Ly DH, et al. Anaphylaxis and reactions to foods in children—a population-based case study of emergency department visits. Clin Exp Allergy. 2012;42:568–77.

    Article  CAS  PubMed  Google Scholar 

  31. Hochstadter E, Clarke A, De Schryver S, LaVieille S, Alizadehfar R, Joseph L, et al. Increasing visits for anaphylaxis and the benefits of early epinephrine administration: a 4-year study at a pediatric emergency department in Montreal, Canada. J Allergy Clin Immunol. Published Online First: 19 April2016. doi:10.1016/j.jaci.2016.02.016.

    PubMed  Google Scholar 

  32. Grabenhenrich LB, Dölle S, Moneret-Vautrin A, Köhli A, Lange L, Spindler T, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol. 2016:1–11.

  33. Cardona V, Ansotegui IJ. Component-resolved diagnosis in anaphylaxis. Curr Opin Allergy Clin Immunol. Published Online First2016. doi:10.1097/ACI.0000000000000261.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Carretera Leioa Unbe 33 bis, 48950, Erandio, Bilbao, Bizkaia, Spain

    Ignacio J Ansotegui MD PhD

  2. Department of Allergy and Clinical Immunology, Centro Medico Docente La Trinidad y Clinica El Avila, Caracas, Venezuela

    Mario Sánchez-Borges MD PhD

  3. Allergy Section, Department of Internal medicine, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Victoria Cardona MD PhD

  4. Allergy Research Group, Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

    Victoria Cardona MD PhD

Authors
  1. Ignacio J Ansotegui MD PhD
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  2. Mario Sánchez-Borges MD PhD
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  3. Victoria Cardona MD PhD
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Corresponding author

Correspondence to Ignacio J Ansotegui MD PhD.

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Conflict of Interest

Dr. Ignacio J Ansotegui and Dr. Mario Sanchez Borges declare that they have no conflict of interest. Dr. Cardona reports personal fees from ALK, personal fees from CIRCASSIA, personal fees from LETI, non-financial support from SHIRE, non-financial support from THERMOFISHER, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Anaphylaxis

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Ansotegui, I.J., Sánchez-Borges, M. & Cardona, V. Current Trends in Prevalence and Mortality of Anaphylaxis. Curr Treat Options Allergy 3, 205–211 (2016). https://doi.org/10.1007/s40521-016-0094-0

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