Skip to main content
Log in

Epidemiology of anaphylaxis in the united states

  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Anaphylaxis is a potentially life-threatening allergic reaction characterized by a syndrome of dermatologic and systemic signs and symptoms, at times including cardiovascular collapse from distributive shock. Although it is recognized that the incidence of anaphylaxis is increasing, the extent of its prevalence, both from individual causes and in toto, remains unclear. Common causes include pharmacologic agents, such as antibiotics and radiocontrast media, as well as foods, insect stings, and latex exposure. The available literature suffers from methodologic shortcomings, limiting the accuracy of estimated prevalence. However, current data suggest that there are approximately 1500 annual deaths from anaphylaxis, and between 2.8 million and 42.7 million Americans are at risk of experiencing an episode of anaphylaxis during their lives.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Portier P, Richet C: Action anaphylactique des quelques venims. C R Soc Biol 1902, 54:170–172.

    Google Scholar 

  2. Becker EL: Elements of the history of our present concepts of anaphylaxis, hay fever, and asthma. Clin Exp Allergy 1999, 29:875–895. An excellent, detailed review of how our understanding of anaphylaxis and allergy has evolved.

    Article  PubMed  CAS  Google Scholar 

  3. Stricker BHCh: Anaphylaxis. Epidemiology 1998, 9:114–116.

    Article  PubMed  CAS  Google Scholar 

  4. Bochner BS, Lichtenstein LM: Anaphylaxis. N Engl J Med 1991, 324:1785–1790.

    Article  PubMed  CAS  Google Scholar 

  5. Wasserman SI, Marquardt DL: Anaphylaxis. In In Allergy: Principles and Practice. Vol 2. Edited by Middleton E Jr, Reed CE, Ellis EF, et al. St. Louis: Mosby; 1988; 1365–1376.

    Google Scholar 

  6. Kemp SF, Lockey RF, Wolf BL, et al.: Anaphylaxis: a review of 266 cases. Arch Intern Med 1995, 155:1749–1754.

    Article  PubMed  CAS  Google Scholar 

  7. Dibs SD, Baker MD: Anaphylaxis in children: a 5-year experience. Pediatrics 1997, 99:E7.

    Article  PubMed  CAS  Google Scholar 

  8. Sheikh A, Alves B: Hospital admissions for acute anaphylaxis: time trend study. BMJ 2000, 320:1441.

    Article  PubMed  CAS  Google Scholar 

  9. Wilson R: Upward trend in acute anaphylaxis continued in 1998–1999. BMJ 2000, 321:1021–1022.

    Article  PubMed  CAS  Google Scholar 

  10. Yunginger JW: Anaphylaxis. Ann Allergy 1992, 69:87–96.

    PubMed  CAS  Google Scholar 

  11. Staikowsky F, Zanker C, Casaenove L: Allergic emergencies in the emergency room. Clin Rev Allergy Immunol 1999, 17:429–447.

    PubMed  CAS  Google Scholar 

  12. Barach EM, Nowak RM, Tennyson GL, et al.: Epinephrine for treatment of anaphylactic shock. JAMA 1984, 251:2118–2122.

    Article  PubMed  CAS  Google Scholar 

  13. Stricker BHCh, de Groot RRM, Wilson JH: Glafenine-associated anaphylaxis as a cause for hospital admission in The Netherlands. Eur J Clin Pharmac 1991, 40:367–371.

    Article  CAS  Google Scholar 

  14. Laporte JR, de Latorre FJ, Gadgil A, et al.: An epidemiologic study of severe anaphylactic and anaphylactoid reactions among hospital patients: methods and overall risks. Epidemiology 1998, 9:141–146.

    Article  Google Scholar 

  15. Stark BJ, Sullivan TJ: Biphasic and protracted anaphylaxis. J Allergy Clin Immunol 1986, 78:76–83.

    Article  PubMed  CAS  Google Scholar 

  16. Weiss ME, Adkinson NF: Immediate hypersensitivity reactions to penicillin and related antibiotics. Clin Allergy 1988, 18:515–540.

    Article  PubMed  CAS  Google Scholar 

  17. International Rheumatic Fever Study Group: Allergic reactions to long-term benzathine penicillin prophylaxis for rheumatic fever. Lancet 1991, 337:1308–1310.

    Google Scholar 

  18. Sullivan TJ: Pathogenesis and management of allergic reactions to penicillin and other beta-lactam antibiotics. Pediatr Infect Dis 1982, 1:344–50.

    Article  PubMed  CAS  Google Scholar 

  19. Kagy L, Blaiss MS: Anaphylaxis in children. Pediatr Ann 1998, 27:727–734.

    PubMed  CAS  Google Scholar 

  20. Bush WH, Swanson DP: Acute reactions to intravascular contrast media. AJR Am J Roentgenol 1991, 157:1153–1161.

    PubMed  CAS  Google Scholar 

  21. Katayama H, Yamaguchi K, Kozuka T, et al.: Adverse reactions to ionic and nonionic contrast media. Radiology 1990, 175:621–628.

    PubMed  CAS  Google Scholar 

  22. .Shehadi WH: Adverse reactions to intravascularly administered contrast media: a comprehensive study based on a prospective survey. Am J Roentgenol Radium Ther Nucl Med 1975, 124:145–52.

    PubMed  CAS  Google Scholar 

  23. Lieverman P: Anaphylactoid reactions to radiocontrast material. Immunol Allergy Clin North Am 1992, 12:649–670.

    Google Scholar 

  24. Lang DM, Alpern MB, Visintainer PF, et al.: Increased risk for anaphylactoid reaction from contrast media in patients on βadrenergic blockers or with asthma. Ann Intern Med 1991, 115:270–276.

    PubMed  CAS  Google Scholar 

  25. Toogood JH: Risk of anaphylaxis in patients receiving betablocker drugs. J Allergy Clin Immunol 1991, 81:1–5.

    Article  Google Scholar 

  26. Caro JJ, Trindade E, McGregor M: The risks of death and of severe nonfatal reactions with high- vs low-osmolality contrast media: a meta-analysis. AJR Am J Roentgenol 1991, 156:825–832.

    PubMed  CAS  Google Scholar 

  27. .Sampson HA: Fatal food-induced anaphylaxis. Allergy 1998, 53(Suppl 46):125–130.

    PubMed  CAS  Google Scholar 

  28. Sicherer SH, Munoz-Furlong A, Burke AW, et al.: Prevalence of peanut and tree nut allergy in the US determined by a random digit dial telephone survey. J Allergy Clin Immunol 1992, 90:683–685.

    Article  Google Scholar 

  29. Bock SA: Incidence of severe adverse reactions to food in Colorado. J Allergy Clin Immunol 1992, 90:683–685.

    Article  PubMed  CAS  Google Scholar 

  30. Yocum MW, Butterfield JH, Klein JS, et al.: Epidemiology of anaphylaxis in Olmstead County: a population-based study. J Allergy Clin Immunol 1999, 104:452–456. A unique and well-performed trial that identified and characterized all of the cases of anaphylaxis in one county over a predefined period of time.

    Article  PubMed  CAS  Google Scholar 

  31. Van der KlauwMM, Wilson JHP, Herings RMC: Drug-associated anaphylaxis: 20 years of reporting in the Netherlands (1974-1994) and review of the literature. Clin Exper Allergy 1996, 26:1355–1363. One of two large, long-term retrospective studies from Northern Europe to lend significant insight into incidence of anaphylaxis as well as relative contributions of individual etiologies.

    Article  Google Scholar 

  32. Lenler-Petersen P, Hansen D, Andersen M, et al.: Drug-related fatal anaphylactic shock in Denmark 1968–1990: A study based upon notifications to the committee on adverse drug reactions. J Clin Epidemiol 1995, 48:1185–1188. The second, and more recent, of the two long-term retrospective studies.

    Article  PubMed  CAS  Google Scholar 

  33. Klein JS, Yocum MW: Underreporting of anaphylaxis in a community emergency room. J Allergy Clin Immunol 1995, 95:673–678. A small but insightful investigation highlighting many methodologic shortcomings in the anaphylaxis literature.

    Article  Google Scholar 

  34. Valentine MD: Anaphylaxis and stinging insect hypersensitivity. JAMA 1992, 268:2830–2833.

    Article  PubMed  CAS  Google Scholar 

  35. Golden DB, Marsh DG, Kagey-Sobotka A, et al.: Epidemiology of insect venom sensitivity. JAMA 1989, 262:240–244.

    Article  PubMed  CAS  Google Scholar 

  36. Sussman Gl, Beezhold DH: Allergy to latex rubber. Ann Intern Med 1995, 122:43–46.

    PubMed  CAS  Google Scholar 

  37. Ownby DR, Ownby HE, McCullough J, et al.: The prevalence of anti-latex IgE antibodies in 1000 volunteer blood donors. J Allergy Clin Immunol 1996, 97:1188–1192.

    Article  PubMed  CAS  Google Scholar 

  38. Arellano R, Bradley J, Sussman G: Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves. Anaesthesiology 1992, 77:905–908.

    Article  CAS  Google Scholar 

  39. Liss GM, Sussman GL, Deal K, et al.: Latex allergy: epidemiological study of 1351 hospital workers. Occup Environ Med 1997, 54:335–342.

    Article  PubMed  CAS  Google Scholar 

  40. Kelly KJ, Kurup VP, Reijula KE, Fink JN: The diagnosis of natural rubber latex allergy. J Allergy Clin Immunol 1994, 93:813–816.

    Article  PubMed  CAS  Google Scholar 

  41. Neugut AI, Ghatak AT, Miller RL: Anaphylaxis in the United States: an investigation into its epidemiology. Arch Intern Med 2001, 161:15–21. The first investigation to systematically investigate the existing literature on rates of anaphylaxis, deriving estimates of population at risk of, and annual deaths due to, the syndrome.

    Article  PubMed  CAS  Google Scholar 

  42. Brown AFT, McKinnon D, Chu K: Emergency department anaphylaxis: a review of 142 patients in a single year. J Allergy Clin Immunol 2001, 108:861–866.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matasar, M.J., Neugut, A.I. Epidemiology of anaphylaxis in the united states. Curr Allergy Asthma Rep 3, 30–35 (2003). https://doi.org/10.1007/s11882-003-0007-8

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11882-003-0007-8

Keywords

Navigation