Food-Induced Anaphylaxis: Keeping Kids Safe

Julie Wang, MD; Michael Young, MD; Anna Nowak-Wegrzyn, MD


July 18, 2013

Food Allergies: Not to Be Underestimated

A 7-year-old girl with known peanut allergy was given 1 peanut on the playground during a school recess break by another child who was unaware of her severe allergies. Shortly after eating the peanut, she felt unwell and asked the teacher for help.

We will use the tragic example of the fatal outcome of peanut anaphylaxis in a child to discuss several important issues, with special emphasis on managing food allergies at school.

Epidemiology of Food-Induced Anaphylaxis

Food allergies are an important public health concern, and their prevalence is increasing. Recent data indicate that 5.1% of children 0-17 years of age were affected by food allergies in 2009-2011, an increase from 3.4% in 1997-1999.[1]

Food allergies trigger allergic reactions that can range from mild to severe, including life-threatening anaphylaxis.[2] In fact, food was the most common trigger of anaphylaxis in a population-based incidence study.[3] In another study examining emergency department visits and admissions for food-induced anaphylaxis between 2001 and 2006, a significant increase in both was observed, demonstrating that food-induced anaphylaxis continues to be an important issue.[4]

Deaths as a result of anaphylaxis do occur, and approximately 500-1000 fatalities per year are reported in the United States.[5] Up to 30% of fatal anaphylaxis cases are triggered by food allergens. Although over 90% of these are associated with nut (peanut or tree nuts) exposures in the United States, it is important to note that allergic reactions to any foods have the potential to cause severe allergic reactions and anaphylaxis. Furthermore, the severity of allergic reactions to foods cannot be predicted by history or by either skin prick or allergen-specific IgE level testing.[6]

For some, the first presenting sign of an allergy is anaphylaxis. Nearly 25% children who received epinephrine to treat severe allergic reactions in schools had no history of life-threatening allergy,[7] and approximately 20% of reactions occurring in school settings are due to first exposure to the food allergen.[8]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.