“What Can Population Data Teach us about Food Allergy?”

At a presentation at the ACAAI annual conference, the latest results from a food allergy prevalence survey on Monday morning at the ACAAI annual conference.

The survey was adapted from the 2009-2010 survey instrument and was administered between October 2015 and September 2016 to a sample of more than 40,000 households across the US. Analysis and results were presented by Ruchi S. Gupta, MD, MPH, Professor of Pediatrics and Director of Science and Outcomes of Allergy and Asthma Research Program at Northwestern Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago,

The prevalence of peanut food allergy was still the highest at 2.2% of the population, with milk (1.9%), shellfish (1.3%), tree nuts (1.2%), egg (0.9%), fin fish (0.6%), wheat (0.5%), soy (0.5%), and sesame (0.2%) following, respectively. When Gupta presented the prevalence of each food allergy by age, she noted several important trends. Peanut allergy is not easily outgrown, as the prevalence stays level across different age groups with only about 15% of children out growing their peanut allergy. Milk allergy is not being outgrown either, as the prevalence only drops by approximately 13% between children aged 0 to 2 years old and teenagers 14 years and older. Shellfish allergy is the top food allergy in adults as people do not usually introduce shellfish into their diet until they are older.

Another interesting data point: 42.3% of food-allergic kids reported a history of one or more severe reactions (defined as a reaction that involved two or more organ systems in the respondent’s most severe reported food allergy reaction or write-in anaphylaxis). Peanut food allergy once again ranked the highest at 59.2% of children reporting a severe reaction history. On a related question asking participants about the number of emergency department visits for food allergy in their lifetime compared with the past year, 42% of respondents indicated that they had one or more lifetime emergency department visits, and 19% of respondents indicated they had one or more emergency department visits within the last year to receive allergy treatment.

Gupta mentioned that the survey also asked the parents, “What if you could purchase a completely effective and safe treatment to eliminate all food allergies for your child that would allow him/her to safely eat all foods? What is the most that you would be willing and able to pay out-of-pocket each month?” Surprisingly, the price parents were willing to pay was equivalent to the out-of-pocket costs they currently pay per child with food allergy. The opportunity cost for parents of children with food allergy was very high, totaling $14.2 billion per year or $2,399 per child.

“This opportunity cost is representative of parents who had to change jobs to care for their child and those who decided to change their job to be closer to their child’s school in case of emergencies or managing food intake of the child while at school,” Gupta explained.

In a separate retrospective study, reviewed the charts of children 18 or younger who had presented with food-induced anaphylaxis to the emergency department from July 2015 to 2017, Gupta reported that the majority of infant cases (aged less than 12 months) presented with skin and gastrointestinal symptoms. Very few cases in infants had respiratory symptoms. She explained that infants experiencing anaphylaxis have different symptoms than older children.

“Overall, the results of both studies suggest the need for stronger relationships with pediatricians and the appropriate Sublingual Immunotherapy Training so that they are familiar with treatment options, as well as tests to assess risk of food allergy in infants,” Gupta concluded. “They can follow the appropriate prevention guidelines and refer to allergists as needed.”