Anaphylaxis Statistics

 

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Graphic showing life-threatening allergies statistics

Anaphylaxis Prevalence

Between 1.6 and 5.1% of the United States Population have experienced anaphylaxis 10

Definition of Anaphylaxis

Anaphylaxis is a sudden onset of severe and potentially life-threatening symptoms that occur within minutes to hours of exposure to an allergen 1 

Causes of Anaphylaxis

Anaphylaxis is caused by exposure to a trigger or allergen.  The most common triggers include 2:

  • Foods (31%) 10
    • Peanuts or tree nuts 3
    • Cow’s milk 3
    • Hen’s egg 3
  • Medication (34%) 10
    • Non-steroidal anti-inflammatories (NSAIDs) are responsible for 48.7–57.8% of incidents 7
    • Antibiotics 4
  • Insect sting (20%) 10
    • Bees, wasps, hornets, or yellow jackets 6
    • Fire ants 6

Symptoms

Symptoms may affect the skin, respiratory system mucosal system (tongue, lips, throat), gastrointestinal system, and cardiovascular system 1

  • 80-90% of patients report subjective or general symptoms and skin issues 5
  • 62% develop hives 5
  • 53% develop angioedema (swelling of the mucous membranes, such as the tongue, lips or throat) 5
  • 27% develop vomiting 5
  • 24% report nausea 5
  • 16% report abdominal pain or cramping 5
  • 5% develop diarrhea 5

 

Treatment of Anaphylaxis

  • Primary Treatment: Epinephrine should be the first treatment for anaphylaxis.  It should be administered as soon as symptoms develop, with the preferred method being intramuscular injection 8
  • Secondary Treatments – there is no substitute for epinephrine, but other treatments may help manage symptoms.  These may include:
    • H1 antihistamines such as cetirizine or diphenhydramine, though the latter may be more sedating.  These may help reduce itching and hives 8
    • H2 antihistamines such as ranitidine or famotidine may be used in conjunction with an H1 antihistamine to reduce symptoms 8
    • Bronchodilators such as albuterol may help in individuals experiencing bronchospasm 8
    • Glucocorticoids have been commonly given, but there is little evidence that these are beneficial 8
  • Supportive Treatment:  Focus is to manage airway, breathing and circulation. These may include:
    • Positioning to provide circulation to vital organs while ensuring airway is maintained 8
    • Supplemental oxygen 8
    • Insertion of intravenous catheters which can be used to administer medication and fluids 8
    • Monitoring of heart rate, blood pressure, respirations, oxygen level 8
    • Maintaining airway, which may require intubation 8
    • Cardiopulmonary resuscitation (CPR) when necessary 8

Anaphylaxis Morbidity & Mortality

  • Most people report more 2 or more prior episodes of anaphylaxis 10
  • 19% report more than 5 episodes 10
  • 42% sought treatment within 15 minutes of the onset of symptoms 10
  • 34% went to the hospital 10
  • 27% treated themselves with antihistamines 10
  • 11% self-administered epinephrine 10
  • 10% called 911 10
  • The fatality rate for an anaphylactic reaction in the United States is about 0.3% 10

School Children & Anaphylaxis

  • Approximately 10% of schools reported anaphylactic events in the 2013-2014 school year 12
    • 44.9% occurred in high school students 12
    • 18.9% occurred in middle school students 12
    • 32.5% in elementary school students 12
    • 22% of events were in students with no known allergies 12
    • Food is the most common trigger (60%) 12
    • Unknown trigger in 21.6% of cases 12
  • All 50 states permit students to carry and self-administer epinephrine 12
  • Many schools provide training on identifying anaphylaxis:
    • 37.3% for the school nurse and select staff 12
    • 30.4% provided training for all staff 12
    • 28.2% for most staff 12
    • 2.0% for only the school nurse 12
  • Schools often limit who can administer epinephrine:
    • 55% school nurse and select trained staff 12
    • 21.5% all staff 12
    • 15.6% most staff 12
    • 3% school nurse only 12

Economic Burden of Anaphylaxis

  • The direct costs associated with anaphylaxis are $1.2 billion annually 13
    • $294 million for epinephrine alone 13
  • Indirect costs associated with anaphylaxis are $609 million annually 13

Includes loss of work productivity 13

References

  1. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/2015-Anaphylaxis-PP-Update.pdf
  2. https://onlinelibrary.wiley.com/doi/10.1111/all.12437 (3/21/20)
  3. https://onlinelibrary.wiley.com/doi/10.1111/all.12272 (3/21/20)
  4. https://www.researchgate.net/profile/Alberto_Alvarez-Perea2/publication/281311091_Anaphylaxis_in_AdolescentAdult_Patients_Treated_in_the_Emergency_Department_Differences_Between_Initial_Impressions_and_the_Definitive_Diagnosis/links/564aee2908ae44e7a28e41b0/Anaphylaxis-in-Adolescent-Adult-Patients-Treated-in-the-Emergency-Department-Differences-Between-Initial-Impressions-and-the-Definitive-Diagnosis.pdf (3/21/20)
  5. https://www.researchgate.net/profile/Alberto_Alvarez-Perea2/publication/281311091_Anaphylaxis_in_AdolescentAdult_Patients_Treated_in_the_Emergency_Department_Differences_Between_Initial_Impressions_and_the_Definitive_Diagnosis/links/564aee2908ae44e7a28e41b0/Anaphylaxis-in-Adolescent-Adult-Patients-Treated-in-the-Emergency-Department-Differences-Between-Initial-Impressions-and-the-Definitive-Diagnosis.pdf (3/21/20)
  6. https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/Insect-hypersensitivity-2011.pdf (3/15/20)
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5446992/ (3/15/20)
  8. https://www.uptodate.com/contents/anaphylaxis-emergency-treatment (3/21/20)
  9. https://www.ncbi.nlm.nih.gov/pubmed?term=22513951 (3/21/20)
  10. https://www.ncbi.nlm.nih.gov/pubmed/24144575 (3/21/20)
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972293/ (3/21/20)
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314730/ (3/21/20)
  13. https://www.ingentaconnect.com/content/ocean/aap/2012/ 00000033/00000004/art00012;jsessionid=203st4xj13im5.x-ic-live-01

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