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Accidental exposures to peanut in a large cohort of Canadian children with peanut allergy.

Cherkaoui S, Ben-Shoshan M, Alizadehfar R, Asai Y, Chan E, Cheuk S, Shand G, St-Pierre Y, Harada L, Allen M, Clarke A - Clin Transl Allergy (2015)

Bottom Line: Children with physician-confirmed peanut allergy were recruited from Canadian allergy clinics and allergy advocacy organizations from 2004 to May 2014.Age ≥ 13 years at study entry and living with a single parent increased the risk.Consequently, more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, University of Montreal, Montreal, QC Canada.

ABSTRACT

Background: We previously estimated that the annual rate of accidental exposure to peanut in 1411 children with peanut allergy, followed for 2227 patient-years, was 11.9% (95% CI, 10.6, 13.5). This cohort has increased to 1941 children, contributing 4589 patient-years, and we determined the annual incidence of accidental exposure, described the severity, management, location, and identified associated factors.

Findings: Children with physician-confirmed peanut allergy were recruited from Canadian allergy clinics and allergy advocacy organizations from 2004 to May 2014. Parents completed questionnaires regarding accidental exposure to peanut over the preceding year. Five hundred and sixty-seven accidental exposures occurred in 429 children over 4589 patient-years, yielding an annual incidence rate of 12.4% (95% CI, 11.4, 13.4). Of 377 accidental exposures that were moderate or severe, only 109 (28.9%) sought medical attention and of these 109, only 40 (36.7%) received epinephrine. Of the 181 moderate/severe accidental exposures treated outside a health care facility, only 11.6% received epinephrine. Thirty-seven percent of accidental exposures occurred at home. In multivariate analyses, longer disease duration, recruitment through an allergy advocacy association, and having other food allergies decreased the likelihood of accidental exposures. Age ≥ 13 years at study entry and living with a single parent increased the risk.

Conclusion: Despite increased awareness, accidental exposures continue to occur, mainly at home, and most are managed inappropriately by both health care professionals and caregivers. Consequently, more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.

No MeSH data available.


Related in: MedlinePlus

Annual incidence rate of accidental exposure stratified by disease duration.
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Fig1: Annual incidence rate of accidental exposure stratified by disease duration.

Mentions: Five hundred and sixty-seven AEs occurred in 429 children over 4589 patient-years, yielding an annual incidence rate of 12.4% (95% CI, 11.4, 13.4). Figure 1 depicts these AEs stratified by disease duration. The rate was similar when those with one mild symptom or no previous exposure and positive confirmatory tests were excluded (n remaining = 1767; rate of AE: 13.3%, 95% CI, 12.2, 14.4) and when only those with a positive food challenge, history of anaphylaxis, or a convincing history and a SPT ≥ 8 mm or a peanut-specific IgE ≥ 15 kU/L were included (n = 1541; rate of AE: 13.5% CI 12.4, 14.8).Figure 1


Accidental exposures to peanut in a large cohort of Canadian children with peanut allergy.

Cherkaoui S, Ben-Shoshan M, Alizadehfar R, Asai Y, Chan E, Cheuk S, Shand G, St-Pierre Y, Harada L, Allen M, Clarke A - Clin Transl Allergy (2015)

Annual incidence rate of accidental exposure stratified by disease duration.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389801&req=5

Fig1: Annual incidence rate of accidental exposure stratified by disease duration.
Mentions: Five hundred and sixty-seven AEs occurred in 429 children over 4589 patient-years, yielding an annual incidence rate of 12.4% (95% CI, 11.4, 13.4). Figure 1 depicts these AEs stratified by disease duration. The rate was similar when those with one mild symptom or no previous exposure and positive confirmatory tests were excluded (n remaining = 1767; rate of AE: 13.3%, 95% CI, 12.2, 14.4) and when only those with a positive food challenge, history of anaphylaxis, or a convincing history and a SPT ≥ 8 mm or a peanut-specific IgE ≥ 15 kU/L were included (n = 1541; rate of AE: 13.5% CI 12.4, 14.8).Figure 1

Bottom Line: Children with physician-confirmed peanut allergy were recruited from Canadian allergy clinics and allergy advocacy organizations from 2004 to May 2014.Age ≥ 13 years at study entry and living with a single parent increased the risk.Consequently, more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.

View Article: PubMed Central - PubMed

Affiliation: Division of Allergy and Clinical Immunology, Department of Medicine, University of Montreal, Montreal, QC Canada.

ABSTRACT

Background: We previously estimated that the annual rate of accidental exposure to peanut in 1411 children with peanut allergy, followed for 2227 patient-years, was 11.9% (95% CI, 10.6, 13.5). This cohort has increased to 1941 children, contributing 4589 patient-years, and we determined the annual incidence of accidental exposure, described the severity, management, location, and identified associated factors.

Findings: Children with physician-confirmed peanut allergy were recruited from Canadian allergy clinics and allergy advocacy organizations from 2004 to May 2014. Parents completed questionnaires regarding accidental exposure to peanut over the preceding year. Five hundred and sixty-seven accidental exposures occurred in 429 children over 4589 patient-years, yielding an annual incidence rate of 12.4% (95% CI, 11.4, 13.4). Of 377 accidental exposures that were moderate or severe, only 109 (28.9%) sought medical attention and of these 109, only 40 (36.7%) received epinephrine. Of the 181 moderate/severe accidental exposures treated outside a health care facility, only 11.6% received epinephrine. Thirty-seven percent of accidental exposures occurred at home. In multivariate analyses, longer disease duration, recruitment through an allergy advocacy association, and having other food allergies decreased the likelihood of accidental exposures. Age ≥ 13 years at study entry and living with a single parent increased the risk.

Conclusion: Despite increased awareness, accidental exposures continue to occur, mainly at home, and most are managed inappropriately by both health care professionals and caregivers. Consequently, more education is required on the importance of strict allergen avoidance and the need for prompt and correct management of anaphylaxis.

No MeSH data available.


Related in: MedlinePlus