Background
Anaphylaxis is a recognized public health issue. There is no doubt that food‐induced anaphylaxis (FIA) has tremendous impact on the quality of life of patients and their families and ...increases direct and indirect costs. FIA is associated with increasing rates of emergency department admissions and hospitalizations and implies the risk of death. Morbidity epidemiological data are a key to tailor public health actions to this non‐communicable disease. The aim of this article was to review published morbidity epidemiological data relating to FIA and potential risk factors, in order to provide evidence‐based recommendations to reduce the risk of severe adverse outcomes.
Methods
We identified published studies available in PUBMED/MEDLINE (1966–2020), EMBASE (1980–2020) and CINAHL (1982–2020). The systematic review was carried out using MeSH terms related to FIA ED admissions and hospitalizations.
Results
A total of 25 articles were selected, 80% published in the last 5 years. After critical analysis of methodological and clinical characteristics reported in the data selected, we were able to propose preventive strategies.
Conclusion
Anaphylaxis is a recognized public health issue. FIA is associated with increasing rates of ED admissions and hospitalizations and imply in risk of death. More than reviewing and critically interpreting the key patterns related to FIA morbidity published data, we proposed strategies in order to promote quality care of patients suffering from FIA. Our World Health Organization Collaborative Center is deeply involved in this process, and we believe that the proposed strategies will inform future healthcare policies on anaphylaxis. The long‐term objective would be to improve clinical care and quality of life of patients and their families, and develop risk‐stratified, cost‐effective preventive measures.
Anafilaxia por alimentos Rojo-Gutiérrez, María Isabel; Valentin Rostan, Marylin; Latour Staffeld, Patricia ...
Revista alergia Mexico (Tecamachalco, Pueblo, Mexico : 1993),
12/2023, Volume:
70, Issue:
4
Journal Article
Peer reviewed
Open access
La anafilaxia, una reacción potencialmente mortal, se caracteriza por la aparición aguda de síntomas que afectan diversos sistemas y requiere intervención médica inmediata. Aunque la tasa de ...mortalidad general es baja, la anafilaxia inducida por alimentos y fármacos ha experimentado un aumento. Los alimentos, fármacos y veneno de himenópteros son desencadenantes comunes. La epidemiología varía según la región y la edad, con una incidencia global de 50-112 episodios anuales por cada 100,000 personas. Los alimentos más implicados varían según la edad y la región, y los desencadenantes más comunes son cacahuetes y nueces. Se reconocen dos mecanismos de anafilaxia: mediado por IgE y no mediado por IgE. El diagnóstico se basa en criterios clínicos y niveles de triptasa sérica. El tratamiento incluye epinefrina, oxígeno y líquidos intravenosos. Se aborda la anafilaxia inducida por ejercicio dependiente de alimentos, donde el ejercicio, en combinación con ciertos alimentos, desencadena reacciones anafilácticas. La comprensión y el manejo adecuados son cruciales para mitigar riesgos.
Latin American anaphylaxis registry Jares, Edgardo J.; Cardona, Victoria; Gómez, R. Maximiliano ...
The World Allergy Organization journal,
02/2023, Volume:
16, Issue:
2
Journal Article
Peer reviewed
Open access
Recent data about clinical features, triggers and management of anaphylaxis in Latin America is lacking.
To provide updated and extended data on anaphylaxis in this region.
An online questionnaire ...was used, with 67 allergy units involved from 12 Latin-American countries and Spain. Among data recorded, demographic information, clinical features, severity, triggering agents, and treatment were received.
Eight hundred and seventeen anaphylactic reactions were recorded. No difference in severity, regardless of pre-existing allergy or asthma history was found. Drug induced anaphylaxis (DIA) was most frequent (40.6%), followed by food induced anaphylaxis (FIA) (32.9%) and venom induced anaphylaxis (VIA) (12%). FIA and VIA were more common in children-adolescents. Non-steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics (BLA) were the most frequent drugs involved. Milk (61.1% of FIA) and egg (15.4% of FIA) in children, and shellfish (25.5% of FIA), fresh fruits (14.2% of FIA), and fish (11.3% of FIA) in adults were the most common FIA triggers. Fire ants were the most frequent insect triggers, and they induced more severe reactions than triggers of FIA and DIA (p < 0.0001). Epinephrine was used in 43.8% of anaphylaxis episodes. After Emergency Department treatment, epinephrine was prescribed to 13% of patients.
Drugs (NSAIDs and BLA), foods (milk and egg in children and shellfish, fruits and fish in adults) and fire ants were the most common inducers of anaphylaxis. Epinephrine was used in less than half of the episodes emphasizing the urgent need to improve dissemination and implementation of anaphylaxis guidelines.
Climate change and global issues in allergy and immunology Pacheco, Susan E.; Guidos-Fogelbach, Guillermo; Annesi-Maesano, Isabella ...
Journal of allergy and clinical immunology,
December 2021, 2021-12-00, 20211201, 2021-12, Volume:
148, Issue:
6
Journal Article
Peer reviewed
Open access
The steady increase in global temperatures, resulting from the combustion of fossil fuels and the accumulation of greenhouse gases (GHGs), continues to destabilize all ecosystems worldwide. Although ...annual emissions must be halved by 2030 and reach net zero by 2050 to limit some of the most catastrophic impacts associated with a warming planet, the world’s efforts to curb GHG emissions fall short of the commitments made in the 2015 Paris Agreement. To this effect, July 2021 was recently declared the hottest month ever recorded in 142 years. The ramifications of these changes for global temperatures are complex and further promote outdoor air pollution, pollen exposure, and extreme weather events. Besides worsening respiratory health, air pollution promotes atopy and susceptibility to infections. The effects of GHGs on pollen affect the frequency and severity of asthma and allergic rhinitis. Changes in temperature, air pollution, and extreme weather events exert adverse multisystemic health effects and disproportionally affect disadvantaged and vulnerable populations. This review article is an update for allergists and immunologists about the health impacts of climate change that are already evident in our daily practices. It is also a call to action and advocacy, including to integrate climate change–related mitigation, education, and adaptation measures to protect our patients and avert further injury to our planet.
Anaphylaxis is a severe allergic reaction with a rapid onset and it is potentially life-threatening. Its clinical manifestations are varied; they may affect the skin, the cardiovascular system, the ...respiratory system, and the digestive system, among others. The treatment of choice, which is an intra-muscular injection of epinephrine (adrenaline), must be applied promptly. Therefore, being prepared to recognize it properly is of crucial importance. The objective of this clinical practice guide is to improve the knowledge of health professionals about anaphylaxis and, consequently, to optimize the treatment and long-term management of this reaction. This guide is adapted to the peculiarities of Latin America; especially in matters regarding the treatment. The need to introduce epinephrine auto-injectors in countries that don't have them yet is highlighted.
Anaphylaxis is a systemic and severe allergic reaction, which can be fatal. The first-line treatment of choice, according to international guidelines, is intramuscular adrenaline. However, different ...studies show that the performance of health professionals managing anaphylaxis is often inadequate.
To assess the current resources available in Latin American countries for the diagnosis and treatment of anaphylaxis.
Online survey promoted by the Latin American Society of Allergy and Immunology to representatives of the national allergy societies of Latin American countries.
Responses were received from 10 countries out of the 14 countries invited to participate. Only five of the countries have clinical practice guidelines in anaphylaxis. Adrenaline autoinjectors are available only in two countries, Argentina and Brazil, but are not subsidized by public health systems. In all countries, adrenaline is available in ampoules, which is the presentation usually prescribed to patients for self-administration. The use of adrenaline was estimated to be less than 50 % of cases in five countries, while antihistamines and corticosteroids are almost always used. The determination of serum tryptase is possible in some health centers, often private, in five of the countries surveyed.
It is necessary to improve resources related to the diagnosis and management of anaphylaxis in Latin American countries.
Anaphylaxis, a potentially life-threatening reaction, is characterized by acute symptoms affecting various systems and requires immediate medical intervention. While the overall mortality rate is ...low, anaphylaxis induced by foods and drugs has seen an increase. Common triggers include foods, drugs, and Hymenoptera venom. Epidemiology varies by region and age, with a global incidence of 50-112 episodes per 100,000 people annually. Implicated foods vary by age and region, with peanuts and nuts being common triggers. Two mechanisms of anaphylaxis are recognized: IgE-mediated and non-IgE-mediated. Diagnosis is based on clinical criteria and serum tryptase levels. Treatment includes epinephrine, oxygen, and intravenous fluids. Exercise-induced food-dependent anaphylaxis is addressed, where exercise, combined with certain foods, triggers anaphylactic reactions. Proper understanding and management are crucial to mitigate risks.
Drug hypersensitivity reactions (DHRs) to intravenous drugs can be severe and might leave patients and doctors in a difficult position where an essential treatment or intervention has to be ...suspended. Even if virtually any intravenous medication can potentially trigger a life-threatening DHR, chemotherapeutics, biologics, and antibiotics are amongst the intravenous drugs most frequently involved in these reactions. Admittedly, suspending such treatments may negatively impact the survival outcomes or the quality of life of affected patients.
Delabeling pathways and rapid drug desensitization (RDD) can help reactive patients stay on first-choice therapies instead of turning to less efficacious, less cost-effective, or more toxic alternatives. However, these are high-complexity and high-risk techniques, which usually need expert teams and allergy-specific techniques (skin testing, in vitro testing, drug provocation testing) to ensure safety, an accurate diagnosis, and personalized management. Unfortunately, there are significant inequalities within and among countries in access to allergy departments with the necessary expertise and resources to offer these techniques and tackle these DHRs optimally.
The main objective of this consensus document is to create a great benefit for patients worldwide by aiding allergists to expand the scope of their practice and support them with evidence, data, and experience from leading groups from around the globe.
This statement of the Drug Hypersensitivity Committee of the World Allergy Organization (WAO) aims to be a comprehensive practical guide on the technical aspects of implementing acute-onset intravenous hypersensitivity delabeling and RDD for a wide range of drugs. Thus, the manuscript does not only focus on clinical pathways. Instead, it also provides guidance on topics usually left unaddressed, namely, internal validation, continuous quality improvement, creating a healthy multidisciplinary environment, and redesigning care (including a specific supplemental section on a real-life example of how to design a dedicated space that can combine basic and complex diagnostic and therapeutic techniques in allergy).
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