Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Rate of severe reactions higher than thought in young children with food allergies

26.06.2012
NIH-funded study finds some caregivers unsure about when to give epinephrine

Young children with allergies to milk and egg experience reactions to these and other foods more often than researchers had expected, a study reports. The study also found that severe and potentially life-threatening reactions in a significant number of these children occur and that some caregivers are hesitant to give such children epinephrine, a medication that reverses the symptoms of such reactions and can save lives.

"This study reinforces the importance of doctors, parents and other caregivers working together to be even more vigilant in managing food allergy in children," said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The study results appear online in the June 25 issue of Pediatrics and are the latest findings from the Consortium of Food Allergy Research (CoFAR), a network established by NIAID to conduct clinical trials, observational studies and basic research to better understand and treat food allergy.

The research is part of an ongoing CoFAR observational study that enrolled 512 infants aged 3 to 15 months who at study entry were allergic to milk or egg, or who were likely to be allergic, based on a positive skin test and the presence of moderate-to-severe eczema, a chronic skin condition. The investigators are carefully following these children to see whether their allergies resolve or if new allergies, particularly peanut allergy, develop. The study is ongoing at research hospitals in Baltimore; Denver; Durham, N.C.; Little Rock, Ark.; and New York City.

CoFAR investigators advised parents and caregivers to avoid giving their children foods that could cause an allergic reaction. Study participants also received an emergency action plan, describing the symptoms of a severe allergic reaction to food and what to do if a child has one, along with a prescription and instructions on how to give epinephrine if a severe reaction occurred.

Data compiled from patient questionnaires and clinic visits over three years showed that 72 percent of the children had a food-allergic reaction, and that 53 percent of the children had more than one reaction, with the majority of reactions being to milk, egg or peanut. This translated into a rate of nearly 1 food-allergic reaction per child per year. Approximately 11 percent of the reactions were classified as severe and included symptoms such as swelling in the throat, difficulty breathing, a sudden drop in blood pressure, dizziness or fainting. Almost all of the severe reactions were caused by ingestion of the allergen rather than inhalation or skin contact.

In only 30 percent of the severe reactions did caregivers administer epinephrine, a drug that alleviates the symptoms of severe reactions by increasing heart rate, constricting blood vessels and opening the airways. Investigators found that caregivers did not give children epinephrine for a number of reasons: the drug was not available, they were too afraid to administer it, they did not recognize the symptoms as those of an allergic reaction, or they did not recognize the reaction as severe.

"This study documenting the natural history of allergic reactions to three of the major food allergens in pre-school children provides important new information for parents, caregivers and health care workers because of the large number of children involved and the rigorous follow-up," said Daniel Rotrosen, M.D., director of the NIAID Division of Allergy, Immunology and Transplantation, which oversees CoFAR. "The findings not only reveal that food-allergic reactions occur at a much higher rate in young children than we thought, they also suggest that more vigilance and increased use of epinephrine is needed."

Almost 90 percent of allergic reactions to egg, milk or peanut occurred after a child accidentally ate the food. The reasons for the accidental exposures included caregivers misreading food labels, not checking a food for an allergen, and unintentionally allowing a food allergen to come into contact with other foods (cross-contamination).

The study also found that approximately 11 percent of allergic reactions to egg, milk or peanut occurred after a caregiver—most often a parent—provided a child the allergenic food intentionally.

"Intentional exposures to allergenic food are typically reported in teenagers, who tend to take more risks or who might be embarrassed about their food allergy," says David Fleischer, M.D., the lead study author. "What is troubling is that in this study we found that a significant number of young children received allergenic foods from parents who were aware of the allergy."

CoFAR investigators are exploring possible reasons for these intentional exposures, but they speculate that it could reflect parents' at-home tests to determine if children have outgrown the food allergy. Because giving children allergenic foods could possibly result in life-threatening reactions, such testing should only be conducted under the direct supervision of a health care professional trained in performing food challenges. The study findings reinforce the importance of caregivers working closely with their doctors to understand how to effectively manage a child's food allergy.

This work was funded by NIH, NIAID under grant numbers U19AI066738 and U01AI066560, and the National Center for Research Resources and the National Center for Advancing Translational Sciences, NIH, under grant numbers UL1RR025780, UL1RR029887, UL1RR029884, UL1RR024128 and UL1RR025005. The clinicaltrials.gov identifier for An Observational Study of Childhood Food Allergy is NCT00356174.

Parents and caregivers are encouraged to view the patient-friendly synopsis of the U.S. food allergy guidelines, which summarizes the most important information from the guidelines published on Dec. 6, 2010 and provides a starting point for doctor-patient conversations about food allergy. For additional free resources, visit NIAID's Food Allergy Web portal.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website at http://www.niaid.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH...Turning Discovery Into Health

Reference: Fleischer DM et al. Allergic reactions to foods in preschool children enrolled in a prospective observational food allergy study. Pediatrics. DOI: 10.1542/peds.2011-1746 (2012).

Julie Wu | EurekAlert!
Further information:
http://www.niaid.nih.gov
http://www.nih.gov

More articles from Health and Medicine:

nachricht The genes are not to blame
20.07.2018 | Technische Universität München

nachricht Targeting headaches and tumors with nano-submarines
20.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Future electronic components to be printed like newspapers

A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.

The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

A smart safe rechargeable zinc ion battery based on sol-gel transition electrolytes

20.07.2018 | Power and Electrical Engineering

Reversing cause and effect is no trouble for quantum computers

20.07.2018 | Information Technology

Princeton-UPenn research team finds physics treasure hidden in a wallpaper pattern

20.07.2018 | Materials Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>