Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Poirot); and New York City Department of Health and Mental Hygiene, New York, New York (Drs Poirot, Gould, and Hadler and Mr He).
J Public Health Manag Pract. 2020 Nov/Dec;26(6):548-556. doi: 10.1097/PHH.0000000000001137.
Food-induced anaphylaxis is potentially fatal but preventable by allergen avoidance and manageable through immediate treatment. Considerable effort has been invested in preventing fatalities from nut exposure among school-aged children, but few population-based studies exist to guide additional prevention efforts.
To describe the epidemiology and trends of food-related anaphylaxis requiring emergency treatment during a 15-year span in New York City when public health initiatives to prevent deaths were implemented and to understand the situational circumstances of food-related deaths.
DESIGN/SETTING/PARTICIPANTS: Retrospective death record review and analysis of inpatient hospital discharges and emergency department (ED) visits in New York City residents, 2000-2014.
Vital statistics data, medical examiner reports, ED, and hospital discharge data were used to examine risk for death and incidence trends in medically attended food-related anaphylaxis. Potentially preventable deaths were those among persons with a known allergy to the implicated food or occurring in public settings.
There were 24 deaths, (1.6 deaths/year; range: 0-5), 3049 hospitalizations, and 4014 ED visits, including 7 deaths from crustacean, 4 from peanut, and 2 each from tree nut or seeds and fish exposures. Risk for death among those hospitalized or treated in the ED was highest for persons older than 65 years and for those treated for crustacean reactions (relative risk 6.5 compared with those treated for peanuts, 95% confidence interval = 1.9-22.1). Eleven of 16 deaths with medical examiner data were potentially preventable. Hospitalizations (2000-2014) and ED visit rates (2005-2014) were highest for children and those with peanut exposure and increased across periods.
Deaths from food-related anaphylaxis were rare; however, rates of hospitalization and ED visits increased. Prevention efforts related to peanut allergies among children should continue, and additional attention is needed to prevent and treat anaphylaxis among adults, particularly those with known crustacean allergies where case fatality is highest.
食物诱发的过敏反应可能致命，但通过过敏原回避和及时治疗可以预防。在学龄儿童中，为防止坚果暴露导致死亡，已经投入了大量的精力，但很少有基于人群的研究来指导额外的预防措施。
描述纽约市 15 年间发生的需要紧急治疗的食物相关过敏反应的流行病学和趋势，在此期间，公共卫生部门采取了预防死亡的措施，并了解食物相关死亡的情况。
设计/地点/参与者：回顾性死亡记录审查，并对 2000 年至 2014 年纽约市居民的住院患者和急诊部（ED）就诊进行分析。
使用生命统计数据、法医报告、ED 和医院出院数据，检查与医疗相关的食物过敏反应的死亡风险和发病趋势。潜在可预防的死亡是指那些对所涉及的食物有已知过敏史或发生在公共场所的人。
有 24 人死亡（1.6 人/年；范围：0-5），3049 人住院，4014 人 ED 就诊，包括 7 人死于甲壳类动物，4 人死于花生，2 人死于坚果或种子，2 人死于鱼类。在住院或 ED 治疗的人中，年龄超过 65 岁和因甲壳类动物反应而治疗的人死亡风险最高（相对风险 6.5，95%置信区间=1.9-22.1）。有医疗鉴定数据的 16 例死亡中有 11 例是潜在可预防的。住院率（2000-2014 年）和 ED 就诊率（2005-2014 年）在儿童和花生暴露者中最高，并在各个时期有所增加。
食物相关过敏反应导致的死亡很少见；然而，住院和 ED 就诊率增加了。应继续针对儿童花生过敏进行预防工作，并且需要额外关注预防和治疗成人过敏反应，特别是那些有已知甲壳类动物过敏史的成人，因为他们的病死率最高。
