Kaneko Mitsunobu, Miyoshi Tomoko, Miyashita Yoshihiro, Hayashi Riku, Hashimoto Takuji
Kaneko Clinic, Kanagawa, Japan.
The Department of Nursery Health Administration in Kawasaki Branch of Japan Medical Association, Kawasaki city, Kanagawa, Japan.
Asia Pac Allergy. 2022 Oct 17;12(4):e34. doi: 10.5415/apallergy.2022.12.e34. eCollection 2022 Oct.
As food allergy potentially can induce life-threatening anaphylaxis, measures for food allergy are required at nurseries caring for food allergy children, but a large-scale factual investigation has not been carried out.
We evaluated measures for food allergy emergency in nurseries.
A questionnaire survey regarding emergency measures in all authorized nurseries (411 facilities including 20,586 children) was conducted in Kawasaki city, Japan.
The recovery rate of the questionnaire was 46.5%, which include 14,343 children of 191 facilities in total. A total of 637 children (4.4%) in 157 facilities (82.2%) requires elimination diets that were suggested by physicians. Among them, 22 children had been suggested to undergo the use of epinephrine auto-injection kit for emergency. 161 facilities (84.3%) had set a specific manual for emergency of food allergy. Emergency cases over the past one year were 4 cases and there was no case that had been suggested to use epinephrine auto-injection kit. All were anaphylaxis and the causes of these included 2 accidental digestion of culprit foods and the causes of other 2 cases were unknown. A case who required no elimination diet showed first episode of anaphylaxis. All cases were recovered.
High percentage of nurseries in Kawasaki city has cared for food allergy children. While many children with food allergy have been in nurseries, only several cases of anaphylaxis have been reported for a 1 year. Among 4 cases of anaphylaxis, no specific cause has been recognized in 2 cases and 1 case has been the first episode of anaphylaxis. While most of nurseries have set specific measures for emergency of food allergy, there is certain possibility that nursery staffs can encounter the first episode of anaphylaxis even if there is no food allergy child. For all nurseries, emergency measures for food allergy are vital.
由于食物过敏可能诱发危及生命的过敏反应，在照顾食物过敏儿童的托儿所需要采取应对食物过敏的措施，但尚未开展大规模的实际调查。
我们评估了托儿所应对食物过敏紧急情况的措施。
在日本川崎市对所有授权托儿所（411所设施，包括20586名儿童）进行了关于应急措施的问卷调查。
问卷回收率为46.5%，共涉及191所设施的14343名儿童。157所设施（82.2%）中的637名儿童（4.4%）需要接受医生建议的排除饮食。其中，22名儿童被建议使用肾上腺素自动注射笔应急。161所设施（84.3%）制定了食物过敏应急的具体手册。过去一年的紧急情况有4例，且没有建议使用肾上腺素自动注射笔的情况。所有病例均为过敏反应，其原因包括2例因意外摄入致敏食物，另外2例原因不明。1例无需排除饮食的病例出现了首次过敏反应。所有病例均康复。
川崎市高比例的托儿所照顾过食物过敏儿童。虽然许多食物过敏儿童在托儿所，但1年期间仅报告了几例过敏反应。在4例过敏反应中，2例未发现具体原因，1例为首次过敏反应。虽然大多数托儿所制定了食物过敏应急的具体措施，但即使没有食物过敏儿童，托儿所工作人员也有可能遇到首次过敏反应情况。对所有托儿所而言，食物过敏应急措施至关重要。
