Very low frequency of latex and fruit allergy in patients with spina bifida from Venezuela: influence of socioeconomic factors.

BACKGROUND

The prevalence of latex allergy appears to be substantially higher in certain high risk groups, particularly in children with spina bifida. The source of this increase is presently unknown and may be due either to increased infantile exposure or to an intrinsic predilection for atopy in this condition.

OBJECTIVE

We attempted to ascertain the prevalence of latex and tropical fruit allergy in children of lower socioeconomic strata with spina bifida from Caracas, Venezuela, who have limited operative and other medical exposure to latex.

METHODS

Ninety-three unselected patients with spina bifida from clinic and hospital populations were prick tested with commercial (Stallergenes-Pasteur) latex extract and crude glove (Baxter-Triflex, 1/5 wt/vol) latex extract as well as with standardized mite and cockroach, 1/10 wt/vol, extracts (Hollister-Stier). An array of tropical fruits were also included in the battery of skin test materials, using the prick by prick method. Careful family and personal history for allergy as well as any reactions to rubber products were noted, placing emphasis on intraoperative anaphylaxis, number of operations and use of bladder catheters.

RESULTS

Only four patients of the 93 skin tested (4.3%) were positive to latex. Atopy was not a predisposing factor for latex allergy and neither was the number of surgical interventions. No fruit allergy was found in this population and three of the four skin test-positive patients had facial angioedema when exposed to balloons.

CONCLUSIONS

The very low incidence of latex allergy found in our patients with spina bifida could very well be due to a low level of rubber exposure as best exemplified in the use of nonlatex bladder catheters, frequently washed and resterilized surgeon's gloves, and low number of operations per patient. The fact that atopy was no more prevalent in children with spina bifida than in the general population in Venezuela strongly supports exposure level as the major factor determining latex sensitization.