Anaphylaxis in Children: Epidemiology, Risk Factors and Management

Anaphylaxis is defined as a serious, generalized or systemic allergic reaction that is rapid in onset and may cause death. It is unpredictable and can be the result of various allergic triggers including food, insect venom and medication. The European Anaphylaxis Registry confirmed food as the major elicitor of anaphylaxis in children, specifically hen's egg, cow's milk and nuts.

It has been reported that the incidence of anaphylaxis is on the rise. In the US, there is a continued trend of increasing food-induced anaphylaxis hospitalizations among children, which is supported by nationally representative data.

Anaphylaxis can occur both in the home and outdoors and can be life-threatening, however, fatalities are a rare occurrence. A recent systematic review and meta-analysis reported that fatal food anaphylaxis is rarer than accidental death in the general population. Studies of fatal and near-fatal allergic reactions have identified potential risk factors for fatalities and have provided important information that may help minimize future risk. Following confirmation of the relevant allergen trigger, prevention of anaphylaxis is through strict avoidance of the allergen and optimal management of existing co-morbidities. The cornerstone in the successful management of anaphylaxis is early recognition of signs and symptoms and the prompt administration of intramuscular adrenaline.

Patients and their families need to be well educated on how to manage potential anaphylactic reactions with training in the use of adrenaline auto-injectors and personalized emergency management plans. Healthcare professionals must be familiar with this clinical emergency and able to respond to anaphylaxis in a timely and appropriate manner.