Frequency
United States
The true incidence of anaphylaxis is unknown, partly because of the lack of a precise definition of the syndrome. Some clinicians reserve the term for the full-blown syndrome, while others use it to describe milder cases. Fatal anaphylaxis is relatively rare; milder forms occur much more frequently. The frequency of anaphylaxis is increasing, and this has been attributed to the increased number of potential allergens to which people are exposed. Up to 500-1000 fatal cases of anaphylaxis per year are estimated to occur in the United States. A recent review concluded that the lifetime prevalence of anaphylaxis is 1-2% of the population as a whole.2
The incidence of anaphylaxis appears to be increasing, especially cases in children attributed to food allergy.
International
Reactions to insects and other venomous plants and animals are more prevalent in tropical areas because of the greater biodiversity in these areas.
Exposure and therefore reactions to medications are more common in industrialized areas.
"There has been a marked increase in community concerns of the risk of food induced anaphylaxis in children and a consequent increase in the provision of the self or carer injectable epinephrine (EpiPen) (CSL Ltd, Parkville, Victoria, Australia)). The Australian use of EpiPens in children under 10 years has increased by 300% over 5 years with a crude rate of EpiPen provision of 1 per 544 Australian children aged under 10 years. However, the risk of a fatal reaction to food, particularly in preschool children, is remote (in Australia, an estimated one fatality in 30 years in the under 5-year-old population and two deaths in 10 years in the entire child population)."
"Recently media commentators have cast doubt on the seriousness of food allergies and the number of deaths from these reactions. These reports show us that we still have a lot of work to do to educate others about food allergies. The bottom line: there is no effort to exaggerate or inflate the numbers as at least one critic would have you believe. We agree with the concern that we still lack the most precise accurate data for the number of allergic reactions and tragic deaths."
"While 3.3 million Americans are allergic to peanuts or tree nuts, 6.9 million are allergic to seafood. Combined, food allergies cause 30,000 cases of anaphylaxis, 2,000 hospitalizations, and 150 deaths annually."
"Although the risk of death from food allergies may be small, parents and physicians should not be lulled into a false sense of security regarding the potential severity of adverse reactions to foods. Concomitant asthma places patients with food allergy at particular risk of a severe reaction. Although some foods more commonly cause severe reactions, it is important to note that any food theoretically can cause a severe life-threatening reaction, and the fact that milk caused more food-related deaths than peanut in this study emphasizes this point. The authors also mention that early epinephrine use may not prevent death, but it is still the general consensus that early and proper use of epinephrine in severe food reactions is associated with a better prognosis."
"Eight children under the age of 16 died from food allergy between 1990 and 2000 in the UK.* That’s one death for every 16 million children each year. Even amongst children who have a food allergy, the risk of death is still low. Working on the principle that about 5% of children have food allergy, which means there’s one death for every 830,000 children who suffer from a food allergy. No child younger than 13 died from eating peanuts in the period in question"
"It may surprise you that we think the risk that a pre-teenage child with nut allergy will have a fatal reaction is so small that the wisdom of supplying adrenaline syringes for them is highly questionable. For the whole of the USA we are currently aware of only three such deaths over many years, far fewer than from a huge variety of other causes. Both in Britain and in the USA children's specialists working on nut allergy are trying hard to establish the facts, and it seems likely that when we are more certain about the facts we will be able to be much more reassuring about nut allergy in the youngest age groups. Of course the simple fact is that anyone who is alive has a risk of dying. If it turns out that the risk from nut allergy is much smaller than the risk from a number of other everyday things, our efforts would be much more sensibly devoted to those other risks. No drug is entirely harmless, and adrenaline (epinephrine) injections carry slight risks of their own. If the risk from nuts is low enough, it will be outweighed by the risks of giving adrenaline."
Information risks factors.