Big rise in hospital visits for kids with allergic reactions

"Our findings suggest a worrisome increase in anaphylaxis rate that is consistent with the world-wide reported increase," says Moshe Ben-Shoshan. (Credit: iStockphoto)

A hospital in Montreal saw the number of emergency department visits by children with a serious allergic reaction, known as anaphylaxis, double between 2011 and 2015.

“With the rising rates of allergies among Canadian children, we were interested in determining if anaphylaxis rates are also increasing,” says Moshe Ben-Shoshan, who is a pediatric allergist and immunologist at the Montreal Children’s Hospital of the MUHC (MCH-MUHC) and an assistant professor of pediatrics at McGill University.

“Our findings suggest a worrisome increase in anaphylaxis rate that is consistent with the world-wide reported increase.”

Anaphylaxis can occur within seconds or minutes of exposure to an allergen, which can include certain foods, medications, insect venom or latex, for example. The allergic response is marked by swelling, hives, lowered blood pressure, and dilated blood vessels. In severe cases, the reaction can be life-threatening.”

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The researchers collected data from 965 anaphylaxis cases seen at the MCH-MUHC between April 2011 and April 2015, as part of the nationwide Cross-Canada Anaphylaxis Registry (C-CARE)—the first prospective study on anaphylaxis to assess the rate, triggers and management of anaphylaxis in different provinces and settings across Canada.

Anaphylaxis was defined in the study as the involvement of two organ systems and/or hypotension in response to a potential allergen.

The study shows that between 2011 and 2015, the annual percentage of ED visits to the MCH-MUHC due to anaphylaxis rose from 0.20 percent to 0.41 percent, with the largest annual increase between 2013-14 and 2014-15.

Auto-injectors are underused

The team also observed that the majority (80.2 percent) of anaphylaxis cases were triggered by food, principally peanut and tree nut, and that children who did not receive epinephrine prior to arrival at the ED were more likely to receive multiple (two or more) doses of epinephrine at the hospital.

The underuse of epinephrine auto-injectors was also highlighted in the research.

“Only slightly more than half of those who had an auto-injector used it prior to arrival in the emergency department,” adds Elana Hochstadter, the study’s lead author, who was a pediatric resident at the Children’s Hospital at London Health Sciences Centre at the time of the study. “This increased the risk of administration of multiple epinephrine doses in hospital, therefore, it is of critical importance for parents and healthcare providers to work together to ensure the appropriate and timely use of epinephrine auto-injectors in the case of anaphylactic reactions.”

The findings appear in the in Journal of Allergy and Clinical Immunology.

This research was made possible by funding from AllerGen NCE Inc., Health Canada and Sanofi. The study involved a team of researchers from the McGill University Health Centre, the University of Calgary, the Children’s Hospital at London Health Sciences Centre, and Health Canada.

Source: McGill University