Emergency room visits and hospitalizations of children with severe, potentially life-threatening food allergy reactions increased an average of nearly 30 percent per year over five years in Illinois, reports a Northwestern Medicine study.

Hispanic children, who previously had the lowest reported cases of food allergies, had the biggest increase of emergency room and hospitalizations overall with a 44 percent average annual rise.

The children in the study experienced anaphylaxis, which can include difficulty breathing, reduced blood pressure, loss of consciousness and potentially death.

“This study shows that severe food allergies are beginning to impact children of all races and income,” said lead study author Dr. Ruchi Gupta, a professor of pediatrics at Northwestern University Feinberg School of Medicine and an attending physician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “This is no longer primarily a disease of children who are white and/or from middle-to-high income families. Nobody is immune to it.”

The study included discharge data from 1,893 emergency room visits at about 200 Illinois hospitals from 2008 to 2012. It will be published June 26 in Annals of Allergy, Asthma & Immunology.

Previously, studies have shown the most affected children with food allergies were white or from higher-income families. Hispanic children and children from lower socioeconomic families were least affected, Gupta said. Scientists don’t know why some ethnicities/races and socioeconomic levels have been more susceptible to food allergies than others.

The study showed an average annual increase of 29.1 percent from 6.3 emergency department visits and hospital admissions per 100,000 children in 2008 to 17.2 emergency department visits and hospital admissions in 2012. Visits were most frequent each year for Asian children. However, the annual percent increase in visits was most pronounced among Hispanic children at 44.3 percent.

Visits by African American children rose an average of 28.1 percent annually with white children up 30.6 percent. The most common allergies causing emergency treatment for all populations were tree nuts, peanuts and milk.

“Ensuring timely diagnosis by the physician and education about recognition and management of severe and potentially fatal reactions is critical,” Gupta said. “We need targeted education to all families and public entities including schools, camps and restaurants because anaphylaxis can happen anywhere and at any time.”

Food allergy is a growing public health concern in the United States that affects an estimated 8 percent of children, according a 2011 study by Gupta. Nearly 40 percent of children with food allergy have a history of severe reactions that can lead to hospitalization or even death without immediate treatment.

Scientists are still trying to understand why food allergies are rising among children. One theory is children in industrialized countries live in overly clean environments and are not exposed to enough bacteria, Gupta said.

In addition, research has shown introducing common allergens early, such as peanuts, may reduce the chances of a child developing food allergies. It also has been theorized the diversity of gut flora, which is largely influenced by diet, determines whether or not a person will develop food allergies.

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Gupta also is a researcher at the Center for Community Health at the Institute for Public Health and Medicine at Feinberg.

Other Northwestern and Lurie Children’s Hospital authors on the paper are lead author Ashley A. Dyer and Claudia H. Lau, Tracie L. Smith and Bridget Smith.

The study was supported by Food Allergy Research & Education.

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Marla Paul
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