Accidental Exposure Causes Most Reactions in Allergic Infants

Undertreatment of severe reactions with epinephrine partly due to not identifying severity

Accidental Exposure Causes Most Reactions in Allergic Infants

MONDAY, June 25 (HealthDay News) -- For infants with documented or likely allergies to milk or eggs, most allergic reactions result from accidental exposures, according to a study published online June 25 in Pediatrics.

David M. Fleischer, M.D., from National Jewish Health in Denver, and colleagues conducted a prospective observational study involving 512 infants, aged 3 to 15 months, with a documented or likely allergy to milk or egg. Data were collected regarding allergic reactions over a median follow-up period of 36 months.

The researchers found that 367 subjects reported 1,171 reactions, with an annualized reaction rate of 0.81 per year. More than one reaction was reported by 52.5 percent of participants. Milk, egg, and peanut (42.3, 21.0, and 7.9 percent, respectively) triggered 71.2 percent of reactions, with unintentional ingestion, label-reading errors, and cross-contact accounting for accidental exposures. Purposeful exposures occurred in 93 of the 834 reactions to milk, egg, or peanut (11.2 percent). In 50.6 percent of reactions, foods were provided by persons other than parents. Of the 134 severe reactions, 29.9 percent were treated with epinephrine. Undertreatment of reactions resulted from a lack of recognition of severity, epinephrine being unavailable, and fears about epinephrine administration.

"Areas for improved education include the need for constant vigilance, accurate label reading, avoidance of non-accidental exposure, prevention of cross-contamination, appropriate epinephrine administration, and education of all caretakers," the authors write.

Several authors disclosed financial ties to the pharmaceutical, biopharmaceutical, and nutrition industries.

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