Food, drug, insect sting allergy, and anaphylaxis
Time trends in Australian hospital anaphylaxis admissions in 1998-1999 to 2011-2012

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Background

Studies from the United Kingdom, the United States, and Australia have reported increased childhood food allergy and anaphylaxis prevalence in the 15 years after 1990.

Objective

We sought to examine whether childhood food allergy/anaphylaxis prevalence has increased further since 2004-2005.

Methods

We examined hospital anaphylaxis admission rates between 2005-2006 and 2011-2012 and compared findings with those from 1998-1999 to 2004-2005.

Results

Overall population food-related anaphylaxis admission rates (per 105 population per year) increased from 5.6 in 2005-2006 to 8.2 in 2011-2012 (a 1.5-fold increase over 7 years). The highest rates occurred in children aged 0 to 4 years (21.7 in 2005-2006 and 30.3 in 2011-2012, a 1.4-fold increase), but the greatest proportionate increase occurred in those aged 5 to 14 years (5.8-12.1/105 population/y, respectively, a 2.1-fold increase) compared with those aged 15 to 29 years and 30 years or older (a 1.5- and 1.3-fold increase, respectively). Not only did absolute food-related anaphylaxis admissions increase, but the modeled year-on-year rate of increase in overall food-related anaphylaxis admissions also increased over time from an additional 0.35 per 105 population/y in 1998-1999 (all ages) to 0.49 in 2004-2005 and 0.63 in 2011-2012 (P < .001).

Conclusions

Food-related anaphylaxis has increased further in all age groups since 2004-2005. Although the major burden falls on those aged 0 to 4 years, there is preliminary evidence for a recent acceleration in incidence rates in those aged 5 to 14 years. This contrasts with the previous decade in which the greatest proportionate increase was in those aged 0 to 4 years. These findings suggest a possible increasing burden of disease among adolescents and adults who carry the highest risk for fatal anaphylaxis.

Section snippets

Hospital anaphylaxis admissions data

Australian National Hospital Morbidity Database principle diagnosis data cubes were obtained from the Australian Institute of Health and Welfare (AIHW).12 These record primary (and important secondary) discharge hospital diagnoses based on ICD-10 codes13 for each financial year (July to June; eg, 1998-1999 denotes the period July 1998 to June 1999). Previous Australian studies of hospital anaphylaxis admission rates combined data derived from ICD-9 codes (between 1993-1994 and 1997-1998) and

Hospital admissions data for allergic conditions from 1998-1999 to 2011-2012

The number of admissions to Australian hospitals recorded for anaphylaxis, asthma, and urticaria/angioedema between July 1998 and June 2012 are summarized in Table I. Over that period, total population hospital anaphylaxis admission rates per 105 population increased from 6.3 in 1998-1999 to 10.6 in 2004-2005 (a 1.7-fold increase over 7 financial years), with a further 1.5-fold increase from 12.2 in 2005-2006 to 17.7 in 2011-2012 over the next 7 financial years (Table II). In the more recent

Discussion

Consistent with other studies in Australia,1, 10, 11 the UK,2 and the United States,4 we confirmed a 1.7-fold increase in overall anaphylaxis admissions in Australia in the 7 years between 1998-1999 and 2004-2005 by reanalyzing data using ICD-10 codes alone for consistency. Importantly, we now report a further 1.5-fold increase in overall anaphylaxis admission rates and a 1.5-fold increase in FA-related anaphylaxis admissions in the subsequent 7 years between 2005-2006 and 2011-2012, which is

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    Disclosure of potential conflict of interest: M. L. K. Tang is a board member for the Nestlé Nutrition Institute and Danone Nutricia, has received consultancy fees from Deerfield and GLG Group, has received lecture fees from Danone Nutricia, has a patent for a novel treatment for food allergy (pending in the United States, awarded in the European Union, and granted in Australia and New Zealand), and has received travel support from WISC 2014. The rest of the authors declare that they have no relevant conflicts of interest.

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