Prevalence of Peanut and Tree Nut Allergies on The Rise

Peanut Allergies

Peanut allergies in children increased two-fold over a five year period from 1997 to 2002, according to a study in the December Journal of Allergy and Clinical Immunology (JACI). The JACI is the peer-reviewed scientific journal of the American Academy of Allergy, Asthma and Immunology (AAAAI).

Scott H. Sicherer, MD, and Hugh A. Sampson, MD, from the Mount Sinai School of Medicine, along with Anne Muсoz-Furlong from the Food Allergy & Anaphylaxis Network (FAAN), conducted a cross-sectional telephone study of 13,493 people using a standardized questionnaire. The study assessed rates of peanut and tree nut allergies over a period of five years.

Participants were asked a series of questions regarding allergies and seriousness of reactions. Prevalence rates were similar overall to those in the initial study. However, it is significant to note that reported peanut allergy in children increased two fold from .4% in 1997 to .8% in 2002, since this type of allergy typically develops in childhood and is usually not outgrown in adulthood. Based on these facts, one could predict that the number of peanut and tree nut allergies may grow larger over time.

"This study confirms what we've been hearing from growing numbers of families, school administrators and other institutional leaders - food allergy is increasing," said Anne Muсoz-Furlong, founder and CEO of FAAN. "This is a public health and food safety issue that affects all of us. Public policy must change to meet the needs of these patients. Continued food allergy education, improved labeling practice and improved emergency treatment programs - especially where children are involved - are more critical than ever."

Researchers believe there are several reasons for increased rates of peanut allergy in children:

• The increased allergenicity of peanuts when roasted.

• Children eating peanuts when their immune systems are immature.

• The use of topical ointments containing peanut and the use of soy formulas.

Other significant findings from the study on peanut allergy:

• Only 74% of children and 44% of adults with higher severities and reactions sought medical evaluation.

• Out of those who did seek medical treatment, fewer than half were prescribed self-injectable epinephrine.

• A predominance of peanut and tree nut was found in males under the age of 18 and in female adults.

Given that reactions to peanut and tree allergy can be severe, the fact that self-reported peanut and/or tree nut allergies are reported by over 3 million Americans should indicate an increasing health concern.

This study was funded by The Food Allergy Initiative, a national non-profit organization, which supports research to find a cure and clinical activities to identify and treat those at risk for food allergies and anaphylaxis.

Increased prevalence to peanut allergy found in Montreal, Canada

In another study performed by Rhoda S. Kagan, MD, and colleagues from the McGill University Health Centre in Montreal, Canada, additional incidences of increased prevalence to peanut allergy were found, seeing a 1.5% prevalence rate of peanut allergy in children.

Questionnaires were administered to children in kindergarten through grade three in randomly selected schools. The sample, 4,339 respondents, was separated into four groups: peanut tolerant; never/rarely ingest peanut; convincing history of peanut allergy and uncertain history of peanut allergy. All groups except for the first were additionally tested for peanut allergy through prick skin testing, peanut-specific IgE and double-blind placebo-controlled food challenges.

The researchers concluded with three estimates of prevalence. Prevalence was 1.34% when including non-respondents to the survey, but their allergy was declared to the school prior to the study. Additionally, prevalence increased to 1.76% if the data included initial responders that withdrew prior to the end of the study. Therefore, the final prevalence rate of 1.5% is conservative, since it only included the full responders to the study.

Researchers feel that these results can be generalized, as Montreal is representative of many populations, being a large, multi-ethnic and urban area. This study is the first in North America to combine allergy history with confirmatory allergy testing, as well as the largest of its kind worldwide. - MILWAUKEE

The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. Established in 1943, the AAAAI has more than 6,000 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information through its Web site at www.aaaai.org

The Food Allergy and Anaphylaxis Network (FAAN) is a Virginia-based, nonprofit organization with more than 26,000 members in the United States and worldwide. Established in 1991, FAAN's mission is to provide education and advocacy, advance research and increase awareness on behalf of all those affected by food allergies and anaphylaxis. For more information, visit the FAAN Web site at www.foodallergy.org or call (800) 920-4040.

EDITOR'S NOTE: These studies were published in the peer-reviewed scientific journal of the American Academy of Allergy, Asthma and Immunology, but do not necessarily reflect the policies or the opinions of the AAAAI.