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Severe sudden allergic reactions can cause death

Harold Mandel's picture
Wasps whose stings can cause fatal allergic reactions

People often manifest justified concerns about how serious an allergic reaction can be. A life threatening allergic reaction is also called anaphylaxis and is a severe reaction to a specific allergen, or what may be called an allergic trigger. Possible allergic triggers are all around us in food, stinging insects, and medication. Exercise can also induce anaphylaxis. Sometimes a severe allergic reaction has no apparent cause and is what is called idiopathic anaphylaxis. An awareness that anaphylaxis can cause death suddenly should alert people to be more careful about potential allergens.

Anaphylaxis may be fatal

Anaphylaxis is defined as the most severe manifestation of a mast cell–dependent immediate reaction and really may be fatal reported the journal Deutsches Aerzteblatt International. In the Berlin region where this study was centered in German speaking countries the incidence of anaphylaxis is 2–3 cases per 100,000 persons per year. In order to study the triggers, clinical manifestations, and treatment of anaphylaxis the researchers evaluated data from the anaphylaxis registry of the German-speaking countries for 2006–2013 along with data from the protocols of the ADAC air rescue service for 2010–2011.

The most common triggers for anaphylaxis in the registry included:

1: Insect venom (50.1%)

2: Foods (25.1%)

3: Drugs (15.1%)

The most common triggers within these groups were observed to be:

1: Wasp and bee stings

2: Legumes

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3: Animal proteins

4: Analgesic drugs

In kids food anaphylaxis was most frequently set off by:

1: Peanuts

2: Cow milk

3: Hen's egg in children

Wheat and shellfish most frequently set off food anaphylaxis in adults.

Epinephrine is given too rarely

A review of the medical emergency cases showed that epinephrine was given for grade 3 or 4 anaphylaxis to 14.5 percent and 43.9 percent respectively of the patients in the anaphylaxis registry and to 19 percent and 78 percent of the patients in the air rescue protocols. The researchers concluded that epinephrine was given too rarely, as epinephrine is recommended in the guidelines for all cases of grade 2 anaphylaxis and above.

There is no doubt that sudden allergic reactions can be fatal reports Deutsches Aerzteblatt International in a discussion of this research. The data for the registry in this study covers Germany, Austria, and Switzerland. In kids boys were affected more often than girls by anaphylaxis. Among adults women were found to be more often affected.

The majority of cases of anaphylaxis at 85 percent were classified as severity grade II or III. Only 3 percent of adult cases and 0.9 percent of pediatric cases were classified as grade IV reactions, which are very severe reactions. In kids foods were observed to be the most frequent triggers of allergic reactions. In adults the most frequent triggers were found to be insect venoms with wasp stings which were responsible for 70 percent of cases and bee stings which were responsible for 20 percent.

It is essential to be aware of how dangerous anaphylaxis can be and what the potential triggers are. Clearly more aggressive prevention can save lives. Also, more aggressive intervention when anaphylaxis occurs can also save lives. In view of the finding that epinephrine is not being used enough for this condition it appears wise to suggest emergency medical personnel and other medical personnel should be made aware of these statistics and make efforts to ensure more careful and aggressive treatment of anaphylaxis.