Serious allergic reactions from Food: UK Findings

The British Medical Journal has published an analysis of hospital admissions due to food anaphylaxis in the UK over the twenty-year period from 1998 to 2018.

Anaphylaxis is a severe and potentially life-threatening reaction to a trigger such as an allergy.

NHS

The items of food that are known to cause these serious allegic reactions in children and adults are shown below:

What might surprise readers is that, in children, although peanut allergies are well-publicised, milk plays a significantly bigger role in triggering serious allergic reactions. It is important to specify that the milk under consideration is cows’ milk, not breast milk. Any allergies to plant-based milks such as soya or almond milks would be covered under the “nut” category.

There are notable differences between adults and children, such as a reduction in milk allergies to 5% in adults, with an almost corresponding increase in unidentified nuts up to 23%. However, as this was an observational study based on analysis of hospital admission data, it does not provide information on the causes of the identified trends. Questions that may legitimately be asked are in relation to whether or not the data suggest that people lose allergy to milk as they grow older; or that younger generations are getting more intolerant to milk. Is it also possible that the reduction in milk allergies is related to older patients making a conscious choice to avoid milk and dairy products on the basis of knowledge about childhood sensitivity?

Further data suggest that there is indeed a growing incidence of allergies over time as reflected by the time trends in hospital admissions per 100,000 population.

Thankfully the actual case fatality rate appears to be on the decline as shown in the inforgraphic at the top of this post. This should, however, not be cause for a relaxation of caution. As the authors of the paper point out, in shool-aged children, cows’ milk is now the most common cause of fatal anaphylaxis. In light of the prevalence not just of milk and dairy products; but also sweets and other products containing milk; it is imperative that schools and affected children have ready access to emergency treatment in the form of adrenaline auto-injector pens for use in anaphylaxis. Training should be provided on their use and education on their availability to schools without prescription, subject to appropriate guidelines, made more widely known.